Medical students’ agenda-setting abilities during medical interviews
2
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Purpose: Identifying patients’ agendas is important; however, the extent of Korean medical students’ agenda-setting abilities is unknown. The study aim was to investigate the patterns of Korean medical students’ agenda solicitation. Methods: A total of 94 third-year medical students participated. One scenario involving a female patient with abdominal pain was created. Students were video-recorded as they interviewed the patient. To analyze whether students identify patients’ reasons for visiting, a checklist was developed based on a modified version of the Calgary-Cambridge Guide to the Medical Interview: Communication Process checklist. The duration of the patient’s initial statement of concerns was measured in seconds. The total number of patient concerns expressed before interruption and the types of interruption effected by the medical students were determined. Results: The medical students did not explore the patients’ concerns and did not negotiate an agenda. Interruption of the patient’s opening statement occurred in 4.62±2.20 seconds. The most common type of initial interruption was a recompleter (79.8%). Closed-ended questions were the most common question type in the second and third interruptions. Conclusion: Agenda setting should be emphasized in the communication skills curriculum of medical students. The Korean Clinical Skills Exam must assess medical students’ ability to set an agenda.
Abstract
Purpose: Identifying patients’ agendas is important; however, the extent of Korean medical students’ agenda-setting abilities is unknown. The study aim was to investigate the patterns of Korean medical students’ agenda solicitation. Methods: A total of 94 third-year medical students participated. One scenario involving a female patient with abdominal pain was created. Students were video-recorded as they interviewed the patient. To analyze whether students identify patients’ reasons for visiting, a checklist was developed based on a modified version of the Calgary-Cambridge Guide to the Medical Interview: Communication Process checklist. The duration of the patient’s initial statement of concerns was measured in seconds. The total number of patient concerns expressed before interruption and the types of interruption effected by the medical students were determined. Results: The medical students did not explore the patients’ concerns and did not negotiate an agenda. Interruption of the patient’s opening statement occurred in 4.62±2.20 seconds. The most common type of initial interruption was a recompleter (79.8%). Closed-ended questions were the most common question type in the second and third interruptions. Conclusion: Agenda setting should be emphasized in the communication skills curriculum of medical students. The Korean Clinical Skills Exam must assess medical students’ ability to set an agenda.
참고문헌 (20)
- Mauksch LB, "Relationship, communication, and efficiency in the medical encounter: creating a clinical model from a literature review", Arch Intern Med, 168, pp.1387~1395 (2008)
- Silverman J, "Skills for communicating with patients", pp.42~55 (2005), Radcliffe Publishing
- Marvel MK, "Soliciting the patient's agenda: have we improved?", JAMA, 281, pp.283~287 (1999)
- Beckman HB, "The effect of physician behavior on the collection of data", Ann Intern Med, 101, pp.692~696 (1984)
- Beasley JW, "How many problems do family physicians manage at each encounter? A WReN study", Ann Fam Med, 2, pp.405~410 (2004)
- Baker LH, ""What else?" Setting the agenda for the clinical interview", Ann Intern Med, 143, pp.766~770 (2005)
- Smith RC, "The patient's story : integrating the patient-and physician-centered approaches to interviewing", Ann Intern Med, 115, pp.470~477 (1991)
- Bishop JM, "Competence of medical students in history taking during the clinical course", Med Educ, 15, pp.368~372 (1981)
- 이영미, "의대생을 위한 환자-의사 커뮤니케이션 모델 개발", Korean Journal of Medical Education, 22(3), pp.185~195 (2010), 한국의학교육학회
- Ahn S, "Developing a Korean communication skills attitude scale: comparing attitudes between Korea and the West", Med Educ, 43, pp.246~253 (2009)
- Kraan HF, "To what extent are medical interviewing skills teachable?", Med Teach, 12, pp.315~328 (1990)
- Menahem S, "Teaching students of medicine to listen: the missed diagnosis from a hidden agenda", J R Soc Med, 80, pp.343~346 (1987)
- Dyche L, "The effect of physician solicitation approaches on ability to identify patient concerns", J Gen Intern Med, 20, pp.267~270 (2005)
- Dugdale DC, "Time and the patient-physician relationship", J Gen Intern Med, 14(Suppl 1), pp.S34~S40 (1999)
- Cape J, "Consultation length, patient-estimated consultation length, and satisfaction with the consultation", Br J Gen Pract, 52, pp.1004~1006 (2002)
- Aspegren K, "Which basic communication skills in medicine are learnt spontaneously and which need to be taught and trained?", Med Teach, 27, pp.539~543 (2005)
- Pfeiffer C, "The rise and fall of students' skill in obtaining a medical history", Med Educ, 32, pp.283~288 (1998)
- Bell RA, "Unsaid but not forgotten : patients' unvoiced desires in office visits", Arch Intern Med, 161, pp.1977~1984 (2001)
- Barry CA, "Patients' unvoiced agendas in general practice consultations : qualitative study", BMJ, 320, pp.1246~1250 (2000)
- "Ten-minute History-taking Station Example" (2014)[URL]
