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Interviewing Techniques in Medicine: Foundations for Diagnosis and Treatment

This session explores the fundamental techniques of medical interviewing, focusing on key skills needed for effective patient interactions. Participants learn the purposes and functions of medical interviews, such as data gathering, rapport building, and emotional support. The course includes practical exercises over two weeks, emphasizing the importance of active listening, non-verbal communication, and feedback mechanisms. By practicing these skills with standardized patients and peers, students enhance their ability to elicit patients' stories and understand their concerns, leading to improved clinical outcomes.

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Interviewing Techniques in Medicine: Foundations for Diagnosis and Treatment

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Presentation Transcript

  1. Interviewing Techniques as Tools for Diagnosis and Treatment, part 1:The Basics The Practice of Medicine - 1 Christine M. Peterson, M.D.

  2. 50-minute lectures

  3. Small groups this week: Session 2 Mentor interview • Recognize the purposes and functions (process and content) of the medical interview. • Observe and participate in the feedback process

  4. Small groups next two weeks • Sessions 3A and 4B: Standardized Patient InterviewStudents will: • Practice eliciting a Chief Concern and taking a History of the Present Illness • Practice: • opening • physical environment • active listening • body language and non-verbal communication • dealing with feelings • closing • Elicit the patients’ story • Give and receive feedback

  5. Small groups next two weeks • Sessions 3B and 4A: Hospital Patient Interview Students will: • Practice eliciting a Chief Concern and taking a History of the Present Illness • Practice specific interviewing skills and observe how a patient responds to them • Elicit how the patient is coping with illness and how illness is affecting the patient and family • Evaluate an interview done by a fellow student and give feedback

  6. What would you like to learn today? • Write down up to three skills that you would like to learn today on a card. • Give the card to someone else.

  7. Techniques as Tools 1 & 2 • Learning Objectives: • Name purposes and functions of the medical interview • Learn non-verbal behaviors &verbal techniques and responses • Practice using and observing skills

  8. Have you had any formal training in interviewing? 0 Seconds Remaining • Yes • No 0 of 30

  9. Time Spent Relating to Patients in Med School – and Afterwards

  10. What is the purpose of the doctor-patient encounter? • “Dr. Google”: In the age of the internet, why would anyone want to see a physician?

  11. Physicians can provide: • Special expertise and judgment • Special skills • Unique socially sanctioned “powers” • Shared vulnerability = empathy

  12. Evaluate Treat Relieve suffering andmaximize functioning Purposes of the medical encounter

  13. Purposes of the Medical Encounter • Help the patient by • Relieving suffering • Maximizing functioning Sharing vulnerability Special skills Special expertise and judgment

  14. Basic Unit of Clinical Work • History • Chief Complaint/Concern • History of Present Illness • Past Medical History • Family History • Social History (incl. Health Habits, Lifestyle) • Review of Systems • Physical Exam

  15. [Other Clinical Work • Selection and interpretation of lab tests, imaging studies, etc. • Diagnostic procedures • Therapeutic procedures]

  16. Communication of Clinical Work • “Write-up” (medical record, chart) and oral presentation (“rounds” and consultation) • History • Physical Exam • Laboratory Tests • Differential Diagnosis  Impression / Assessment • Plan

  17. What are the functions of the medical interview?

  18. Functions of the Medical Interview • Gather data and understand it • Develop rapport and respond to emotions • Educate and motivate • Begin both diagnostic and healing processes

  19. An Analogy • A social conversation is to a medical interview as... tying your shoes is toperforming brain surgery.

  20. A good physician can talk to anyone…

  21. But a great physician can listen to anyone.

  22. Non-Verbal Behavior in Active Listening

  23. Non-Verbal Behavior(Behavior that BEFITS a physician) • Body posture and movements • Eye contact • Facial expression • Inflection, tone of voice and rate of speech • Touch • Space between doctor and patient

  24. Non-verbal Behavior • B • E • F • I • T • S

  25. Verbal Techniques Used in Active Listening

  26. Verbal Techniques Used in Active Listening (FOCUS on active listening) • Facilitations • Open-ended questions • Clarification and direction • Understanding by checking • Surveying problems

  27. Verbal Techniques Used in Active Listening • F • O • C • U • S

  28. American Academy on Communication in Healthcare • AACHonline.org • Doc.com • 15 day free trial membership • 1 year membership for $95 each • 10 or more users for $45 each

  29. What about the patient as a person?

  30. Information about the Patient as a Person (PREP for more information) • Priorities for the patient • Expectations that the patient has • Patient’s ideas about the meaning of the illness

  31. What about the patient as a person? • (PREP for more information) • Pr • E • P

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