Motivational Interviewing (MI) is a powerful, patient-centered communication style designed to explore and resolve ambivalence about behavior change. As a “transcending concept” woven throughout the PharmD curriculum in courses like Patient Care 3 and Patient Care 4, MI is a fundamental skill for modern pharmacists. Rather than simply telling patients what to do, this evidence-based method focuses on collaboration and evoking the patient’s own motivations for change. From encouraging a patient to quit smoking to improving medication adherence, the principles and techniques of MI are essential for effective patient care. This quiz will test your knowledge of the guiding “spirit” and core skills of Motivational Interviewing.
1. Which of the following is a core component of the “Spirit” of Motivational Interviewing?
- a. Confrontation
- b. Expertise
- c. Partnership
- d. Direction
Answer: c. Partnership
2. The acronym OARS represents the core skills of MI. What does the “A” stand for?
- a. Assessment
- b. Advice
- c. Affirmation
- d. Argument
Answer: c. Affirmation
3. Which of the following is an example of an open-ended question?
- a. “Do you take your medication every day?”
- b. “Are you ready to quit smoking?”
- c. “What are some of the challenges you face with managing your diabetes?”
- d. “Is your blood pressure controlled?”
Answer: c. “What are some of the challenges you face with managing your diabetes?”
4. The “righting reflex” in patient communication refers to the healthcare provider’s natural tendency to:
- a. Ask open-ended questions.
- b. Use reflective listening.
- c. Try to fix the patient’s problems by giving unsolicited advice.
- d. Summarize the conversation.
Answer: c. Try to fix the patient’s problems by giving unsolicited advice.
5. A patient says, “I know I should exercise, but I’m just too tired after work.” Which of the following is the best example of a simple reflection?
- a. “Why are you so tired?”
- b. “You should try exercising in the morning then.”
- c. “You feel too tired to exercise after work.”
- d. “Lots of people are tired after work.”
Answer: c. “You feel too tired to exercise after work.”
6. The “Transcending Concept Communications – Patients: MI” is a specific learning module in which course?
- a. PHA5784C Patient Care 4
- b. PHA5104 Sterile Compounding
- c. PHA5703 Pharmacy Law and Ethics
- d. PHA5782C Patient Care 2
Answer: a. PHA5784C Patient Care 4
7. “Change talk” is when a patient expresses:
- a. Reasons to maintain their current behavior.
- b. Their own motivations for making a positive change.
- c. Anger or frustration with the healthcare system.
- d. A lack of interest in the conversation.
Answer: b. Their own motivations for making a positive change.
8. Which of the following is an example of “change talk”?
- a. “I really enjoy smoking on my work breaks.”
- b. “My father smoked his whole life and lived to be 90.”
- c. “I wish I had more energy to play with my kids.”
- d. “Quitting seems impossible right now.”
Answer: c. “I wish I had more energy to play with my kids.”
9. The MI technique of “developing discrepancy” involves helping the patient see the gap between:
- a. The cost of a brand vs. a generic drug.
- b. Their current behavior and their core values or future goals.
- c. What you recommend and what their doctor recommends.
- d. The patient’s opinion and the facts.
Answer: b. Their current behavior and their core values or future goals.
10. “Rolling with resistance” means:
- a. Arguing with the patient to prove your point.
- b. Ignoring the patient when they express resistance.
- c. Acknowledging the patient’s perspective without confrontation.
- d. Immediately changing the subject.
Answer: c. Acknowledging the patient’s perspective without confrontation.
11. The ability to utilize Motivational Interviewing techniques to encourage a patient to quit smoking is a specific learning objective.
- a. True
- b. False
Answer: a. True
12. An affirmation is used to:
- a. Tell the patient they are doing everything wrong.
- b. Recognize and acknowledge the patient’s strengths and efforts.
- c. Give advice.
- d. Ask a closed-ended question.
Answer: b. Recognize and acknowledge the patient’s strengths and efforts.
13. The four overlapping processes of MI are Engaging, Focusing, Evoking, and ______.
- a. Planning
- b. Arguing
- c. Directing
- d. Assessing
Answer: a. Planning
14. A complex reflection is different from a simple reflection because it:
- a. Is much longer.
- b. Repeats the patient’s exact words back to them.
- c. Adds meaning or interprets what the patient might be feeling or thinking.
- d. Is always a question.
Answer: c. Adds meaning or interprets what the patient might be feeling or thinking.
