Motivational interviewing (MI) is a collaborative communication style aimed at exploring a person’s own motivation for behavior change by eliciting from the person their reasons for change and strengthening commitment to change. MI has a strong evidence base with multiple applications for improving health behaviors in pediatrics. MI is not part of the pediatric residency curriculum, and residents receive little formal education on health behavior change counseling. This results in many residents taking an empathic yet overly directive, overly advising approach to health behavior change counselling with little framework to guide these interactions.

Given this educational gap, we propose piloting a "Motivational Interviewing Fellowship" for pediatric residents to teach health behavior change counselling using MI as the foundational communication style with opportunities for supervision, coaching and practical experience. This fellowship will be open to residents, and consist of an introductory workshop, followed by a series of 6 coaching and supervision sessions over six months. These sessions will consist of review of patient interactions and questions by the learner, as well as the opportunity for supervised practice of MI skills in role plays commonly faced in pediatric practice. This program will be evaluated by measuring resident attitudes as they relate to behavior change counselling, and objective scores of MI proficiency based on a videotaped interaction with a simulated patient within an objective structured clinical examination (OSCE), and comparing pre- and post-fellowship values.