Interview Basics

Question 1

Patient-Centered

Answer 1

• recognizes the importance of the patients expressions of personal concerns, feelings and emotions
• encourages the patient to tell their story in their own words
• effective use of open-ended questions

Question 2

Physician-Centered

Answer 2

• clinician takes charge of the interaction to meet their own need to acquire the sxs or details needed to make a dx
• direct, more focused questions
• typically a yes/no or short answer aka closed ended questions

Question 3

Open-Ended Questions

Answer 3

• How can I help you today?
• Tell me more about that…
• What else do you think may be important?
• What have you tried to make this better?

Question 4

Closed-Ended Questions

Answer 4

• When did your cough start?

Question 5

Closed-Ended Questions

Answer 5

• When did your cough start?
• Have you taken any meds?
• Have you had a HA?
• Have you ever had to stay overnight in the hospital?
• Do you have allergies?

Question 6

Non-Verbal Communication

Answer 6

• Professional dress and hygiene
• Posture
• Eye contact
• Active listening
• Professional touch
• Cultural humility

Question 7

Verbal Communication

Answer 7

• Open-ended questions
• Closed-ended questions
• Understandable language
• Empathetic responses
• Written documentation: SOAP Note

Question 8

Body Language

Answer 8

• Eye Level: empowers the patient as a partner in care (be at or below eye level of the patient)
• Open body language
• Reflective (active) listening (ex. nodding, leaning forward, mirroring patient)
• Respectful or supportive touch

Question 9

Sitting vs. Standing

Answer 9

• in studies where physicians sat down during appointments, they were perceived to be in the room longer
• position within 3-4 feet of patient; >5 feet is impersonal; <3 feet is invasive

Question 10

Empathy

Answer 10

• the capacity to identify with the patient and feel the patients pain as your own, then respond in a supportive manner

Question 11

Reasons why you should NOT shake your patient’s hand

Answer 11

• infection control: wash or sanitize hands prior to exam or touching patient
• cultural humility: not all cultures shake hands as a greeting; some cultures do not permit opposite-gender individuals to touch in a non-clinical situation

Question 12

Components of HPI

Answer 12

OLDCAAARTS
(1) Onset
(2) Location
(3) Duration
(4) Character
(5) Aggravating
(6) Alleviating
(7) Associated sxs
(8) Radiation
(9) Timing/Temporal pattern
(10) Severity

Question 13

Wong-Baker Pain Rating Scale

Answer 13

• typically has faces associated with each rating
  0 = No hurt
  2 = Hurts little bit
  4 = Hurts little more
  6 = Hurts even more
  8 = Hurts whole lot
  10 = Hurts worst

Question 14

Initial Steps of SPE that occur BEFORE you sit down

Answer 14

(1) Introduction
(2) Sanitize hands
(3) Make eye contact

Question 15

Initial Steps of SPE that occur AFTER you sit down

Answer 15

(1) Verify name and DOB
(2) How should I address you?
(3) And how old does that make you?
(4) Opening question

Question 16

What information is found in the Subjective portion of the SOAP Note?

Answer 16

• CC
• HPI
• ROS
• PMH
• PSH
• MEDS
• ALL
• SH
• FH

Question 17

What information is found in the Objective portion of the SOAP Note?

Answer 17

• PE
• Laboratory Data (includes Radiology reports)

Question 18

What information is found in the Assessment portion of the SOAP Note?

Answer 18

• Most likely Dx
• Somatic Dysfunction

Question 19

What information is found in the Plan portion of the SOAP Note?

