Biomedical Engineering Reference
In-Depth Information
Another area is learning to talk about and specifi cally ask questions about
sensitive topics like family life, economic situation, mental health or sexuality.
One aim of the course is to encourage the students to adopt a holistic
approach to medical interviewing, which means considering the interplay
of the patient's body, psyche, ethnicity, and environment in different life
contexts. This perspective demands the exploration of the patient's social
background, his/her family, occupation, and his/her own refl ections about
his/her physical condition. Yet many students do not know how they can
address such private aspects of the patient's life in an appropriate way, or
feel that they cannot justify their curiosity about the patient's life. Some
students are afraid to be confronted with emotional accounts that they
cannot handle.
Students often requested help from the group with legitimizing the
intrusion into the patient's privacy, and also with ways of expressing interest
in the patient's life circumstances.
Example 7
STUDENT:
It is just as hard for us to talk about mental problems as it is for
them
and it is much easier not to dig around in it because these are quite
intricate questions addressing 'stress' and asking questions like
'Do you feel depressed?'
I think it's easier to talk about one's shoulder than asking
'Are you anxious?'
but this it what we have to learn.
Sensitive topics are those that students perceive as hard to address and
that they assume the patients would fi nd it hard to talk about. The main
problem for students in this situation is their own emotional reaction to, and
the resulting responsibility for the patient's emotional well-being. Talking
about physical complaints and those aspects of the patient's lifestyle that
are related to physical behaviour (eating, smoking, sports, etc.) is nowadays
no longer perceived as diffi cult. Instead, asking about a person's family and
issues like separation and related problems around child custody, or lack
of friends and social support is not easy for most students, especially if the
direct relevance to the medical diagnosis is not apparent at fi rst glance. As
the interview model taught in the course and the patient-centred attitude
demand an interest in the patient's life, the students on the other hand feel
pressured to touch on those subjects.
Learning self-refl ection
In the group discussions students and supervisors all made contributions to
the discussion in response to some kind of perceived problem. The suggestions
