What are the 3 types of interviewing skills?
- Content skills
- Perceptual skills
- Process skills
What is meant by content skills?
What doctors communicate:
- The substance of their questions and responses
- The information they gather and give
- The treatments
What is meant by perceptual skills?
What they are thinking and feeling:
- Their internal decision making and clinical reasoning
- Their awareness of their own biases, attitudes and distractions
What is meant by process skills?
How the doctors do it:
- The ways doctors communicate with patients
- How they go about discovering the history or providing information
- The verbal and non-verbal skills they use
- The way they structure and organize communication.
What are the two broad types of factors affecting communication?
- Physical factors
2. Personal factors
What are the 4 physical factors which affect consultation?
- Site and Environment
- Adequacy of Medical Records
- Time constraints
- Patient status
What is mean by “Site and Environment” in a physical factor which will affect the consultation?
Attendance at a roadside accident vs doctor in an A&E
What is mean by “Adequacy of Medical Records” in a physical factor which will affect the consultation?
Adequate records of the history - to avoid wasting time in reviewing
What is mean by “patient status” in a physical factor which will affect the consultation?
New or Known patient
What are the personal factors which will affect the consultation?
- Age
- Sex
- Background and Origins
- Knowledge and Skills
- Beliefs
- The illness
How might “Age” affect the consultation?
Younger patients like younger doctors vs older patients like older doctors
How might “Sex” affect the consultation?
Generally, people prefer a doctor of the same sex
How might “Backgrounds and Origins” affect the consultation?
Social class, ethnic factors, and language difficulties will affect if you seek help
How might “Knowledge and Skills” affect the consultation?
Consider when a doctor is a patient, it will change the nature of the consultation
How might “Beliefs” affect the consultation?
Beliefs about diseases are influenced by the media, and are not medically accurate
How might “The Illness” affect the consultation?
Consultations of terminal illnesses are harder to conduct
What are the 3 types of doctor/patient relationship models?
- Authoritarian / Paternalistic relationship
- Guidance / Co-operation
- Mutual participation relationship
What is involved in a Authoritarian / Paternalistic relationship?
The physician uses all the authority inherent in his status and the patient feels no autonomy. He tries to please and does not actively participate in his own treatment
What is involved in a Guidance / Co-operation relationship?
The physician exercises authority, the patient is obedient, but has a greater feeling of autonomy and participates more actively in the relationship
What is involved in a Mutual participation relationship?
Most desirable for complex diagnostic interview, management of patients suffering chronic illness. Patient feels some responsibility which involves active participation and personal autonomy. Created by moderation of the doctor’s use of authority
What are the two types of interviews?
- Closed
2. Open
What is meant by a “Closed” interview?
An interview which is similar to a written questionnaire/ interrogation.
What is meant by a “Open” interview?
An interview where the doctor listens, facilitates and discusses the possible ways forward
What are the 3 activities which can be involved in a consultation?
- Talking together - always occurs
- Doctor examining the patient - occurs often
- Performing procedures - this is rarely done