Answer 19

• Self-care
• Diagnostic procedures (Xray, labs)
• Management (medications)
• F/u or RTC

Question 20

Review of Symptoms

Answer 20

• body divided into 14 systems
• different levels of acuity or severity require different ROS
• require ONE sx out of TWO systems

Question 21

Definition of Symptom

Answer 21

• a physical or mental problem that a person experiences that may indicate a disease or condition
• cannot be seen and do not show up on medical tests
• Ex. fatigue, chills, shortness of breath

Question 22

Definition of Signs

Answer 22

• findings observed during the PE and any laboratory data or reports
• can be measured or reproduced
• Ex. vital signs (BP, Temp, RR, HR)

Question 23

Examples of “Red Flags” (must not miss sxs)

Answer 23

• CC: Ear Pain; ROS: Dizziness and swollen glands = infection
• CC: Back Pain; ROS: Blood in urine and unintentional weight loss = kidney stones, cancer
• CC: Cough; ROS: Night sweats and back pain = TB, pneumonia
• CC: Joint Pain; ROS: Fever and rashes = septic joint, connective tissue disease

Question 24

Where would you document immunizations?

Answer 24

PMH

Question 25

What is NOT included in PSH?

Answer 25

- Dental extractions - Sutures for minor injuries

Question 26

What is included in PSH?

Answer 26

- Preventative surgeries - Commonly included: tonsillectomy, appendectomy, CS

Question 27

Expressing Empathy: Respecting Technique Examples

Answer 27

- I can see how much you love your family - You did the right think by coming in - It must be a lot of stress to deal with ...

Question 28

Expressing Empathy: Naming Technique Examples

Answer 28

- I can see how sad this makes you - Some people would feel ... in this situation

Question 29

Expressing Empathy: Understanding Technique Examples

Answer 29

- I can imagine what that would feel like - This has been a hard time for you

Question 30

Expressing Empathy: Supporting Technique Examples

Answer 30

- I'm going to be with you through all of this - I am here to help you in any way that I can

Question 31

Expressing Empathy: Exploring Technique Examples

Answer 31

- Can you give me a sense of what you're thinking - How are you coping with ...

Question 32

Importance of Transition Statements

Answer 32

- keep the patient informed of the new direction or topic - act as a sign-post for new topic - allows patient time to process the information covered

Question 33

Components of Social History

Answer 33

FED TACOS4 - Food - Exercise - Drugs - Tobacco - Alcohol - Caffeine - Occupation - Safety - Support and living situation - Spirituality - Sexual history

Question 34

Exercise Guidelines

Answer 34

150 minutes / week

Question 35

Effects of Caffeine

Answer 35

- high doses can be toxic resulting in arrhythmia, vomiting, seizures, coma and death - most commonly associated with energy drinks - can lead to insomnia, anxiety, palpitations, HAs

Question 36

Definition of a Drink - Beer: - Wine: - Liquor:

Answer 36

- 12 oz of 5% beer - 5 oz of 12% wine - 1.5 oz of 80 proof liquor

Question 37

Maximum Recommended Alcohol Intake for Men: Per Day? Per Week?

Answer 37

< 4 drinks per day and/or 14 drinks per week

Question 38

Maximum Recommended Alcohol Intake for Women: Per Day? Per Week?

Answer 38

< 3 drinks per day and/or 7 drinks per week

Question 39

Alcohol Use Disorder

Answer 39

- must fulfill 2 of 11 criteria that include craving, tolerance, inability to cut down, etc

Question 40

CAGE Questions: C

Answer 40

Cut - have you ever felt you should Cut down on your drinking?

Question 41

CAGE Questions: A

Answer 41

Annoy - do people Annoy you by criticizing your drinking?

Question 42

CAGE Questions: G

Answer 42

Guilty - do you feel Guilty about your drinking?

Question 43

CAGE Questions: E

Answer 43

Eye-opener - do you ever have an Eye-opener first thing in the morning to steady the nerves, or get rid of a hangover?

Question 44

Psychosocial Health Pyramid

Answer 44

Top -> Bottom - Self-actualization: growth, creativity - Self-esteem: self respect, social recognition, job satisfaction - Belonging: love, friendship - Safety: health and safety, stability - Physiologic: food, water, clothing

Question 45

What 3 things are ALWAYS required in SH?

Answer 45

- Tobacco: current or past use, type, amount - Alcohol: current or past use, drinks per day or drinks per week - Drugs: current or past use, type