15. “Sustain talk” is when a patient expresses:
- a. Their desire to change.
- b. Their reasons for not changing their behavior.
- c. Their ability to change.
- d. Their need for help.
Answer: b. Their reasons for not changing their behavior.
16. Which of the following is the best response to a patient’s sustain talk like, “I’ve tried to quit before and it never works”?
- a. “You should just try harder this time.”
- b. “Quitting is really difficult, and it’s frustrating when past attempts haven’t worked out.” (A reflection)
- c. “Well, you have to quit.”
- d. “Why did you fail before?”
Answer: b. “Quitting is really difficult, and it’s frustrating when past attempts haven’t worked out.” (A reflection)
17. The comMIt eLearning modules on MI are part of the curriculum.
- a. True
- b. False
Answer: a. True
18. The “E” in the MI spirit component PACE stands for:
- a. Expertise
- b. Empathy
- c. Evocation
- d. Engagement
Answer: c. Evocation
19. What is the purpose of using a “readiness ruler” (e.g., “On a scale of 1 to 10, how important is it for you to…”)?
- a. To diagnose the patient’s condition.
- b. To gauge the patient’s motivation and confidence about making a change.
- c. To fulfill a documentation requirement.
- d. To decide which medication to prescribe.
Answer: b. To gauge the patient’s motivation and confidence about making a change.
20. The “Engaging” process in MI is primarily about:
- a. Setting a specific plan for change.
- b. Building a trusting and collaborative relationship with the patient.
- c. Confronting the patient about their behavior.
- d. Giving information.
Answer: b. Building a trusting and collaborative relationship with the patient.
21. A patient says, “I want to lower my blood pressure, but I hate taking pills.” This is an example of:
- a. Adherence
- b. Ambivalence
- c. Resistance
- d. Readiness
Answer: b. Ambivalence
22. Which of the following is NOT one of the core skills of OARS?
- a. Open-ended questions
- b. Affirmations
- c. Reflective listening
- d. Advising
Answer: d. Advising
23. Providing unsolicited advice is an effective MI technique.
- a. True
- b. False
Answer: b. False
24. The “Evoking” process of MI is focused on:
- a. Drawing out the patient’s own arguments for change.
- b. The clinician providing their own arguments for change.
- c. Creating a detailed action plan.
- d. Establishing rapport.
Answer: a. Drawing out the patient’s own arguments for change.
25. A summary is useful in an MI conversation to:
- a. Demonstrate that you have been listening.
- b. Link together different parts of the conversation.
- c. Transition to a new topic or the planning stage.
- d. All of the above.
Answer: d. All of the above.
26. Performing brief tobacco interventions utilizing motivational interviewing is a competency for PharmD students.
- a. True
- b. False
Answer: a. True
27. “So, on one hand, you enjoy the social aspect of smoking, but on the other hand, you’re worried about your health.” This is an example of what type of complex reflection?
- a. A single-sided reflection
- b. A double-sided reflection
- c. An amplified reflection
- d. A simple reflection
Answer: b. A double-sided reflection
28. According to the spirit of MI, the patient is viewed as:
- a. Unmotivated and resistant.
- b. The expert on their own life and motivations.
- c. Lacking the knowledge to make good decisions.
- d. Someone who needs to be directed.
Answer: b. The expert on their own life and motivations.
29. The goal of MI is to:
- a. Persuade the patient to make a change.
- b. Trick the patient into agreeing with you.
- c. Resolve ambivalence and help the patient move forward with a positive change.
- d. Make the patient feel guilty about their behavior.
Answer: c. Resolve a ambivalence and help the patient move forward with a positive change.
30. The “Focusing” process in MI involves:
- a. Concentrating on the patient’s chart.
- b. Finding a specific behavior change to talk about from a range of possibilities.
- c. Focusing on all of the patient’s problems at once.
- d. The patient focusing on the clinician.
Answer: b. Finding a specific behavior change to talk about from a range of possibilities.
31. Which of the following questions is most likely to elicit “change talk”?
- a. “Why haven’t you quit smoking yet?”
- b. “What would be some of the benefits for you if you were to quit smoking?”
- c. “Do you understand the risks of smoking?”
- d. “You know you need to quit, right?”
Answer: b. “What would be some of the benefits for you if you were to quit smoking?”
32. MI is considered a “guiding” communication style, falling between directing and following.
- a. True
- b. False
Answer: a. True
33. An affirmation should focus on:
- a. Praising the patient for simply showing up.
