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Is history taking a dying skill? An exploration using a simulated learning environment
Lisa McKenna1, Kelli Innes, Jill French
1School of Nursing & Midwifery, Monash University, Clayton Campus, Clayton, Victoria 3800, Australia. lisa.mckenna@monash.edu
Abstract:
History taking is a vital component of patient assessment. Nurses need sound interviewing skills to identify care priorities. Verbal and non-verbal cues provide triggers to follow-up with appropriate questions during health assessment for development of appropriate care plans. This skill, however, is a difficult one for students to learn and develop. This paper reports on a study that explored the value of video-recording, facilitated review and debriefing following a simulated patient experience to enhance final year nursing students' history taking and assessment skills. Scenarios, from commonly encountered situations, with imbedded cues were developed. Actors were employed as simulated patients from whom students took histories while being videotaped. Video-recordings were then reviewed by each student with a lecturer to highlight missed cues or areas where questioning could be developed. These were later analysed to explore cue identification. Finally, a focus group was conducted with participants to elicit feedback on the experience. Findings suggested that it was a valuable exercise. Students lacked prior appreciation for many aspects, such as lifestyle, on planning care. Some reported never having had opportunity during clinical placement to take a full history. Analysis of recordings identified commonly missed social cues and failure to fully explore emerging data.
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