Motivational interviewing is a practical skill to assist providers in discussing and implementing behavior modification. It is based on sound research and is becoming a more mainstream and available approach. When I was in medical school I had a few lectures on motivational interviewing and it was incorporated into the independent learning curricula of my primary care rotations. I have used the extremely helpful book Motivational Interviewing in Healthcare, but the concepts really sunk in when I saw other practitioners using the techniques. Motivational Interviewing is best learned with live examples so, with this in mind, Kognito has created a virtual Motivational Interviewing experience available in app format.

As noted on their website,

Change Talk: Childhood Obesity™ is a role-play simulation where you take the role of a healthcare provider and engage in a practice conversation with a virtual mother and her child. Through the conversation, you learn to apply Motivational Interviewing (MI) techniques to help them identify motivation for change, supporting them to implement changes in their diet, screen time, and exercise.

Change Talk is available online and on several mobile device platforms. I used their iPad version and it was impressive in both content and effectiveness.

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The opening screen navigates the user through a video introduction to Motivational Interviewing (MI). It expands on this introduction with an article on MI techniques as well as a list of reading material including web links, books, and research papers.

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The user interface of the scenario is creative and flawless. One of the challenges of motivational interviewing is that each sentence dictates a different response. For instance, “your child is obese” will illicit a different response from the parents and child than, “Johnny, how do you feel about your size?”. Likewise, “you should drink less soda” leads down a different road than “some changes other people have made include soda intake, exercise, or decreased screen time, which would you like to talk about?”.

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The application is built like a virtual “choose your own adventure” novel. At each juncture the provider has five options to pick from: 1) choose what the provider says, 2) ask what the child and/or Mom is thinking after each of your comments, 3) view the level of change Mom is considering based upon your line of questioning and advise, 4) get coaching advice, or 5) undo your comment and take another route.

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The app was easy to navigate on my iPad and the conversation was long enough that I could try different approaches and see very different results. The depth allowed me to view an entire visit using a traditional approach and a motivational interviewing approach. The motivational interviewing style created a different conversation and better result.

Brief Clinical Scenario
I use this app to remind myself of the skills and techniques used in Motivational Interviewing. I have a monthly reminder set on my phone which prompts me to use the app. Each time I use the app, I remember one or two techniques which I incorporate into my clinical interactions.

I have also used this app to teach Motivational Interviewing techniques to other providers. When my medical students have a free 30 minutes, I hand them my iPad and ask them to navigate through the application. On their next patient I ask them to use 1-2 of the skills they learned.

Evidence based medicine:
Linked websites, books, and research articles. This and the other Kognito apps are undergoing active clinical trials.

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What providers would benefit from this App?

  • Physicians – especially family medicine, internists, and pediatrics
  • Residents
  • Mid-levels
  • Medical students
  • Nutritionists
  • Price
    • Free
    • Flawless user interface
    • Great use of the iPad format
    • Forward thinking combination of teaching with game techniques
    • Available for Android as well as iOS
  • Dislikes
    • Slightly large at 200 MB
  • Overall

    Evidence based and a powerful app. I look forward to diabetic teaching and other chronic disease management applications from this group.

  • Overall Score
  • User Interface

    Easy to navigate

  • Multimedia Usage

    Interactive video

  • Price

    Free

  • Real World Applicability

    Great for personal development as well as teaching

  • Device Used For Review

    iPad with retina display

  • Available for DownloadAndroidiPhoneiPadWindows