Sample scripting using the OARS framework

Using motivational interviewing to engage patients in their care

This tool contains an overview of the OARS framework and sample scripting for frontline clinicians to reference when using the OARS framework in conversations with patients. OARS employs four techniques for patient engagement: Open questions, Affirmation, Reflective listening, and Summary reflections.

The goal of this tool is to help staff understand how OARS questions differ from traditional interviewing questions and how they can use the OARS framework in practice.

This tool can be reviewed on its own or used in a role-play workshop.

Intended audience

Clinicians who interact directly with patients as well as managers and clinical educators.

Time required

Allow 30 minutes for individual review. If used in a workshop, allow up to two hours.

Materials

Print one copy per participant:

 Skill   Description   Purpose
 O
  Open questions
  • Ask the patient open-ended questions
  • Allow the patient to reflect and elaborate in response to questions
  • Let the patient do most of the talking
  • Establish a safe environment, and build a trusting and respectful relationship
  • Explore, clarify, and gain an understanding of the patient’s world
  • Learn about the patient’s past experiences, feelings, thoughts, beliefs, and behaviors
  • Gather information
 A
Affirmations
  • Recognize and reinforce success
  • Express a positive statement about what the patient has already done or a personal strength or ability
  • Show empathy for the patient’s situation
  • Build rapport and affirm exploration into the patient’s world
  • Affirm the patient’s past decisions, abilities, and healthy behaviors
  • Build the patient’s confidence and self-efficacy
 R
 Reflective  listening
  • Mirror what the patient is saying
  • Rephrase what the patient says in your own words
  • Reflect the patient’s thoughts, feelings, and behaviors
  • Demonstrate to the patient that you’re listening and trying to understand his or her situation
  • Offer the patient the opportunity to “hear” his or her own words, feelings, and behaviors reflected back to him or her
 S
Summarizing
  • Apply reflective listening when closing the conversation or transitioning to a different part of the conversation
  • Paraphrase and/or pull out key points from the conversation
  • Keep the patient and care team “on the same page”
  • Close the conversation with a plan of action
  • Help the patient see the bigger picture
  • Highlight the most important elements of the conversation

 Skill   Traditional interviewing   OARS interviewing
 O
  Open questions
  • Is your asthma improving?
  • Did you use your asthma inhaler every day last week?
  • How is your asthma affecting you today?
  • Tell me about the things that seem to trigger an asthma attack.
  • Explain what you are currently doing that helps you manage your asthma.
  • What worries you most about your condition?
 A
Affirmations
  • We need to discuss other ways for you to quit smoking. What you’re doing now doesn’t seem to be working.
  • I’m so glad you are asking about strategies to quit smoking.
  • I’m impressed by the way you’ve already made it through a whole morning without a cigarette.
  • Chewing nicotine gum to curb cravings sounds like a good idea.
 R
 Reflective  listening
  • You need to lose weight to reduce your risk of heart disease.
  • From your point of view, you want to make sure you’ll be there for your family.
  • So you feel frustrated by your previous attempts to control your weight.
  • It sounds like you’re wondering if you can avoid having
 S
Summarizing
  • Those are all the questions I have for you today.
  • Here’s what I heard. Tell me if I’ve missed anything.
  • Let’s go over what we talked about today.
  • I’d like to check to see if what we talked about today made sense to you.
  • What things did I not ask about that you think are important?

Download the tool


Topics

Nursing

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Motivational interviewing

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