Skip to main content
Top
Published in: Journal of General Internal Medicine 12/2007

01-12-2007 | Original Article

Teaching the Medical Interview: Methods and Key Learning Issues in a Faculty Development Course

Authors: David S. Hatem, MD, Susan V. Barrett, MS, Mariana Hewson, PhD, David Steele, PhD, Urip Purwono, Drs, MS, MSc, Robert Smith, MD

Published in: Journal of General Internal Medicine | Issue 12/2007

Login to get access

Abstract

OBJECTIVE

To describe the American Academy on Communication in Healthcare’s (AACH) Faculty Development Course on Teaching the Medical Interview and report a single year’s outcomes.

DESIGN

We delivered a Faculty Development course on Teaching the Medical Interview whose theme was relationship-centered care to a national and international audience in 1999. Participants completed a retrospective pre-post assessment of their perceived confidence in performing interview, clinical, teaching, and self-awareness skills.

PARTICIPANTS AND SETTING

A total of 79 participants in the 17th annual AACH national faculty development course at the University of Massachusetts Medical School in June 1999.

INTERVENTION

A 5-day course utilized the principles of learner-centered learning to teach a national and international cohort of medical school faculty about teaching the medical interview.

MEASUREMENTS AND MAIN RESULTS

The course fostered individualized, self-directed learning for participants, under the guidance of AACH faculty. Teaching methods included a plenary session, small groups, workshops, and project groups all designed to aid in the achievement of individual learning goals. Course outcomes of retrospective self-assessed confidence in interview, clinical, teaching, self-awareness, and control variables were measured using a 7-point Likert scale. Participants reported improved confidence in interview, clinical, teaching, and self-awareness variables. After controlling for desirability bias as measured by control variables, only teaching and self-awareness mean change scores were statistically significant (p < .001).

