Talk Less. Listen More: The Effect of Motivational Interviewing Training on Health Science Students’ Communication Skills

Talk Less. 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Listen More: The Effect of Motivational Interviewing Training on Health Science Students’ Communication Skills Diana Daus, Maureen Becker, Clover Hutchinson, Stephanie Store, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7179015/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Effective communication is essential in healthcare, yet many occupational therapy and nursing students feel underprepared to engage in emotionally complex client interactions. Motivational Interviewing (MI), a client-centered approach to enhancing intrinsic motivation, has been shown to improve empathy, reflective listening, and autonomy support. This study explores how MI training influences communication development among health science students. Methods A qualitative design was used to examine the experiences of six students (five occupational therapy, one nursing) at an urban public university who completed a structured MI certification as part of an interprofessional education program. Following community-based telehealth sessions with clients, students participated in a virtual focus group. Transcripts were analyzed using inductive thematic analysis. Results Five themes emerged: development of communication strategies, challenges in MI implementation, personal interviewing styles, professional growth, and acquisition of clinical skills. Students reported increased use of open-ended questions, greater comfort with client-led dialogue, and improved emotional intelligence. Participants noted difficulty resisting directive tendencies, managing emotional boundaries, and adapting MI principles within traditional clinical expectations. Conclusion MI training was perceived to improve communication competence, self-awareness, and therapeutic presence in future clinicians. Findings suggest that integrating MI early in health sciences curricula may enhance readiness for client-centered care and foster reflective, empathetic practice across diverse settings. motivational interviewing communication occupational therapy nursing education qualitative research health science training interprofessional education Introduction Motivational interviewing (MI) is a collaborative, client-centered counseling approach designed to elicit and strengthen intrinsic motivation for change [ 1 ]. Widely applied in health behavior change contexts [ 2 ]. Recent literature found that individuals who received structured MI in conjunction with ongoing support, such as healthcare professional intervention and individualized feedback, demonstrated greater adherence to health-management behaviors compared to those who received MI alone [ 3 ]. These are basic tenants of both occupational therapy and nursing education [ 4 , 5 , 6 ]. MI training teaches health science students to be reflective about their own needs, while the interviewer avoids using “I” statements, ensuring they are utilizing a client centered approach while communication regarding health behaviors [ 7 ]. Within the academic and clinical preparation of future health professionals—including students in nursing, occupational therapy, and social work—there is growing recognition of the importance of effective communication training [ 8 , 4 ]. The evolving healthcare landscape, characterized by increasing patient diversity and the integration of artificial intelligence, has amplified the need for students to be adept in empathy-driven and culturally sensitive communication. Yet, many students report feeling underprepared to navigate emotionally charged conversations, culturally specific concerns, or spiritual dimensions in client care [ 9 ]. Emerging research supports the use of motivational interviewing as an educational tool to foster both communication competence and clinical reasoning among health science students [ 4 , 9 ]. Experiential learning methods that integrate MI training have been shown to improve students’ confidence, reflective capacity, and interpersonal skills when engaging with diverse client populations [ 10 ]. A recent controlled trial demonstrated that structured MI training significantly improved abilities to build therapeutic rapport, navigate ambivalence, and support behavior change in simulated clinical encounters that aimed at improving health outcomes in clients [ 3 ]. EnhanceWellness (EW) EW is an evidence-based program that uses MI and validated assessment tools that connect students to training as certified health coaches. Based on the chronic care model, it trains students on improving physical, emotional, and social well-being [ 11 ]. EW utilizes a specific 3 step model: Screen, Plan, Action. The EW screening assesses the participants' strengths and risks through a detailed health questionnaire and interview with an EW coach. The participant and health coach then collaboratively craft an action plan, focused on the areas of health the client chooses. The plan then gets put into action with regular collaboration between the EW coach and the client [ 9 ]. In the current study, students from occupational therapy, social work and nursing were trained together during virtual training sessions. Breakout rooms fostered communication between students from these 3 disciplines. Engagement in interprofessional education (IPE) assists with forming trusting relationships across educational programs within the allied health professions [ 12 ]. Types of Interview Personalities Training of allied health students in MI takes more than teaching basic communication habits in their professional roles, it takes fostering self-awareness regarding personal communication tendencies that may support or hinder the therapeutic rapport. The roots of MI are grounded in partnership, compassion, and evocation. However, students often default to learned habits based on their personality types. While utilizing MI techniques with clients, health science students may naturally deviate from the client-centered interviewing and respond and interact with clients based on their ingrained habits [ 13 ]. Common interview styles presented in MI models include the analyst, director, supporter, harmonizer and expressor [ 14 , 1 ]. Each style presents strengths and weaknesses in applying MI’s core techniques. The analyst is characterized by logical, data driven structured dialogues. This personality type is adept at organizing a client's functional deficits, and a strength in identifying a client's overall challenges in health management. Analysts may lack emotional attunement and reflective listening and responses. They may be prone to focus on factual precision instead of attunement to client ambivalence or personal struggles. MI education and practice supports these learners in developing emotional intelligence [ 15 ]. The director type communicator is often driven by decisiveness and a results-oriented mindset. Though this often allows learners to exude confidence, they often attempt to fix problems instead of giving clients time to explain their experiences. MI training can reduce this authoritarian centered dialogue with exploring the client's motivation for change [ 1 ]. MI can assist such learners with shifting communication focus from telling to guiding, allowing the client to lead discussions. The supporter tends to create a safe and accepting space for clients. They often remain calm and stable. Though this is a core tenant of MI, they may avoid discussing challenging conversations or evoking discussions on changing non-productive behaviors. Supporters benefit from MI’s techniques such as the strategic use of evocative questions to navigate difficult topics while maintaining their natural ability to preserve the therapeutic alliance [ 16 ]. The harmonizer values emotional connection and like the supporter responds with empathy and emotional validation. However, they may shy away from meaningful client-initiated statements for fear of disrupting therapeutic rapport. Incorporating MI change talk and engaging in self-reflection can assist