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Interviewing Techniques as Tools for Diagnosis and Treatment, part 1: The Basics

Interviewing Techniques as Tools for Diagnosis and Treatment, part 1: The Basics. The Practice of Medicine - 1 Christine M. Peterson, M.D. 50-minute lectures. Small groups this week: Session 2. Mentor interview

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Interviewing Techniques as Tools for Diagnosis and Treatment, part 1: The Basics

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  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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