Patient interviewing, a monograph
From Iusmicm
- We know that clinical decision-making is accomplished through entirely different mechanisms by the novice and the skilled practitioner. Where the amateur, that is to say, you, will develop a mental list of the facts relevant to a particular clinical decision and methodically reach a decision, the accomplished clinician will make a poorly understood intuitive leap to his or her preliminary hypothesis. These "mental shortcuts," according to Dr. Scott Smith of the University of Washington, engage a part of the brain analogous to that used when we find ourselves at our destination after a familiar drive and don't really remember the trip.
- According to Cole, there are three functions of the medical interview:
- to gather information,
- to develop rapport and respond to patients’ emotions, and
- to educate patients and motivate them to cooperate with treatment planning.
- The following is an outline of the method recommended to Indiana University first and second year medical students.
- Borrowed from:
- The Medical Interview: The Three Function Approach by Steven A. Cole.
- The Clinical Encounter: by Billings and Stoeckle.
- The Medical Interview: A Primer for Students of the Art by John L. Coulehan and Marian R. Block. This is not a required text but is a good reference for those of you interested in perfecting the art.
- All three of Cole's functions are of equal importance in the clinical interview. Developing rapport and gaining trust starts the moment you introduce yourself to the patient. This can be accomplished, in large part, by being responsive to the patient's emotional state during the interview.
...need to keep reading this