this type of student with guiding clients to promote change while preserving deep therapeutic connection and engagement [ 14 ]. The expressor tends to exude an energetic, engaging warmth during client interactions and is often liked by clients. However, they may inadvertently interrupt communication with their own stories and experiences, cutting off clients and halting the clients' thinking silence. Educators can guide expressors in restraint and emphasize the importance of allowing the client time to process, notice, adapt and respond to prompts [ 15 ]. Given these findings, integrating motivational interviewing into interprofessional education (IPE) offers a promising strategy to address communication gaps and enhance student preparedness for real-world patient interactions. The present study explores the experiences of health science students who completed a motivational interviewing certification through a program called “EnhanceWellness,” (EW) and examines how this training influenced their perceived professional growth, communication development, and therapeutic engagement in a community-based setting. Methods Study Design and Setting This qualitative study was embedded within a broader health disparities initiative implemented through the School of Health Sciences at York College, City University of New York. It utilized a phenomenological approach to explore how students from occupational therapy, nursing, and social work experienced motivational interviewing (MI) training (EW). The EW program, grounded in the chronic care model [ 11 ], aimed to prepare students to act as Certified EW Health Coaches using motivational interviewing techniques. Clinical Trial Number Not applicable. Funding declaration This study received no external funding. Participants and Recruitment CUNY IRB approval was granted prior to the initiation of this study. Following approval, participants were recruited from a cohort of students who completed the EW training and earned certification as health coaches. Eligible participants included students from the occupational therapy, nursing, and social work programs who had engaged in the full EW curriculum. A total of six students—five from occupational therapy and one from nursing participated and provided informed consent to participate in a post-training focus group. As part of the broader EW training program, each student delivered weekly health coaching sessions to one to four community members residing in underserved neighborhoods in Jamaica, New York. Ethics, Consent to Participate, and Consent to Publish declarations Participation in this study was entirely voluntary. All participants provided verbal consent to participate and to have their sessions audio-recorded for the purpose of transcription and potential publication. Institutional ethics approval was not required for this educational study involving minimal risk and voluntary student participation (CUNY IRBManager: Exempt #20240365) Intervention: Enhanced Wellness (EW) Training The EW program was delivered through virtual, interprofessional sessions that brought together students across disciplines. The training emphasized screening, collaborative goal planning, and follow-up using a structured MI framework [ 9 ]. Participants engaged in breakout sessions to promote interprofessional communication and practiced applying MI principles during simulated and real-world coaching scenarios. Data Collection Following program completion, eligible students were invited to participate in a virtual focus group. The session lasted approximately one hour and was conducted using the Zoom platform. A faculty moderator unaffiliated with the students’ grading or clinical supervision facilitated the session. All participants provided written informed consent and received a $ 50 Amazon gift card for participation. Consent included approval for the session to be audio-recorded and transcribed using OtterAI. Focus Group Guide A semi-structured focus group guide was developed to elicit reflections on the MI training experience. The guide included the following questions: How do you feel the EnhancWellness training affected your interactions with community members? In what ways were you able to implement motivational interviewing techniques? What communication challenges did you encounter? Based on the list provided (analyst, director, supporter, harmonizer, expressor), what type of interviewer do you consider yourself to be? Do you think students could benefit from becoming certified as an Enhanced Wellness Coach prior to working with patients? If so, how? These questions were designed to uncover participants’ perceptions of MI integration, skill development, and communication identity. Data Analysis Audio recordings were transcribed verbatim. An inductive thematic analysis was conducted to identify recurring themes and subthemes. Thematic analysis followed Braun and Clarke’s six-step framework [ 17 ]. Two researchers independently coded the data to ensure reliability and resolved discrepancies through discussion until consensus was reached. Major themes included communication development, challenges in applying MI, personality influence on communication, personal growth, and skill acquisition. This analytic approach supported exploration of the depth and nuance of student reflections [ 14 , 15 ]. Qualitative Analysis of a Focus Group on Motivational Interviewing Training A focus group was conducted with six students enrolled in Occupational Therapy and Nursing programs who participated in the EW motivational interviewing (MI) training. Thematic analysis of the transcribed session revealed five major themes: development of communication techniques, challenges in implementing MI, identification of interviewing personality types, personal growth, and acquisition of key clinical skills. All participants agreed on the value of the training and recommended it for all health science students prior to direct patient interaction. The following themes emerged: 1. Communication Techniques Developed Participants described significant improvement in foundational communication strategies following the training. Core techniques acquired included the use of open-ended questions, active listening, and a client-centered approach, all of which align with motivational interviewing principles [ 1 ]. One participant explained, “I started asking more open-ended questions, and it changed the way patients responded. They talked more, and I didn’t feel like I was leading them.” Students also reported increased awareness of avoiding self-focused language, such as “I” statements, to keep the emphasis on the client. The training fostered a shift from directive, cheerleader, empathizer, harmonizer, and supporter communication styles to a more facilitative, autonomy-supportive, collaborative model. 2. Communication Challenges Using Motivational Interviewing Students noted several challenges while implementing MI. A common theme was the struggle to resist the urge to "fix" client problems too quickly—a tendency described by one student as “hardwired from clinical training” [ 14 ]. Participants also found it difficult to balance supportive communication with challenging clients, especially in emotionally charged scenarios. Another challenge included maintaining professional boundaries while engaging in deeply empathetic conversations. These challenges reflect a developing awareness of the internal tension between clinical authority and client autonomy [ 17 ]. 