CONCLUSIONS

The AACH Faculty Development course on Teaching the Medical Interview utilized learner-centered teaching methods important to insure learning with experienced course participants. Perceived teaching and self-awareness skills changed the most when compared to other skills.
Appendix
Available only for authorised users
Literature
1.
go back to reference Greenfield S, Kaplan S, Ware JE Jr. Expanding patient involvement in care. Effects on patient outcomes. Ann Int Med. 1985;102:520–8.PubMed Greenfield S, Kaplan S, Ware JE Jr. Expanding patient involvement in care. Effects on patient outcomes. Ann Int Med. 1985;102:520–8.PubMed
2.
go back to reference O’Keefe M, Sawyer M, Roberton D. Medical student interviewing skills and mother reported satisfaction and recall. Med Educ. 2001;35:637–44.PubMedCrossRef O’Keefe M, Sawyer M, Roberton D. Medical student interviewing skills and mother reported satisfaction and recall. Med Educ. 2001;35:637–44.PubMedCrossRef
3.
go back to reference Mangione-Smith R, McGlynn EA, Elliott MN, McDonald L, Franz CE, Kravitz RL. Parent expectations for antibiotics, physician-parent communication, and satisfaction. Arch Pediatr Adolesc Med. 2001;155:800–6.PubMed Mangione-Smith R, McGlynn EA, Elliott MN, McDonald L, Franz CE, Kravitz RL. Parent expectations for antibiotics, physician-parent communication, and satisfaction. Arch Pediatr Adolesc Med. 2001;155:800–6.PubMed
4.
go back to reference Jackson JL, Chamberlin J, Kroenke K. Predictors of patient satisfaction. Soc Sci Med. 2001;52:609–20.PubMedCrossRef Jackson JL, Chamberlin J, Kroenke K. Predictors of patient satisfaction. Soc Sci Med. 2001;52:609–20.PubMedCrossRef
5.
go back to reference Hausman A. Taking your medicine: relational steps to improving patient compliance. Health Market Quart. 2001;19:49–71.CrossRef Hausman A. Taking your medicine: relational steps to improving patient compliance. Health Market Quart. 2001;19:49–71.CrossRef
6.
go back to reference Vermeire E, Hearnshaw H, Van Royen P, Denekens J. Patient adherence to treatment: three decades of research. J Clin Pharm Ther. 2001;26:331–42.PubMedCrossRef Vermeire E, Hearnshaw H, Van Royen P, Denekens J. Patient adherence to treatment: three decades of research. J Clin Pharm Ther. 2001;26:331–42.PubMedCrossRef
7.
go back to reference Levinson W, Roter DL, Mullooly JP, Dull VT, Frankel RM. Physician–patient communication. The relationship with malpractice claims among primary care physicians and surgeons. JAMA. 1997;277:553–9.PubMedCrossRef Levinson W, Roter DL, Mullooly JP, Dull VT, Frankel RM. Physician–patient communication. The relationship with malpractice claims among primary care physicians and surgeons. JAMA. 1997;277:553–9.PubMedCrossRef
8.
go back to reference Smith RC, Lyles, JS, Mettler MA, Stoffelmayr BE, et al. The effectiveness of intensive training for residents in interviewing: A randomized controlled study. Ann Int Med. 1998;128:118-126.PubMed Smith RC, Lyles, JS, Mettler MA, Stoffelmayr BE, et al. The effectiveness of intensive training for residents in interviewing: A randomized controlled study. Ann Int Med. 1998;128:118-126.PubMed
9.
go back to reference Smith RC, Lyles JS, Gardiner JC, et al. Primary care clinicians treat patients with medically unexplained symptoms—a randomized controlled trial. J Gen Intern Med. 2006;21:671–7.PubMedCrossRef Smith RC, Lyles JS, Gardiner JC, et al. Primary care clinicians treat patients with medically unexplained symptoms—a randomized controlled trial. J Gen Intern Med. 2006;21:671–7.PubMedCrossRef
10.
go back to reference Novack DH, Volk G, Drossman DA, Lipkin M Jr. Medical interviewing and interpersonal skills teaching in US medical schools. Progress, problems, and promise. JAMA. 1993;269:2101–5.PubMedCrossRef Novack DH, Volk G, Drossman DA, Lipkin M Jr. Medical interviewing and interpersonal skills teaching in US medical schools. Progress, problems, and promise. JAMA. 1993;269:2101–5.PubMedCrossRef
11.
go back to reference Anonymous. Consensus statement from the workshop on the teaching and assessment of communication skills in Canadian medical schools. Can Med Assoc J. 1992;147:1145–9. Anonymous. Consensus statement from the workshop on the teaching and assessment of communication skills in Canadian medical schools. Can Med Assoc J. 1992;147:1145–9.
14.
go back to reference Simpson M, Buckman, Stewart M, et al. Doctor–patient communication: the Toronto consensus statement. BMJ. 1991;303:1385–7.PubMed Simpson M, Buckman, Stewart M, et al. Doctor–patient communication: the Toronto consensus statement. BMJ. 1991;303:1385–7.PubMed
15.
