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Context and setting A behaviour change project was introduced into the Psychological and Social Dimensions of Medicine course at Creighton University School of Medicine. The principles of adult learning hold that learning is most effective when it occurs around a real-life problem and allows the learner to apply prior knowledge and experience. Consequently, the behaviour change project provides an opportunity for students to select their own projects and to learn through personal experience the principles and methods of behavioural change that will enable them to work effectively with the common lifestyle and behavioural problems in patients. Why the idea was necessary An important aspect of preparing students for clinical practice involves giving them information about the principles and methods of enabling patients to understand the importance of change, maintain and enhance their motivations, and surmount the temptations to relapse as they continue the change process. These methods contribute to the patient's sense of control, self-efficacy and positive attitude, all of which facilitate such changes as smoking cessation and increasing exercise. What was done Following an introduction to the Transtheoretical Model of Behaviour Change and related lectures on the change process, students select a meaningful change project (e.g. decrease in caffeine intake) in order to optimise their learning about the challenges of changing a behaviour. Students select an advisor for their projects and complete a Behavioural Change Plan that describes their goal(s) and goal-facilitating behaviours. During the 2-week action phase, students maintain a log of their feelings and self-observations regarding their change programme. During this phase, a student will interact with his or her advisor, who serves as a counsellor providing support and help in problem-solving. The advisee will also serve as advisor to another student, in order to practise his or her own techniques of communication, social support and problem-solving. At the conclusion of the experience, students discuss the experience in small groups and describe in a brief paper the experience, its effect on them, and the adequacy of their change plan in helping them to achieve their intended changes. In addition, they relate the challenges of advising a person engaged in changing, and discuss personal insights that might be applicable when helping patients undertake behavioural and lifestyle changes. Evaluation of results and impact Many students have reported having positive experiences with, and learning the importance of, aspects of the project such as setting goals, devising a behavioural plan with measurable goals, counting and charting behaviours, and having a helping relationship for support and problem-solving. The most common insight gained by students is that successfully making a change in behaviour is surprisingly difficult. Many students have written that they are now in a better position to be empathic and supportive and are thus more able to help patients change those behaviours that will improve their health status. The results of a preliminary survey (n = 23) administered 2 weeks after the action phase support these findings. The 3 items cited by students as most valuable in completing their project were the behaviour plan (34·8%), the daily awareness and logging strategy (30·4%) and the support of a helping relationship (17·4%).