3. Interviewing Personality Types The group discussed how their personal communication styles affected the way they applied motivational interviewing techniques. Using a framework introduced during the training, students self-identified with five personality types: Collaborator, Harmonizer, Supporter, Director, and Expresser [ 15 ]. Those who identified as Collaborators and Supporters reported a smoother adaptation to MI principles. In contrast, students with Director tendencies admitted needing to consciously withhold advice and adopt a more guiding approach. One participant reflected, “As a director, it’s been a shift. I have to pause and remind myself to let the client take the lead.” 4. Personal Growth Participants unanimously described the training as a catalyst for personal and professional growth. They reported increased patience, enhanced comfort with client-led conversations, and a growing ability to adapt communication styles to meet the needs of diverse clients. One student noted, “We had a lot in common, and I felt like I was sharing too much at times, but I began to realize using MI techniques and giving the client space to think is an important part of the client–therapist relationship.” These reflections indicate internalization of MI’s spirit of evocation, acceptance, and compassion [ 8 ]. 5. Key Skills Developed The training also contributed to the development of advanced interpersonal and therapeutic skills. Students identified gains in emotional intelligence, empathic listening, ease of interaction, and the ability to support autonomy. These skills are essential for facilitating behavioral change in clinical practice and align closely with both occupational therapy and nursing values [ 7 ]. A student remarked, “I learned how to listen without talking about my own advice. That alone makes a huge difference.” Another stated, “This was great training for students that don’t have a lot of experience working with other people in this way,” and three others agreed. Thematic analysis of student reflections revealed five key areas of growth resulting from the EW MI training: development of communication techniques, challenges in implementing MI, identification of personal interviewing styles, personal growth, and acquisition of clinical skills (see Table 1 ). These themes highlight how MI fosters essential competencies such as empathy, active listening, and autonomy-supportive dialogue. Students also developed greater self-awareness and adaptability in communication, critical for delivering client-centered care in diverse clinical settings. Incorporating MI into health science curriculums is justified by its alignment with ethical, interpersonal, and professional standards in allied health education. Table 1 Themes and Educational Implications of Motivational Interviewing (MI) Training in Health Science Curriculums Theme Theme Description Considerations for Use in Health Science Curriculums Development of Communication Techniques Participants reported improved use of open-ended questions, reflective listening, and a client-centered approach. These techniques align with culturally competent and client-centered practice. Teaching them early supports communication readiness for clinical placements. Communication Challenges Using MI Students identified barriers in adopting MI techniques, such as time constraints, emotional difficulty, or defaulting to directive communication. Training must acknowledge and prepare students for real-world challenges and ethical dilemmas. This promotes reflective practice and resilience. Interviewing Personality Types Students self-identified communication styles that affected their ability to implement MI, including Director, Supporter, and Harmonizer types. Recognizing personal communication tendencies fosters self-awareness and adaptability—key for tailoring patient care and maintaining rapport. Personal Growth Students described increased patience, empathy, and self-awareness, as well as confidence in managing emotionally charged conversations. Personal development supports professional identity formation and ethical reasoning. This theme is vital for navigating complex client dynamics. Key Clinical Skills Developed Students reported gains in interpersonal skills including emotional intelligence, therapeutic alliance, and supporting autonomy. These clinical skills directly contribute to improved patient outcomes and align with interprofessional competencies required in modern healthcare. Discussion This qualitative study examined how structured motivational interviewing (MI) training through the Enhanced Wellness (EW) program influenced the communication strategies, interpersonal awareness, and therapeutic readiness of occupational therapy and nursing students. Participants consistently described improved use of open-ended questions, reflective listening, and reductions in directive or self-focused communication habits. These outcomes are consistent with previous research suggesting MI enhances client-centeredness, empathy, and communication efficacy in health care trainees [ 1 , 3 , 14 ]. Despite overall positive impacts, students identified several barriers to implementing MI techniques in practice. Many found it challenging to resist the impulse to "fix" clients' problems too quickly, a tendency shaped by traditional clinical training models. Others struggled with maintaining emotional boundaries and navigating complex conversations without reverting to familiar or dominant communication styles [ 10 , 17 ]. An important feature of the study was the identification and discussion of students’ interview personality types—such as supporter, director, harmonizer, and expressor. This reflective component helped participants recognize how their communication tendencies influenced client engagement, and how MI training provided strategies for balancing personal style with therapeutic presence [ 15 ]. By identifying their own styles, students were better able to apply MI in a client-centered, flexible manner. The structure and delivery of the EW training further contributed to its effectiveness. Students participated in interdisciplinary breakout sessions with peers from social work and nursing, which fostered collaboration, shared learning, and interprofessional respect. These findings align with literature supporting the value of interprofessional education (IPE) in enhancing trust and understanding among healthcare providers [ 12 ]. Additionally, the EW program's structure—screen, plan, and action—mirrors key components of the Chronic Care Model, promoting a proactive, partnership-based approach to health management [ 11 ]. This design not only provided students with a clear, evidence-informed process for applying MI but also highlighted the importance of shared decision-making in clinical care. Students reported that this framework helped them build confidence and structure in real-world telehealth interactions with clients. Embedding MI training early in the curriculum appears to support communication development and ethical clinical decision-making. Prior studies have shown that such training boosts students’ confidence, clinical reasoning, and empathy with diverse populations, which aligns with the student reflections in this study [ 7 , 8 ]. These findings suggest that earlier and more intentional integration of MI can improve students’ preparedness for practice, particularly in settings that demand culturally responsive care. Conclusion In summation, the findings of this study reinforce the idea that meaningful communication in health care is less about delivering solutions and more about creating space for clients to be heard. As participants embraced the principle to “Talk Less. Listen More,” they began to shift from performing clinical interviews to cultivating therapeutic dialogue. This subtle but powerful transformation reflects a broader cultural shift toward relationship-centered care, one that values presence over persuasion and curiosity over correction. By integrating MI early in professional training, students learn not just techniques but a mindset that fosters empathy, reflection, and authentic connection—skills essential for effective, culturally responsive practice. Abbreviations MI Motivational Interviewing EW Enhanced Wellness IRB Institutional Review Board OT Occupational Therapy Declarations Ethics Approval and Consent to Participate The study was reviewed and approved by the York College (City University of New York) Institutional Review Board. All participants provided verbal consent to be audio-recorded for research purposes. Consent for Publication No identifying personal data from participants is included in this publication; therefore, additional consent for publication was not required. Availability