JMIR Publications

ABSTRACT

Background:

Motivational Interviewing (MI) is a patient-centered communication approach that supports health behavior change, yet its integration into undergraduate medical curricula remains inconsistent. Blended learning models that combine face-to-face instruction with structured web-based components may strengthen MI training, but evidence supporting their effectiveness among medical students, particularly in Asian contexts, is limited.

Objective:

This study evaluated the impact of a blended MI educational model on final-year medical students’ MI knowledge, confidence, and application in real patient encounters during clinical rotations.

Methods:

A mixed methods design was used. The quantitative component employed a before-and-after study of final-year medical students attending an Ambulatory Care course in 2024. All 130 students participated in a brief MI workshop, and 120 completed pre- and post-tests assessing MI knowledge and confidence. Learning-management system analytics were used to track engagement with the web-based MI course. The qualitative component involved semi-structured interviews with 12 purposively selected students from different course periods. Quantitative data were analyzed using paired-samples t tests, and qualitative data were examined through conventional content analysis. Findings were integrated using triangulation.

Results:

Students demonstrated a significant improvement in MI knowledge following the educational intervention (pre-test mean 8.87, SD 2.69; post-test mean 15.04, SD 2.99; t₍₁₁₉₎=–18.45; P < .001; η²=0.74). After the workshop, 96.9 % of students reported applying MI with patients, and 92.3 % agreed that the blended learning approach was adequate for supporting clinical use. Learning-analytics data showed that 76.9 % of students enrolled in the web-based MI module and 51.0 % completed all lessons. Students most frequently applied MI when counseling patients with diabetes, hypertension, and dyslipidemia, especially related to diet, physical activity, and medication adherence. Interview findings indicated that students mainly used brief MI, were most comfortable with engaging and focusing, and developed greater empathy, confidence, and patient-centered communication skills. Challenges included limited time during consultations, clinical workload, and difficulty applying all MI processes with complex cases.

Conclusions:

A blended MI learning model integrating a short workshop with a web-based course significantly improved medical students’ MI knowledge and supported effective clinical application. Students valued MI as a practical and ethical communication approach that enhances patient engagement, particularly in chronic disease management. Incorporating MI training longitudinally through a spiral, blended curriculum with opportunities for repeated practice may strengthen behavior-change communication competencies in undergraduate medical education.