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Patients often cry during the course of a medical interview. The interviewer does not have to rush in to stop the tears. It is often best to let the storm pass, providing time for the emotional release that crying provides. The interview can then resume with gentle questioning. In general, it is good to avoid questions like "Why do you feel angry (or sad) about that?" Instead, try rephrasing the question to: "You seem angry about that. Can you tell me more about what has been going on?" or "Tell me what the tears are about." Most clinicians rate the patient's medical history as having greater diagnostic value than either the physical examination or results of laboratory investigations ( Rich, 1987). The clinical adage that about two-thirds of diagnoses can be made on the basis of the history alone has retained its validity despite the technological advances of the modern hospital. An accurate history also provides focus to the physical examination, making it more productive and time efficient. Clinical hypotheses generated during the interview provide the basis for a cost-effective utilization of the clinical laboratory and other diagnostic modalities. The medical interview is the practicing physician's most versatile diagnostic and therapeutic tool. However, interviewing is also one of the most difficult clinical skills to master. The demands made on the physician are both intellectual and emotional. The analytical skills of diagnostic reasoning must be balanced with the interpersonal skills needed to establish rapport with the patient and facilitate communication. read Medical Interviews - a Comprehensive Guide to Ct, St and Registrar Interview Skills: Over 120 Medical Interview Questions, Techniques and NHS Topics Explained
Medical Interviews: a comprehensive guide to CT, ST and
If someone asked you "Why medicine?" or "What are the qualities of a good doctor?" Would you crumble or would you respond with the same old cliché as the next candidate? How about: these are questions posed at real interviews for medical school, and at last there is a comprehensive text that will help you answer them and many more.
Reassurance may be provided as the interview proceeds in an attempt to reduce the patient's anxiety. Statements such as "Anyone would be upset if they didn"t know what caused their pain" or "Waiting for biopsy results is pretty tough for most patients" may increase the patient's self-esteem and let him or her know that it is all right to share experiences with the physician. Avoid false reassurance— the unrealistic promise of a happy outcome. A chronologic description provides the framework for characterizing the course of an illness. The interviewer should obtain a chronologic report by asking when the problem first started and facilitate a continuing flow of information with questions such as "And then what happened? … and then? … and after that?" Dating the onset of illness may be difficult for some patients, but a general estimate should be made. Questions such as, "When did you last feel really well?" or "How did you feel at Christmastime?" can help time the onset of illness. Ask specifically if the patient has ever had similar symptoms in the past. The multiple mini interview (MMI) format is a commonly used interview process used by UK medical schools in assessing candidates for acceptance into their medical programmes. As the name suggests, it involves a number of smaller interviews, typically lasting 8-15 minutes, with independent assessors. Some interviews may have a rest station in between, with an average of 5-7 stations in one interview. To obtain accurate information about emotion-laden issues, the physician may need to "roll out the carpet," inviting the patient's honest answers. Patients often respond defensively to questions such as "How much do you drink?" minimizing the quantity to please the interviewer. Rephrasing the question in a less accusatory tone provides reassurance and an atmosphere of acceptance. "Some people under stress find that they drink more than they would like to. Have you ever experienced that?" During the sexual history, patient's often respond more candidly to the statement "Some patients with heart problems find that they have difficulties with sexual function. Has this been a problem for you?" rather than "How is your sex life?" You have mentioned quite a few problems and we may not have time to clarify all of them now. I can see that you are very worried about your finances. Those concerns will need further attention … and we will work on them. What I would like to do now is find out more about your chest pain and the fainting spell that you mentioned.
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The clinician now explores as fully as possible the patient's major problems, following leads obtained during the discussion of the chief complaint. The history of the present illness (HPI) includes all of the patient's history, both recent and remote, that is pertinent to understanding the current illness. In completing the HPI, the physician will often collect pertinent information about the patient's past history (for example, a history of hypertension in a patient with stroke), the patient's family history (for example, a family history of breast cancer in a patient with a breast lump), and the social history (for example, domestic discord in a patient with insomnia and fatigue).Medical Interviews - a Comprehensive Guide to Ct, St and Registrar Interview Skills: Over 120 Medical Interview Questions, Techniques and NHS Topics Explained txt The MMI, whilst a relatively newer format as compared to traditional interviews, offers students multiple advantages. Firstly, it is considered far more holistic in its assessment of one’s candidature. For example, most MMIs will cover a range of topics in it’s stations, from motivation to study medicine to ethical debates and innovation in Medicine. This allows applicants to showcase their skills, dedication and motivation in more ways than one. Moreover, MMIs are considered to be a fairer judge of character as each individual station is marked independently of the others. Consequently, students have multiple chances to score highly in the interview as opposed to in a traditional setup, where candidature is assessed by one person or a single panel throughout. Ultimately, there is no right or wrong way to prepare for the MMI. The key to success in the MMI is to show self-reflection and dedication whilst maintaining strong communication skills and approachability. There are dozens of preparatory sources available at your disposal and these books are just some of the popular ones. Regardless of how you choose to prepare for the MMI, know that these books will not make or break your chances of admission as much as they may ameliorate your existing skill-set. The medical interview provides two categories of information unavailable from any other source: what the patient says about the illness and how it is said. What the patient tells the physician provides the factual content of the medical history. The factual content is what the physician edits and records in the written record—the medical history. It should include a comprehensive, chronological report of the patient's illness with enough information, both positive and negative, for accurate and inclusive diagnostic reasoning regarding possible etiologies of the patient's problem(s). The process of the interview is what actually happens between physician and patient during their encounter.
Medical Interviews: A comprehensive guide to CT, ST Medical Interviews: A comprehensive guide to CT, ST
Medical Interviews - a Comprehensive Guide to Ct, St and Registrar Interview Skills: Over 120 Medical Interview Questions, Techniques and NHS Topics Explained ebookLichstein PR. The Medical Interview. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 3. reading Medical Interviews - a Comprehensive Guide to Ct, St and Registrar Interview Skills: Over 120 Medical Interview Questions, Techniques and NHS Topics Explained
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