of Data and Materials The transcript used in this study is available through Figshare . Additional materials and de-identified data are available https://figshare.com/s/de39b4237a450a3204ca Competing Interests The authors declare that they have no competing interests. Funding No external funding was received for this study. Maureen Becker personally funded the participant incentives in the form of six Amazon gift cards valued at $50 each. Authors’ Contributions Diana Daus contributed the main body of the Introduction and Conclusion. Maureen Becker submitted the IRB application, coordinated the study logistics, and edited the manuscript. Clover Hutchinson and Stephanie Store conducted the data analysis. Grace Jos prepared Table 1 summarizing the findings and contributed to the reference list. All authors reviewed and approved the final manuscript. Acknowledgements The authors would like to thank the York College IRB Manager for guidance and timely approval of the study, as well as the occupational therapy and nursing students who generously participated in the research. Manuscript Status This manuscript is not under review with any other journal. References Miller WR, Rollnick S. Motivational interviewing: Helping people change . 3rd ed. New York: Guilford Press; 2013. Zhu X. Motivational interviewing for physical activity promotion: Meta-analytic evidence from randomized controlled trials. 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Effectiveness of the chronic care model for adults with type 2 diabetes in primary care: A systematic review and meta-analysis. Syst Rev. 2022;11:273. https://doi.org/10.1186/s13643-022-02117-w Corbaz-Kurth S, Weissbrodt R, Juvet TM, Hannart S, Krsmanovic B, Salamin Plaschy I, Terrier P. How does trust emerge in interprofessional collaboration? A qualitative study of the significance, importance, and dynamics of trust in healthcare teams and networks. J Interprof Care. 2025. https://doi.org/10.1080/13561820.2025.2495013 Saarnio P. Therapist’s preference on motivational interviewing and its relationship to interpersonal functioning and personality traits. Couns Psychol Q. 2011;24(3):171–180. https://doi.org/10.1080/09515070.2011.618258 Apodaca TR, Longabaugh R. Mechanisms of change in motivational interviewing: A review and preliminary evaluation of the evidence. Addiction. 2009;104(5):705–715. https://doi.org/10.1111/j.1360-0443.2009.02527.x Fletcher AC, Delgadillo J. Psychotherapists' personality traits and their influence on treatment processes and outcomes: A scoping review. J Clin Psychol. 2022;78(7):1267–1287. https://doi.org/10.1002/jclp.23313 Martino S, Ball SA, Nich C, Canning-Ball M, Rounsaville BJ. Community program therapist adherence and competence in motivational enhancement therapy. Drug Alcohol Depend. 2008;96(1–2):37–45. https://doi.org/10.1016/j.drugalcdep.2008.03.020 Hilson AJ, Foster C, Thorogood M. Motivational interviewing and physical activity: A review of evidence. Br J Sports Med. 2005;39(6):370–376. https://doi.org/10.1136/bjsm.2004.013193 Naeem M, Ozuem W, Howell K, Ranfagni S. A step-by-step process of thematic analysis to develop a conceptual model in qualitative research. Int J Qual Methods. 2023;22:1–12. https://doi.org/10.1177/16094069231205789 Additional Declarations No competing interests reported. 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Listen More: The Effect of Motivational Interviewing Training on Health Science Students’ Communication Skills","fulltext":[{"header":"Introduction","content":"\u003cp\u003eMotivational interviewing (MI) is a collaborative, client-centered counseling approach designed to elicit and strengthen intrinsic motivation for change [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Widely applied in health behavior change contexts [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Recent literature found that individuals who received structured MI in conjunction with ongoing support, such as healthcare professional intervention and individualized feedback, demonstrated greater adherence to health-management behaviors compared to those who received MI alone [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. These are basic tenants of both occupational therapy and nursing education [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. MI training teaches health science students to be reflective about their own needs, while the interviewer avoids using “I” statements, ensuring they are utilizing a client centered approach while communication regarding health behaviors [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eWithin the academic and clinical preparation of future health professionals—including students in nursing, occupational therapy, and social work—there is growing recognition of the importance of effective communication training [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. The evolving healthcare landscape, characterized by increasing patient diversity and the integration of artificial intelligence, has amplified the need for students to be adept in empathy-driven and culturally sensitive communication. Yet, many students report feeling underprepared to navigate emotionally charged conversations, culturally specific concerns, or spiritual dimensions in client care [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eEmerging research supports the use of motivational interviewing as an educational tool to foster both communication competence and clinical reasoning among health science students [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Experiential learning methods that integrate MI training have been shown to improve students’ confidence, reflective capacity, and interpersonal skills when engaging with diverse client populations [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. A recent controlled trial demonstrated that structured MI training significantly improved abilities to build therapeutic rapport, navigate ambivalence, and support behavior change in simulated clinical encounters that aimed at improving health outcomes in clients [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003c/p\u003e\u003cp\u003e\u003cb\u003eEnhanceWellness (EW)\u003c/b\u003e\u003c/p\u003e\u003cp\u003eEW is an evidence-based program that uses MI and validated assessment tools that connect students to training as certified health coaches. Based on the chronic care model, it trains students on improving physical, emotional, and social well-being [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. EW utilizes a specific 3 step model: Screen, Plan, Action. The EW screening assesses the participants' strengths and risks through a detailed health questionnaire and interview with an EW coach. The participant and health coach then collaboratively craft an action plan, focused on the areas of health the client chooses. The plan then gets put into action with regular collaboration between the EW coach and the client [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eIn the current study, students from occupational therapy, social work and nursing were trained together during virtual training sessions. Breakout rooms fostered communication between students from these 3 disciplines. Engagement in interprofessional education (IPE) assists with forming trusting relationships across educational programs within the allied health professions [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e\u003cp\u003e\u003cb\u003eTypes of Interview Personalities\u003c/b\u003e\u003c/p\u003e\u003cp\u003eTraining of allied health students in MI takes more than teaching basic communication habits in their professional roles, it takes fostering self-awareness regarding personal communication tendencies that may support or hinder the therapeutic rapport. The roots of MI are grounded in partnership, compassion, and evocation. However, students often default to learned habits based on their personality types. While utilizing MI techniques with clients, health science students may naturally deviate from the client-centered interviewing and respond and interact with clients based on their ingrained habits [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Common interview styles presented in MI models include the analyst, director, supporter, harmonizer and expressor [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Each style presents strengths and weaknesses in applying MI’s core techniques.