Problem-oriented instruction as a predictor of success in early psychiatric interviewing

Of 77 second-year medical students, the 27 who were randomly assigned to problem-oriented instruction (POI) in interviewing skills rated themselves as better prepared and more successful in interviews of psychiatric patients, compared with students receiving lecture only or no classroom instruction in interviewing skills. POI-trained students also rated themselves as better in focusing on nonverbal aspects, effective questioning, and exploring feelings. The POI involved hierarchically organized, skills-focused role-plays in which students rotated through the roles of "doctor," "patient," and "observer." The method enhances the similarity between the instructional environment during training and the problem-solving processes necessary at the time of transfer to a new problem. Supervisors who observed the interview did not rate the three groups differently on interviewing skills.