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Challenging history taking encounters: a systematic review, meta-analysis and phenomenological framework
Sabrina Hossain1, Kate Murray2, Liyang Zhang1
1School of Medicine and Dentistry, Griffith University, Southport, Queensland, Australia.
Challenging physician-patient communication occurs in 19.5% of encounters, impacting diagnosis. This review identifies causes and strategies for difficult history-taking scenarios to improve medical training.
Area of Science:
- Medical Education
- Clinical Communication
- Diagnostic Process
Background:
- Physicians frequently encounter challenging history-taking situations.
- Impaired communication during history taking can negatively affect diagnosis.
Purpose of the Study:
- To meta-analyze the prevalence of challenging history-taking encounters.
- To identify adverse outcomes, causes, and strategies for these encounters.
- To align strategies with a phenomenological framework for history taking.
Main Methods:
- Systematic review and meta-analysis of 73 articles.
- Literature search across MEDLINE, Embase, and Cochrane databases.
- Inductive coding for categorizing factors and strategies; meta-analysis for prevalence estimation.
Main Results:
- Overall prevalence of challenging history-taking encounters is 19.5%.
- Adverse outcomes include patient dissatisfaction and diagnostic uncertainty.
- 22 factors and 13 strategies were categorized, forming a framework for novice physicians.
Conclusions:
- Challenging history-taking encounters are common and impact patient care.
- Further research is needed to understand the impact of strategies and develop better educational models.
- Many effective strategies require deviation from standard history-taking protocols.
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