\u003c/p\u003e\u003cp\u003eThe analyst is characterized by logical, data driven structured dialogues. This personality type is adept at organizing a client's functional deficits, and a strength in identifying a client's overall challenges in health management. Analysts may lack emotional attunement and reflective listening and responses. They may be prone to focus on factual precision instead of attunement to client ambivalence or personal struggles. MI education and practice supports these learners in developing emotional intelligence [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe director type communicator is often driven by decisiveness and a results-oriented mindset. Though this often allows learners to exude confidence, they often attempt to fix problems instead of giving clients time to explain their experiences. MI training can reduce this authoritarian centered dialogue with exploring the client's motivation for change [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. MI can assist such learners with shifting communication focus from telling to guiding, allowing the client to lead discussions.\u003c/p\u003e\u003cp\u003eThe supporter tends to create a safe and accepting space for clients. They often remain calm and stable. Though this is a core tenant of MI, they may avoid discussing challenging conversations or evoking discussions on changing non-productive behaviors. Supporters benefit from MI’s techniques such as the strategic use of evocative questions to navigate difficult topics while maintaining their natural ability to preserve the therapeutic alliance [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe harmonizer values emotional connection and like the supporter responds with empathy and emotional validation. However, they may shy away from meaningful client-initiated statements for fear of disrupting therapeutic rapport. Incorporating MI change talk and engaging in self-reflection can assist this type of student with guiding clients to promote change while preserving deep therapeutic connection and engagement [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe expressor tends to exude an energetic, engaging warmth during client interactions and is often liked by clients. However, they may inadvertently interrupt communication with their own stories and experiences, cutting off clients and halting the clients' thinking silence. Educators can guide expressors in restraint and emphasize the importance of allowing the client time to process, notice, adapt and respond to prompts [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eGiven these findings, integrating motivational interviewing into interprofessional education (IPE) offers a promising strategy to address communication gaps and enhance student preparedness for real-world patient interactions. The present study explores the experiences of health science students who completed a motivational interviewing certification through a program called “EnhanceWellness,” (EW) and examines how this training influenced their perceived professional growth, communication development, and therapeutic engagement in a community-based setting.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cb\u003eStudy Design and Setting\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThis qualitative study was embedded within a broader health disparities initiative implemented through the School of Health Sciences at York College, City University of New York. It utilized a phenomenological approach to explore how students from occupational therapy, nursing, and social work experienced motivational interviewing (MI) training (EW). The EW program, grounded in the chronic care model [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e], aimed to prepare students to act as Certified EW Health Coaches using motivational interviewing techniques.\u003c/p\u003e\u003cp\u003e\u003cb\u003eClinical Trial Number\u003c/b\u003e\u003c/p\u003e\u003cp\u003eNot applicable.\u003c/p\u003e\u003cp\u003e\u003cb\u003eFunding declaration\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThis study received no external funding.\u003c/p\u003e\u003cp\u003e\u003cb\u003eParticipants and Recruitment\u003c/b\u003e\u003c/p\u003e\u003cp\u003eCUNY IRB approval was granted prior to the initiation of this study. Following approval, participants were recruited from a cohort of students who completed the EW training and earned certification as health coaches. Eligible participants included students from the occupational therapy, nursing, and social work programs who had engaged in the full EW curriculum. A total of six students—five from occupational therapy and one from nursing participated and provided informed consent to participate in a post-training focus group. As part of the broader EW training program, each student delivered weekly health coaching sessions to one to four community members residing in underserved neighborhoods in Jamaica, New York.\u003c/p\u003e\u003cp\u003e\u003cb\u003eEthics, Consent to Participate, and Consent to Publish declarations\u003c/b\u003e\u003c/p\u003e\u003cp\u003eParticipation in this study was entirely voluntary. All participants provided verbal consent to participate and to have their sessions audio-recorded for the purpose of transcription and potential publication. Institutional ethics approval was not required for this educational study involving minimal risk and voluntary student participation (CUNY IRBManager: Exempt #20240365)\u003c/p\u003e\u003cp\u003e\u003cb\u003eIntervention: Enhanced Wellness (EW) Training\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe EW program was delivered through virtual, interprofessional sessions that brought together students across disciplines. The training emphasized screening, collaborative goal planning, and follow-up using a structured MI framework [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Participants engaged in breakout sessions to promote interprofessional communication and practiced applying MI principles during simulated and real-world coaching scenarios.\u003c/p\u003e\u003cp\u003e\u003cb\u003eData Collection\u003c/b\u003e\u003c/p\u003e\u003cp\u003eFollowing program completion, eligible students were invited to participate in a virtual focus group. The session lasted approximately one hour and was conducted using the Zoom platform. A faculty moderator unaffiliated with the students’ grading or clinical supervision facilitated the session. All participants provided written informed consent and received a \u003cspan\u003e$\u003c/span\u003e50 Amazon gift card for participation. Consent included approval for the session to be audio-recorded and transcribed using OtterAI.\u003c/p\u003e\u003cp\u003e\u003cb\u003eFocus Group Guide\u003c/b\u003e\u003c/p\u003e\u003cp\u003eA semi-structured focus group guide was developed to elicit reflections on the MI training experience. The guide included the following questions:\u003c/p\u003e\u003col\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eHow do you feel the EnhancWellness training affected your interactions with community members?\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eIn what ways were you able to implement motivational interviewing techniques?\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eWhat communication challenges did you encounter?\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eBased on the list provided (analyst, director, supporter, harmonizer, expressor), what type of interviewer do you consider yourself to be?\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eDo you think students could benefit from becoming certified as an Enhanced Wellness Coach prior to working with patients? If so, how?\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003c/ol\u003e\u003cp\u003e These questions were designed to uncover participants’ perceptions of MI integration, skill development, and communication identity.