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The Medical Interview: Communication Skills II (Large then Small groups) - |
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September 16, 2009 1:00 PM - 3:00 PM |
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John Ma M.D. |
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Large group lecture from 1-1:30 followed by small groups from 1:30-3.
Optional reading available on PCM Online. |
| Assignment Due Today: |
Students should come prepared 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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| 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 introduce concepts related to service excellence in communication.
To review previous components of the medical interview.
To identify interviewing techniques to facilitate rapport and obtaining the patient's story.
To learn how to conduct the PMHx, Meds, FHx, SHx, ROS.
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| Student Objectives: |
List what each letter of the AIDET acronym stands for and examples of actions for each.
Describe the advantages for the patient and physician of using the AIDET approach to patient communication.
Describe how the doctor-patient relationship maximizes quantity/quality of information obtained from the patient, and fosters patient commitment to treatment.
Describe how attending to and utilizing nonverbal cues can improve doctor-patient communication: the way a person uses his or her body; paralinguistics (e.g., pressure of speech, dead voice tone); use of personal and social space; appearance and grooming; eye contact.
Demonstrate the ability to gather sufficient information needed to establish a differential diagnosis in a well-organized and efficient medical interview (knowing when to use open-ended questions, eliciting specific symptom descriptions, following up where appropriate on cues, etc.).
Demonstrate cultural assessment techniques of developing rapport/building mutual agenda with patient through basic listening skills:
a.) respectful attention to story,
b.) paraphrasing to acknowledge patient's concerns / feelings/ ideas of what is causing illness,
c.) using perception check and behavior description in responding to patient's affect, social context, and experience of illness.
d) service excellence in communication skills
Demonstrate proficiency with PMH, ROS, family, social, and spiritual histories.
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| Small Group Activities: |
- The time in small group should be structured around students taking turns role-playing patient-physician interactions in front of their group. Have each student playing the “patient” briefly sum up their CC and HPI for the group so the physician interviewing them can concentrate on the PMH, ROS, family, and social history portions of the interview. Each interview should go no longer than 7 minutes so that as many students as possible get a chance to be the physician. Group focus in watching the interactions: "What questioning strategy or communication skill would be most helpful in eliciting key information from this particular patient?"
- The group may discuss interviewing techniques as the interview unfolds, e.g., "Time out. What other questions might be asked at this point during this part of the interview?" or, "What should the interviewer attend to (verbally or non-verbally) right now?" Or the group may prefer to have the “physicians” get as far as they can before discussing the interaction, so the flow of the interview is not interrupted.
- What have students learned about interviewing from the patient whose story they've shared? How can students judge what portions of the history are most important to focus upon in a given, time-limited interview?
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Assignment
Due
Sep 23:
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Students should come prepared to discuss a patient they have seen with a psychosocial issue (not a diagnosable mental illness) that directly or indirectly affected their medical care.
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