Interaction goals in the primary care medical interview

To examine the extent to which nurse practitioners (NPs) pursue three supraordinate goals (instrumental, relational, and self-presentational) in their interactions with patients in the primary care medical interview.

One hundred three NPs representing a variety of specialties who responded to open-ended survey.

A content analysis of 590 goal statements listed by respondents resulted in the generation of seven basic level instrumental goals (global/general health care issues; diagnostic/assessment issues; treatment/plan of care issues; information-gathering; information-giving; information-verifying; and resource management); four basic level relational goals (relationship-building; compliance-gaining; anxiety management; and identity management); and three basic level self-presentational goals (establishing expertise; demonstrating professionalism; and demonstrating compassion).

Primary care medical interviews are recurring events that can produce automatic or habitual communication that may not be optimal for patient care. Training sessions that enable NPs to observe themselves and others in interactions with patients can improve NP ability to recognize and attend to the multiple goals in effect at given point. Ultimately, this goal-oriented approach to interaction should generate more efficient, productive, and satisfying primary care medical interviews for both the NP and the patient.