\u003c/p\u003e\u003ch2\u003eData Analysis\u003c/h2\u003e\u003cp\u003eAudio recordings were transcribed verbatim. An inductive thematic analysis was conducted to identify recurring themes and subthemes. Thematic analysis followed Braun and Clarke’s six-step framework [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Two researchers independently coded the data to ensure reliability and resolved discrepancies through discussion until consensus was reached. Major themes included communication development, challenges in applying MI, personality influence on communication, personal growth, and skill acquisition. This analytic approach supported exploration of the depth and nuance of student reflections [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e].\u003c/p\u003e\u003cp\u003e\u003cb\u003eQualitative Analysis of a Focus Group on Motivational Interviewing Training\u003c/b\u003e\u003c/p\u003e\u003cp\u003e A focus group was conducted with six students enrolled in Occupational Therapy and Nursing programs who participated in the EW motivational interviewing (MI) training. Thematic analysis of the transcribed session revealed five major themes: development of communication techniques, challenges in implementing MI, identification of interviewing personality types, personal growth, and acquisition of key clinical skills. All participants agreed on the value of the training and recommended it for all health science students prior to direct patient interaction. The following themes emerged:\u003c/p\u003e\u003ch3\u003e1. Communication Techniques Developed\u003c/h3\u003e\u003cp\u003e Participants described significant improvement in foundational communication strategies following the training. Core techniques acquired included the use of open-ended questions, active listening, and a client-centered approach, all of which align with motivational interviewing principles [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. One participant explained, “I started asking more open-ended questions, and it changed the way patients responded. They talked more, and I didn’t feel like I was leading them.” Students also reported increased awareness of avoiding self-focused language, such as “I” statements, to keep the emphasis on the client. The training fostered a shift from directive, cheerleader, empathizer, harmonizer, and supporter communication styles to a more facilitative, autonomy-supportive, collaborative model.\u003c/p\u003e\u003ch3\u003e2. Communication Challenges Using Motivational Interviewing\u003c/h3\u003e\u003cp\u003eStudents noted several challenges while implementing MI. A common theme was the struggle to resist the urge to \"fix\" client problems too quickly—a tendency described by one student as “hardwired from clinical training” [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Participants also found it difficult to balance supportive communication with challenging clients, especially in emotionally charged scenarios. Another challenge included maintaining professional boundaries while engaging in deeply empathetic conversations. These challenges reflect a developing awareness of the internal tension between clinical authority and client autonomy [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e].\u003c/p\u003e\u003ch3\u003e3. Interviewing Personality Types\u003c/h3\u003e\u003cp\u003eThe group discussed how their personal communication styles affected the way they applied motivational interviewing techniques. Using a framework introduced during the training, students self-identified with five personality types: Collaborator, Harmonizer, Supporter, Director, and Expresser [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Those who identified as Collaborators and Supporters reported a smoother adaptation to MI principles. In contrast, students with Director tendencies admitted needing to consciously withhold advice and adopt a more guiding approach. One participant reflected, “As a director, it’s been a shift. I have to pause and remind myself to let the client take the lead.”\u003c/p\u003e\u003ch3\u003e4. Personal Growth\u003c/h3\u003e\u003cp\u003eParticipants unanimously described the training as a catalyst for personal and professional growth. They reported increased patience, enhanced comfort with client-led conversations, and a growing ability to adapt communication styles to meet the needs of diverse clients. One student noted, “We had a lot in common, and I felt like I was sharing too much at times, but I began to realize using MI techniques and giving the client space to think is an important part of the client–therapist relationship.” These reflections indicate internalization of MI’s spirit of evocation, acceptance, and compassion [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e\u003ch3\u003e5. Key Skills Developed\u003c/h3\u003e\u003cp\u003eThe training also contributed to the development of advanced interpersonal and therapeutic skills. Students identified gains in emotional intelligence, empathic listening, ease of interaction, and the ability to support autonomy. These skills are essential for facilitating behavioral change in clinical practice and align closely with both occupational therapy and nursing values [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. A student remarked, “I learned how to listen without talking about my own advice. That alone makes a huge difference.” Another stated, “This was great training for students that don’t have a lot of experience working with other people in this way,” and three others agreed.\u003c/p\u003e\u003cp\u003eThematic analysis of student reflections revealed five key areas of growth resulting from the EW MI training: development of communication techniques, challenges in implementing MI, identification of personal interviewing styles, personal growth, and acquisition of clinical skills (see Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). These themes highlight how MI fosters essential competencies such as empathy, active listening, and autonomy-supportive dialogue. Students also developed greater self-awareness and adaptability in communication, critical for delivering client-centered care in diverse clinical settings. Incorporating MI into health science curriculums is justified by its alignment with ethical, interpersonal, and professional standards in allied health education.\u003c/p\u003e\u003cdiv class=\"gridtable\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eThemes and Educational Implications of Motivational Interviewing (MI) Training in Health Science Curriculums\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003c/colgroup\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTheme\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTheme Description\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eConsiderations for Use in Health Science Curriculums\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDevelopment of Communication Techniques\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eParticipants reported improved use of open-ended questions, reflective listening, and a client-centered approach.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eThese techniques align with culturally competent and client-centered practice. Teaching them early supports communication readiness for clinical placements.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCommunication Challenges Using MI\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eStudents identified barriers in adopting MI techniques, such as time constraints, emotional difficulty, or defaulting to directive communication.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eTraining must acknowledge and prepare students for real-world challenges and ethical dilemmas. This promotes reflective practice and resilience.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eInterviewing Personality Types\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eStudents self-identified communication styles that affected their ability to implement MI, including Director, Supporter, and Harmonizer types.