go back to reference Association of American Medical Colleges. Contemporary Issues in Medicine: Communication in Medicine. Washington, DC: Association of American Medical Colleges; 1999. Association of American Medical Colleges. Contemporary Issues in Medicine: Communication in Medicine. Washington, DC: Association of American Medical Colleges; 1999.
16.
17.
go back to reference Lang F, Everett K, McGowen R, Bernard B. Faculty development in communication skills instruction: insights from a longitudinal program with “real time feedback.” Acad Med. 2000;75:1222–8.PubMedCrossRef Lang F, Everett K, McGowen R, Bernard B. Faculty development in communication skills instruction: insights from a longitudinal program with “real time feedback.” Acad Med. 2000;75:1222–8.PubMedCrossRef
18.
go back to reference Bertakis KD. The communication of information from physician to patient: a method of increasing patient retention and satisfaction. J Fam Pract. 1977;5:217–22.PubMed Bertakis KD. The communication of information from physician to patient: a method of increasing patient retention and satisfaction. J Fam Pract. 1977;5:217–22.PubMed
19.
go back to reference Safran D, Montgomery J, Chang H, et al. Switching doctors: predictors of voluntary disenrollment from a primary physician’s practice. J Fam Pract. 2001;50:130–6.PubMed Safran D, Montgomery J, Chang H, et al. Switching doctors: predictors of voluntary disenrollment from a primary physician’s practice. J Fam Pract. 2001;50:130–6.PubMed
20.
go back to reference Federman AD, Cook EF, Phillips RS, et al. Intention to discontinue care among primary care patients: influence of physician behavior and process of care. J Gen Intern Med. 2001;16:668–74.PubMedCrossRef Federman AD, Cook EF, Phillips RS, et al. Intention to discontinue care among primary care patients: influence of physician behavior and process of care. J Gen Intern Med. 2001;16:668–74.PubMedCrossRef
21.
go back to reference Fellowes D, Wilkinson S, Moore P. Communication skills training for health care professionals working with cancer patients, their families and/or carers. Cochrane Database of Systematic Reviews 2004, Issue 2. Art. No.: CD03751. DOI 10.1002/14651858.CD002751.pub2. Fellowes D, Wilkinson S, Moore P. Communication skills training for health care professionals working with cancer patients, their families and/or carers. Cochrane Database of Systematic Reviews 2004, Issue 2. Art. No.: CD03751. DOI 10.​1002/​14651858.​CD002751.​pub2.
22.
go back to reference Jonassen JA, Pugnaire MP, Mazor K, et al. The effect of a domestic violence interclerkship on the knowledge, attitudes, and skills of third-year medical students. Acad Med. 1999;74:821–8.PubMedCrossRef Jonassen JA, Pugnaire MP, Mazor K, et al. The effect of a domestic violence interclerkship on the knowledge, attitudes, and skills of third-year medical students. Acad Med. 1999;74:821–8.PubMedCrossRef
23.
go back to reference Rosenbaum ME, Kreiter C. Teaching delivery of bad news using experiential sessions with standardized patients. Teaching and Learning in Medicine. 2002;14:144–9.PubMedCrossRef Rosenbaum ME, Kreiter C. Teaching delivery of bad news using experiential sessions with standardized patients. Teaching and Learning in Medicine. 2002;14:144–9.PubMedCrossRef
24.
go back to reference Yedidia MJ, Gillepsie CC, Kachur E, et al. Effect of communications training on medical student performance. JAMA. 2003;290:1157–65.PubMedCrossRef Yedidia MJ, Gillepsie CC, Kachur E, et al. Effect of communications training on medical student performance. JAMA. 2003;290:1157–65.PubMedCrossRef
25.
go back to reference Kalet A, Pugnaire MP, Cole-Kelley K, et al. Teaching communication in clinical clerkships: models from the Macy initiative in health communication. Acad Med. 2004;79:511–20.PubMedCrossRef Kalet A, Pugnaire MP, Cole-Kelley K, et al. Teaching communication in clinical clerkships: models from the Macy initiative in health communication. Acad Med. 2004;79:511–20.PubMedCrossRef
26.
go back to reference Rost K, Gordon GH. The teacher simulation exercise: changes in physician teaching emphasis and strategy. J Gen Intern Med. 1989;4:121–6.PubMedCrossRef Rost K, Gordon GH. The teacher simulation exercise: changes in physician teaching emphasis and strategy. J Gen Intern Med. 1989;4:121–6.PubMedCrossRef
27.
go back to reference Gordon GH, Levinson W. Attitudes toward learner-centered learning at a faculty development course. Teaching and Learning in Medicine. 1990;2:106–9.CrossRef Gordon GH, Levinson W. Attitudes toward learner-centered learning at a faculty development course. Teaching and Learning in Medicine. 1990;2:106–9.CrossRef
28.
go back to reference Tresolini CP, Pew-Fetzer Task Force. Health Professions Education and Relationship-centered Care. San Francisco: Pew Health Professions Commission; 1994. Tresolini CP, Pew-Fetzer Task Force. Health Professions Education and Relationship-centered Care. San Francisco: Pew Health Professions Commission; 1994.
