How can clinical educators use a system approach to embed best practice motivational interviewing to enhance sustainable health behaviour change?

Introduction/background: Motivational interviewing (MI) is internationally recognised as an effective intervention to facilitate health related behaviour change and takes place on the clinical microsystem level (departmental), whereas training is more likely to take place at the meso-level (health disciplines across the university and health organisation). Successfully embedding MI in client-centred health care requires awareness of the possible barriers and facilitating agreed guidelines and processes that not only support education and skills development of MI and interprofessional collaborative practice on the micro-level. Meso and macro-level related factors to be considered include professional standards and associated training requirements, local and regional health needs, acute versus chronic condition management, and associated funding. Purpose/objectives: (1) To identify barriers and enablers to implementation and maintenance of MI in clinical practice; and (2) To outline a conceptual framework(s) to assist clinical educators in embedding MI in their practice and learning environment and to enhance practitioners’ and students’ competence and confidence in using MI as part of routine care, and or interprofessional practice, to optimise health outcomes. Relevant issues/questions that need to be considered: How is MI as an intervention implemented (or can be implemented) in clinical practice and learning environments? How are MI skills best developed and maintained in a high workload practice environment that includes students? How to ensure the sustainability of MI in clinical practice and learning environments