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eRecognizing personal communication tendencies fosters self-awareness and adaptability—key for tailoring patient care and maintaining rapport.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePersonal Growth\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eStudents described increased patience, empathy, and self-awareness, as well as confidence in managing emotionally charged conversations.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePersonal development supports professional identity formation and ethical reasoning. This theme is vital for navigating complex client dynamics.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eKey Clinical Skills Developed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eStudents reported gains in interpersonal skills including emotional intelligence, therapeutic alliance, and supporting autonomy.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eThese clinical skills directly contribute to improved patient outcomes and align with interprofessional competencies required in modern healthcare.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/table\u003e\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis qualitative study examined how structured motivational interviewing (MI) training through the Enhanced Wellness (EW) program influenced the communication strategies, interpersonal awareness, and therapeutic readiness of occupational therapy and nursing students. Participants consistently described improved use of open-ended questions, reflective listening, and reductions in directive or self-focused communication habits. These outcomes are consistent with previous research suggesting MI enhances client-centeredness, empathy, and communication efficacy in health care trainees [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eDespite overall positive impacts, students identified several barriers to implementing MI techniques in practice. Many found it challenging to resist the impulse to \"fix\" clients' problems too quickly, a tendency shaped by traditional clinical training models. Others struggled with maintaining emotional boundaries and navigating complex conversations without reverting to familiar or dominant communication styles [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eAn important feature of the study was the identification and discussion of students\u0026rsquo; interview personality types\u0026mdash;such as supporter, director, harmonizer, and expressor. This reflective component helped participants recognize how their communication tendencies influenced client engagement, and how MI training provided strategies for balancing personal style with therapeutic presence [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. By identifying their own styles, students were better able to apply MI in a client-centered, flexible manner.\u003c/p\u003e\u003cp\u003eThe structure and delivery of the EW training further contributed to its effectiveness. Students participated in interdisciplinary breakout sessions with peers from social work and nursing, which fostered collaboration, shared learning, and interprofessional respect. These findings align with literature supporting the value of interprofessional education (IPE) in enhancing trust and understanding among healthcare providers [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eAdditionally, the EW program's structure\u0026mdash;screen, plan, and action\u0026mdash;mirrors key components of the Chronic Care Model, promoting a proactive, partnership-based approach to health management [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. This design not only provided students with a clear, evidence-informed process for applying MI but also highlighted the importance of shared decision-making in clinical care. Students reported that this framework helped them build confidence and structure in real-world telehealth interactions with clients.\u003c/p\u003e\u003cp\u003eEmbedding MI training early in the curriculum appears to support communication development and ethical clinical decision-making. Prior studies have shown that such training boosts students\u0026rsquo; confidence, clinical reasoning, and empathy with diverse populations, which aligns with the student reflections in this study [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. These findings suggest that earlier and more intentional integration of MI can improve students\u0026rsquo; preparedness for practice, particularly in settings that demand culturally responsive care.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIn summation, the findings of this study reinforce the idea that meaningful communication in health care is less about delivering solutions and more about creating space for clients to be heard. As participants embraced the principle to \u0026ldquo;Talk Less. Listen More,\u0026rdquo; they began to shift from performing clinical interviews to cultivating therapeutic dialogue. This subtle but powerful transformation reflects a broader cultural shift toward relationship-centered care, one that values presence over persuasion and curiosity over correction. By integrating MI early in professional training, students learn not just techniques but a mindset that fosters empathy, reflection, and authentic connection\u0026mdash;skills essential for effective, culturally responsive practice.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eMI\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eMotivational Interviewing\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eEW\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eEnhanced Wellness\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eIRB\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eInstitutional Review Board\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eOT\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eOccupational Therapy\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics Approval and Consent to Participate\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;The study was reviewed and approved by the York College (City University of New York) Institutional Review Board. All participants provided verbal consent to be audio-recorded for research purposes.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for Publication\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;No identifying personal data from participants is included in this publication; therefore, additional consent for publication was not required.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of Data and Materials\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;The transcript used in this study is available through Figshare . Additional materials and de-identified data are available https://figshare.com/s/de39b4237a450a3204ca\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;The authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;No external funding was received for this study. Maureen Becker personally funded the participant incentives in the form of six Amazon gift cards valued at $50 each.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDiana Daus\u003c/strong\u003e contributed the main body of the Introduction and Conclusion. \u003cstrong\u003eMaureen Becker\u003c/strong\u003e submitted the IRB application, coordinated the study logistics, and edited the manuscript. \u003cstrong\u003eClover Hutchinson\u003c/strong\u003e and \u003cstrong\u003eStephanie Store\u003c/strong\u003e conducted the data analysis.\u0026nbsp;\u003cstrong\u003eGrace Jos\u003c/strong\u003e prepared Table 1 summarizing the findings and contributed to the reference list.\u003cbr\u003e\u0026nbsp;All authors reviewed and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;The authors would like to thank the York College IRB Manager for guidance and timely approval of the study, as well as the occupational therapy and nursing students who generously participated in the research.