Biomedical Engineering Reference
In-Depth Information
Skills: organizing the interview
One important technique that the students had to learn to use is how to
structure the medical interview with the help of the communicative model
used in their training. This ideological model of medical communication
sketches the main traits of successful doctor-patient communication, both in
temporal form and interview content.
Some students had problems with internalizing and realizing these
guidelines, or did not know how to apply them to a concrete case. Where
does the patient's presentation of his or her complaint start and end, when
is it time to become directive and where is the right place for a summary?
What does the understanding of one's own and the patient's reactions mean,
and what signifi es professional empathy?
These are common questions that confront medical students, especially in
the beginning of their experience with patient contact. Some students did not
agree with the model and felt a need to discuss it critically. Also, the general
practitioner's and the group supervisor's conduct in encountering patients,
sometimes served as a more vivid impression of
good
patient-physician
communication as compared with the formal model by which the students
were supposed to be guided. In general the students identifi ed a need to
refl ect upon the model and fi nd their personal styles of adopting it.
Stopping the videotape, one student wondered how she could encourage
the patient to give a complete account of his complaints before she summarizes
the interview:
Example 1a
STUDENT:
I could not get it out (…) after having asked him several times if
he had any other complaints I was ready to summarize the interview just
when I tried to summarize he said:
'Yeah, last year in September I had an operation for prostate tumour'
you know
then he started coming up with [more problems]
how might one try to encourage patients to mention their complaints
and symptoms before one summarizes?
Other common diffi culties concerned with the interview's structure were
how to plan an optimal time disposal, how to control the length of a patient's
account, the best point of time for initiating a new interview phase and how
to handle situations in which the patient did not follow the agenda.
Many students had diffi culties in establishing a mutually open relationship
with the patient. Some felt unable to adopt a therapeutic attitude towards the
patient, while others felt unable to locate a specifi c problem in the particular
patient's report about symptoms and ailments.