- b. Specific positive behaviors or strengths the patient has demonstrated.
- c. A general statement like “good job”.
- d. The pharmacist’s own accomplishments.
Answer: b. Specific positive behaviors or strengths the patient has demonstrated.
34. If a patient expresses strong resistance, a pharmacist using MI should:
- a. Argue back and list all the reasons why the patient is wrong.
- b. Reflect the resistance back to the patient to show you heard them.
- c. End the conversation and refuse to help the patient.
- d. Tell the patient they are being difficult.
Answer: b. Reflect the resistance back to the patient to show you heard them.
35. The “S” in OARS stands for:
- a. Situation
- b. Solution
- c. Summary
- d. Sustain
Answer: c. Summary
36. A key to effective reflective listening is:
- a. Formulating it as a question.
- b. Making it a statement based on what you heard.
- c. Adding your own opinion to it.
- d. Interrupting the patient to deliver it.
Answer: b. Making it a statement based on what you heard.
37. When is it appropriate to give advice in an MI conversation?
- a. At the very beginning of the conversation.
- b. Whenever you think of a good idea.
- c. After asking for permission from the patient (e.g., “Would you be interested in hearing about some options?”).
- d. It is never appropriate to give advice.
Answer: c. After asking for permission from the patient (e.g., “Would you be interested in hearing about some options?”).
38. The use of MI techniques is a curriculum topic in Patient Care 3.
- a. True
- b. False
Answer: a. True
39. “So, if you decide to quit smoking, how would you go about it?” This question is primarily aimed at evoking what type of change talk?
- a. Desire
- b. Ability
- c. Reasons
- d. Commitment/Taking Steps
Answer: d. Commitment/Taking Steps
40. The overall tone of an MI conversation should be:
- a. Judgmental and authoritarian.
- b. Empathetic, respectful, and non-confrontational.
- c. Distant and clinical.
- d. Rushed and efficient.
Answer: b. Empathetic, respectful, and non-confrontational.
41. Developing rapport with a patient is a key part of which MI process?
- a. Engaging
- b. Focusing
- c. Evoking
- d. Planning
Answer: a. Engaging
42. Which of the following is a barrier to using MI in practice?
- a. It takes too much time.
- b. It is too complicated to learn.
- c. The provider’s own “righting reflex”.
- d. Patients do not like it.
Answer: c. The provider’s own “righting reflex”.
43. MI was originally developed for use in what field?
- a. Smoking cessation
- b. Diabetes management
- c. Addiction and substance abuse counseling
- d. Hypertension adherence
Answer: c. Addiction and substance abuse counseling
44. The “Planning” process should only begin when:
- a. The pharmacist decides it is time.
- b. The appointment time is almost over.
- c. The patient shows signs of readiness and has expressed a desire to make a plan.
- d. The patient has failed to make a change on their own.
Answer: c. The patient shows signs of readiness and has expressed a desire to make a plan.
45. Which of the following is NOT consistent with the spirit of MI?
- a. “You are the expert on yourself.”
- b. “I’m here to help you figure this out.”
- c. “You must follow my instructions exactly if you want to get better.”
- d. “What works for you?”
Answer: c. “You must follow my instructions exactly if you want to get better.”
46. A “key question” in MI, after establishing a direction, is:
- a. “Why haven’t you made this change?”
- b. “What makes you think you might want to change?”
- c. “Do you understand the consequences of not changing?”
- d. “Are you ready to commit today?”
Answer: b. “What makes you think you might want to change?”
47. A good summary in MI often links a patient’s sustain talk with their change talk, followed by an open-ended question.
- a. True
- b. False
Answer: a. True
48. The primary goal of using OARS is to:
- a. Make the conversation last longer.
- b. Elicit and reinforce change talk.
- c. Gather data for the medical record.
- d. Assess the patient’s cognitive function.
Answer: b. Elicit and reinforce change talk.
49. An active learning session on MI is part of which course?
- a. PHA5784C Patient Care 4
- b. PHA5163L Professional Skills Lab 3
- c. Both a and b
- d. Neither a nor b
Answer: c. Both a and b
50. The ultimate goal of using MI in pharmacy practice is to:
- a. Force patients to be adherent.
- b. Win every argument about behavior change.
- c. Support patient autonomy and collaboration to help them make healthier choices.
- d. Prove that pharmacists are excellent communicators.
Answer: c. Support patient autonomy and collaboration to help them make healthier choices.
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