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eManuscript Status\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;This manuscript is not under review with any other journal.\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eMiller WR, Rollnick S. \u003cem\u003eMotivational interviewing: Helping people change\u003c/em\u003e. 3rd ed. New York: Guilford Press; 2013.\u003c/li\u003e\n\u003cli\u003eZhu X. Motivational interviewing for physical activity promotion: Meta-analytic evidence from randomized controlled trials. \u003cem\u003eHealth Psychol Rev.\u003c/em\u003e 2024;18(1):55\u0026ndash;72. https://doi.org/10.1080/17437199.2023.2256781\u003c/li\u003e\n\u003cli\u003eBischof G, Bischof A, Rumpf HJ. Motivational interviewing: An evidence-based approach for use in medical practice. \u003cem\u003eDtsch Arztebl Int.\u003c/em\u003e 2021;118(7):109\u0026ndash;115. https://doi.org/10.3238/arztebl.m2021.0014\u003c/li\u003e\n\u003cli\u003eMcCormack B. A conceptual framework for person-centred practice with older people. \u003cem\u003eInt J Nurs Pract.\u003c/em\u003e2003;9(3):202\u0026ndash;209. https://doi.org/10.1046/j.1440-172X.2003.00423.x\u003c/li\u003e\n\u003cli\u003eAmerican Occupational Therapy Association. Occupational therapy practice framework: Domain and process\u0026mdash;Fourth edition. \u003cem\u003eAm J Occup Ther.\u003c/em\u003e 2020;74(Suppl 2). https://doi.org/10.5014/ajot.2020.74S2001\u003c/li\u003e\n\u003cli\u003eWallengren C, Billig H, Bj\u0026ouml;rkman I, et al. Person-centered care content in medicine, occupational therapy, nursing, and physiotherapy education programs. \u003cem\u003eBMC Med Educ.\u003c/em\u003e 2022;22:492. https://doi.org/10.1186/s12909-022-03502-8\u003c/li\u003e\n\u003cli\u003eNorris M, Eva G, Fortune J, et al. Educating undergraduate occupational therapy and physiotherapy students in motivational interviewing: the student perspective. \u003cem\u003eBMC Med Educ.\u003c/em\u003e 2019;19:117. https://doi.org/10.1186/s12909-019-1560-8\u003c/li\u003e\n\u003cli\u003eFortune J, Breckon J, Norris M, Eva G, Frater T. Motivational interviewing training for physiotherapy and occupational therapy students: effect on confidence, knowledge and skills. \u003cem\u003ePatient Educ Couns.\u003c/em\u003e 2018;102:694\u0026ndash;700.\u003c/li\u003e\n\u003cli\u003eHughes SL, Seymour RB, Campbell RT, Shaw JW, Fabiyi C, Sokas R. Comparison of two health-promotion programs for older workers. \u003cem\u003eAm J Public Health.\u003c/em\u003e 2011;110(5):883\u0026ndash;890. https://doi.org/10.2105/AJ\u003c/li\u003e\n\u003cli\u003eHe L, Basar E, Krahmer E, Wiers R, Antheunis M. Effectiveness and user experience of a smoking cessation chatbot: Mixed methods study comparing motivational interviewing and confrontational counseling. \u003cem\u003eJ Med Internet Res.\u003c/em\u003e2024;26:e53134. https://doi.org/10.2196/53134\u003c/li\u003e\n\u003cli\u003eGoh LH, Siah CJR, Tam WWS, Aris IM, Pek PP, Lau Y, Lee CW. Effectiveness of the chronic care model for adults with type 2 diabetes in primary care: A systematic review and meta-analysis. \u003cem\u003eSyst Rev.\u003c/em\u003e 2022;11:273. https://doi.org/10.1186/s13643-022-02117-w\u003c/li\u003e\n\u003cli\u003eCorbaz-Kurth S, Weissbrodt R, Juvet TM, Hannart S, Krsmanovic B, Salamin Plaschy I, Terrier P. How does trust emerge in interprofessional collaboration? A qualitative study of the significance, importance, and dynamics of trust in healthcare teams and networks. \u003cem\u003eJ Interprof Care.\u003c/em\u003e 2025. https://doi.org/10.1080/13561820.2025.2495013\u003c/li\u003e\n\u003cli\u003eSaarnio P. Therapist\u0026rsquo;s preference on motivational interviewing and its relationship to interpersonal functioning and personality traits. \u003cem\u003eCouns Psychol Q.\u003c/em\u003e 2011;24(3):171\u0026ndash;180. https://doi.org/10.1080/09515070.2011.618258\u003c/li\u003e\n\u003cli\u003eApodaca TR, Longabaugh R. Mechanisms of change in motivational interviewing: A review and preliminary evaluation of the evidence. \u003cem\u003eAddiction.\u003c/em\u003e 2009;104(5):705\u0026ndash;715. https://doi.org/10.1111/j.1360-0443.2009.02527.x\u003c/li\u003e\n\u003cli\u003eFletcher AC, Delgadillo J. Psychotherapists\u0026apos; personality traits and their influence on treatment processes and outcomes: A scoping review. \u003cem\u003eJ Clin Psychol.\u003c/em\u003e 2022;78(7):1267\u0026ndash;1287. https://doi.org/10.1002/jclp.23313\u003c/li\u003e\n\u003cli\u003eMartino S, Ball SA, Nich C, Canning-Ball M, Rounsaville BJ. Community program therapist adherence and competence in motivational enhancement therapy. \u003cem\u003eDrug Alcohol Depend.\u003c/em\u003e 2008;96(1\u0026ndash;2):37\u0026ndash;45. https://doi.org/10.1016/j.drugalcdep.2008.03.020 \u003c/li\u003e\n\u003cli\u003eHilson AJ, Foster C, Thorogood M. Motivational interviewing and physical activity: A review of evidence. \u003cem\u003eBr J Sports Med.\u003c/em\u003e 2005;39(6):370\u0026ndash;376. https://doi.org/10.1136/bjsm.2004.013193\u003c/li\u003e\n\u003cli\u003eNaeem M, Ozuem W, Howell K, Ranfagni S. A step-by-step process of thematic analysis to develop a conceptual model in qualitative research. \u003cem\u003eInt J Qual Methods.\u003c/em\u003e 2023;22:1\u0026ndash;12. https://doi.org/10.1177/16094069231205789\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"motivational interviewing, communication, occupational therapy, nursing education, qualitative research, health science training, interprofessional education","lastPublishedDoi":"10.21203/rs.3.rs-7179015/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7179015/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eEffective communication is essential in healthcare, yet many occupational therapy and nursing students feel underprepared to engage in emotionally complex client interactions. Motivational Interviewing (MI), a client-centered approach to enhancing intrinsic motivation, has been shown to improve empathy, reflective listening, and autonomy support. This study explores how MI training influences communication development among health science students.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eA qualitative design was used to examine the experiences of six students (five occupational therapy, one nursing) at an urban public university who completed a structured MI certification as part of an interprofessional education program. Following community-based telehealth sessions with clients, students participated in a virtual focus group. Transcripts were analyzed using inductive thematic analysis.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eFive themes emerged: development of communication strategies, challenges in MI implementation, personal interviewing styles, professional growth, and acquisition of clinical skills. Students reported increased use of open-ended questions, greater comfort with client-led dialogue, and improved emotional intelligence. Participants noted difficulty resisting directive tendencies, managing emotional boundaries, and adapting MI principles within traditional clinical expectations.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eMI training was perceived to improve communication competence, self-awareness, and therapeutic presence in future clinicians. Findings suggest that integrating MI early in health sciences curricula may enhance readiness for client-centered care and foster reflective, empathetic practice across diverse settings.\u003c/p\u003e","manuscriptTitle":"Talk Less. Listen More: The Effect of Motivational Interviewing Training on Health Science Students’ Communication Skills","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-19 12:00:31","doi":"10.21203/rs.3.rs-7179015/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"1ac52edd-df98-4499-9176-d6e4b6bd6ef5","owner":[],"postedDate":"September 19th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-10-13T08:54:00+00:00","versionOfRecord":[],"versionCreatedAt":"2025-09-19 12:00:31","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7179015","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7179015","identity":"rs-7179015","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}