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Related Experiment Videos

How should trainees be taught to open a clinical interview?

Alex Walter1, Chris Bundy, Tim Dornan

  • 1School of Medicine, University of Manchester, Manchester, UK.

Medical Education
|April 22, 2005
PubMed
Summary

This study analyzed how secondary care consultations begin, finding doctors use a 5-step process to establish context and encourage active listening, differing from previous research on consultation openings.

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Area of Science:

  • Medical Communication
  • Clinical Practice

Background:

  • Understanding the initial moments of patient-doctor interactions is crucial for effective healthcare delivery.
  • Previous research suggested a specific sequence for consultation openings, involving doctor solicitation, patient statement, and interruption.

Purpose of the Study:

  • To characterize the opening sequences of secondary care consultations.
  • To identify patterns in how doctors initiate patient interactions in a clinical setting.

Main Methods:

  • Audio-recording of 17 first consultations in medical clinics.
  • Verbatim transcription and analysis of verbal interactions from room entry to initial questioning.

Main Results:

  • Consultation openings did not follow the previously reported sequence.

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  • Doctors employed a 5-step process: calling the patient, greeting, introducing, transitioning to clinical talk, and framing the consultation.
  • Framing involved informal use of referral letters, case notes, computer records, and prior knowledge, often with humor.

    • Conclusions:

    • The identified 5-step process can aid trainees in establishing a context conducive to active listening.
    • This structured approach may reduce the likelihood of premature interruptions during consultations.