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The Medical Interview: Communication Skills I (Large then Small groups) - |
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September 09, 2009 1:00 PM - 3:00 PM |
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Shawn Blanchard M.D. |
| Assignment Due Today: |
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| Student Readings: |
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| Faculty Only: |
| Syllabus |
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Faculty copy of Mengel reading |
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| Internet Sites: |
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| Session Goal: |
To help patients present uncensored information about real feelings and experiences concerning the chief complaint and the history of present illness, so the physician can make accurate observations about the patient and the diagnosis.
To introduce methods of establishing patient trust, obtaining information, and developing communication skills in conducting a medical interview.
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| Student Objectives: |
Describe the characteristics of positive regard for patients (respect, genuineness, empathy) and how this leads to willingness to join patients as partners.
Describe the purpose of each of the three basic functions of the interview: a.) gathering data, b.) building rapport and responding to patient's emotions, c.) education, negotiation, motivation.
List the topics of an initial interview and written history: identifying data, CC, HPI, PMH, ROS, family, social and spiritual histories.
Describe how to greet and put a patient at ease; typical comments to start the interview; typical comments to organize and guide the interview; and typical comments to close the interview.
Describe the difference between open ended and close ended questions.
Describe and demonstrate the use of the “OPQRST” approach to the HPI.
Demonstrate the ability to effectively elicit the patient’s priorities and concerns at the beginning of an encounter and thereby negotiate an agenda for the medical visit.
Demonstrate the ability to engender a therapeutic relationship with a patient through use of communication skills such as such as expressing empathy, active listening, and eliciting information about the patients life, expectations and concerns about medical care.
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| Small Group Activities: |
- To begin discussion, ask students to relate their most positive experiences as patients being interviewed by physicians and to indicate what the physician did or didn't do which made those experiences positive. Identify and list on a flipchart the qualities described which were most appreciated about a physician's manner or interviewing style.
- Have a student with the group's help (without notes) outline on the board the basic structure of the interview, identifying the abbreviations commonly used and listing as many systems as the group can recall under ROS.
- Break down the CC, PI and PMH into their detailed components.
- Groups might appreciate a facilitator demonstration of a typical interview through HPI, with either the co-facilitator or a student playing the role of a patient. Discussion may take place either as the interview progresses (What should s/he ask now?) or after the entire interview. Students may choose to practice interviewing skills by role-playing in pairs, with first one and then the other being the "doctor." Facilitators can observe interactions and give ongoing feedback.
- Students will practice interview skills outlined in objectives by role-playing interviews just through HPI. If they need ideas, they may play the parts of patients in cases at the end of the Mengel chapter. Groups and facilitators will observe these interactions, give feedback, and discuss key issues of each interview.
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Assignment
Due
Sep 16:
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Students should come prepared next week to role-play the part of a patient they have seen in their preceptorship, thinking through their responses to ROS questions. They should feel free to make up background they don't know, such as family history.
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