Purpose of this Scenario
This scenario is designed to help you practice Motivational Interviewing (MI), a collaborative conversation style for strengthening a person's own motivation and commitment to change. When a patient is diagnosed with a new chronic illness like diabetes, they are often overwhelmed. MI is a powerful tool to help them navigate their feelings and build confidence (self-efficacy) that they can make necessary lifestyle changes. The core skills of MI are summarized by the acronym OARS.
- Open-Ended Questions: Ask questions that can't be answered with a simple "yes" or "no." They invite the patient to tell their story. (e.g., "How have you been feeling since you got the diagnosis?")
- Affirmations: Acknowledge the patient's strengths and past efforts. This builds self-efficacy. (e.g., "It sounds like you've tried hard to lose weight in the past. That's not easy to do.")
- Reflections: Listen carefully and reflect back what you hear. This shows you're listening and helps the patient hear their own thoughts. (e.g., "It sounds like this diagnosis is really scary, and you're worried you won't be able to make these changes.")
- Summaries: Periodically summarize the conversation to reinforce key points and demonstrate that you've been listening.
Your Objective
Your objective is to have a conversation with Mr. Smith, a 45-year-old man who was just diagnosed with Type 2 Diabetes and is overwhelmed. Using the OARS framework, you must help him process the news, build his confidence, and collaboratively identify one small, achievable first step.
Patient Background
Mr. Smith is a 45-year-old who is here for his follow-up visit after routine labs showed a high blood sugar and an A1c consistent with Type 2 Diabetes. He is overweight and has a sedentary job.
Crucial Information: Mr. Smith feels a sense of failure and hopelessness. He has tried to lose weight many times in the past without success. He believes he is "doomed to fail" and is having trouble engaging with the plan.