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Using simulation-based training to improve health conversations by developing motivational interviewing in clinical support workers
  1. Sandra Parish1,
  2. Leonie Williams1,
  3. Chris Attoe2,
  4. Hannah Iannelli2
  1. 1Maudsley Simulation, South London and Maudsley NHS Foundation Trust, London, UK
  2. 2Maudsley Learning, South London and Maudsley NHS Foundation Trust, London, UK
  1. Correspondence to Hannah Iannelli, Maudsley Learning, South London and Maudsley NHS Foundation Trust, London, UK; Hannah.iannelli{at}

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This article describes the effectiveness of using a mixed method approach incorporating simulation-based training (SBT) to improve awareness of and skills in motivational interviewing (MI) to promote conversations with patients about health behaviours. The course was delivered to apprentice clinical support workers (CSWs) working in mental health settings across South London.


MI is an evidenced-based psychosocial intervention used to enhance intrinsic motivation to facilitate behaviour change in a non-coercive manner by exploring and resolving ambivalence (Miller and Rollnick as cited by Martins and McNeil).1 First ‘developed’ in 1983 by William Miller, it was initially used to help those with substance misuse.

At its core, MI combines a non-judgemental person-centred approach, with listening and communication skills, to help build self-efficacy and strengthen the person’s own ideas, reasons and need for change. It works on the principle that behavioural change is most successful when driven from within, rather than imposing external beliefs.

There is increasing evidence for its application in a wide variety of health areas, including weight-loss, blood pressure, smoking cessation, gambling, treatment compliance, diabetes management and oral health (further references).1 2

Training methods in MI vary in modality, degree of passivity and length. There is little conclusive evidence to …

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  • Contributors SP and LW contributed significantly to the delivery of the training programme outlined in the report. However, all authors contributed to the acquisition, analysis and interpretation of data. All authors contributed to drafting the work and revising it until a final version was agreed upon.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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