Exploring motivational interviewing in chiropractic education: A mixed methods study of chiropractic students in North America.

OBJECTIVE: This study explored chiropractic students' self-reported understanding and attitudes regarding motivational interviewing (MI), and examined the relationship between students' patient-centered communication (PCC)-related attitudes and beliefs and intent to use MI. METHODS: An explanatory sequential mixed methods study was conducted with full-time chiropractic students enrolled across 7 North American doctor of chiropractic degree programs. Eligible students completed an online survey; descriptive statistics and logistic regression were used to examine the relationship between PCC-related attitudes and beliefs and intent to use MI. Following the survey, students were invited to participate in virtual interviews; qualitative data were analyzed using thematic analysis. RESULTS: Of the 426 survey respondents (7% response rate), most reported completing PCC-related coursework (75.85%). While 69.73% reported understanding MI principles, only 13.51% felt proficient in its use. Over half (53.25%) intended to use MI, yet many endorsed beliefs misaligned with MI principles. The mean PCC-related attitudes and beliefs score was 143.39 (SD 18.42). Higher PCC-related attitudes and beliefs was significantly associated with greater odds of intent to use MI (odds ratio 1.03 [1.01-1.04], P < .001). Qualitative data responses reflected positivity toward MI, inconsistent exposure and training in MI, and student viewpoints that may be inconsistent with the spirit of MI. CONCLUSION: This study contributes toward the understanding of North American chiropractic students' understanding of MI and its relationship with PCC-related attitudes and beliefs. Further research is needed to investigate how MI is introduced, taught, and longitudinally supported within chiropractic education programs.