29.
go back to reference Kaplan C. Learner centered learning. Medical Encounter. 1992;8:2–4. Kaplan C. Learner centered learning. Medical Encounter. 1992;8:2–4.
30.
go back to reference Hasson F, Keeney S, McKenna H. Research guidelines for the Delphi survey technique. J Adv Nurs. 2000;32:1008–15.PubMedCrossRef Hasson F, Keeney S, McKenna H. Research guidelines for the Delphi survey technique. J Adv Nurs. 2000;32:1008–15.PubMedCrossRef
31.
go back to reference Smith CS, Irby DM. The roles of experience and reflection in ambulatory education. Acad Med. 1997;72:32–5.PubMed Smith CS, Irby DM. The roles of experience and reflection in ambulatory education. Acad Med. 1997;72:32–5.PubMed
33.
go back to reference Mengel MB. Physician ineffectiveness due to family-of-origin issues. Fam Syst Med. 1987;5:176–90.CrossRef Mengel MB. Physician ineffectiveness due to family-of-origin issues. Fam Syst Med. 1987;5:176–90.CrossRef
34.
go back to reference Rogers C. On Becoming a Person. Boston: Houghton Mifflin Co.; 1961. Rogers C. On Becoming a Person. Boston: Houghton Mifflin Co.; 1961.
35.
go back to reference Aiken LS, West SG. Invalidity of true experiments: self-report pretest biases. Eval Rev. 1990;14:374–90.CrossRef Aiken LS, West SG. Invalidity of true experiments: self-report pretest biases. Eval Rev. 1990;14:374–90.CrossRef
36.
go back to reference Howard GS, Dailey PR. Response-shift bias: a source of contamination of self-report measures. J Appl Psychol. 1979;64:144–50.CrossRef Howard GS, Dailey PR. Response-shift bias: a source of contamination of self-report measures. J Appl Psychol. 1979;64:144–50.CrossRef
37.
go back to reference Sprinagers M, Hoogstraten J. On delay and reassessment of retrospective preratings. J Exp Educ. 1988;56:148–53. Sprinagers M, Hoogstraten J. On delay and reassessment of retrospective preratings. J Exp Educ. 1988;56:148–53.
38.
go back to reference Hebert J, Clemow L, Pbert L, et al. Social desirability bias in dietary self-report may compromise the validity of dietary intake measures. Int J Epidemiol. 1995;24:389-98.PubMedCrossRef Hebert J, Clemow L, Pbert L, et al. Social desirability bias in dietary self-report may compromise the validity of dietary intake measures. Int J Epidemiol. 1995;24:389-98.PubMedCrossRef
39.
go back to reference Branch WT Jr, Kern D, Haidet P, et al. The patient–physician relationship. Teaching the human dimensions of care in clinical settings. JAMA. 2001;286:1067–74.PubMedCrossRef Branch WT Jr, Kern D, Haidet P, et al. The patient–physician relationship. Teaching the human dimensions of care in clinical settings. JAMA. 2001;286:1067–74.PubMedCrossRef
40.
go back to reference Gracey CF, Haidet P, Branch WT, et al. Precepting humanism: strategies for fostering the human dimensions of care in ambulatory settings. Acad Med. 2005;80:21–8.PubMedCrossRef Gracey CF, Haidet P, Branch WT, et al. Precepting humanism: strategies for fostering the human dimensions of care in ambulatory settings. Acad Med. 2005;80:21–8.PubMedCrossRef
41.
go back to reference Fryer-Edwards K, Arnold R, Baile W, et al. Reflective teaching practices: an approach to teaching communication skills in a small group setting. Acad Med. 2006;81:638–44.PubMedCrossRef Fryer-Edwards K, Arnold R, Baile W, et al. Reflective teaching practices: an approach to teaching communication skills in a small group setting. Acad Med. 2006;81:638–44.PubMedCrossRef
42.
go back to reference Quirk ME. Intuition and Metacognition in Medical Education: Keys to Developing Expertise. New York: Springer Publishing; 2006. Quirk ME. Intuition and Metacognition in Medical Education: Keys to Developing Expertise. New York: Springer Publishing; 2006.
43.
go back to reference Makoul G. The SEGUE framework for teaching and assessing communication skills. Patient Educ Couns. 2001;45:23–34.PubMedCrossRef Makoul G. The SEGUE framework for teaching and assessing communication skills. Patient Educ Couns. 2001;45:23–34.PubMedCrossRef
44.
go back to reference Marshall AA, Smith RC. Physicians’ emotional reactions to patients: recognizing and managing counter transference. Am J Gastroenterol. 1995;90:4–8.PubMed Marshall AA, Smith RC. Physicians’ emotional reactions to patients: recognizing and managing counter transference. Am J Gastroenterol. 1995;90:4–8.PubMed
45.
go back to reference Novack DH, Suchman AL, Clark W, et al. Calibrating the physician. Personal awareness and effective patient care. JAMA. 1997;278:502–9.PubMedCrossRef Novack DH, Suchman AL, Clark W, et al. Calibrating the physician. Personal awareness and effective patient care. JAMA. 1997;278:502–9.PubMedCrossRef
47.
go back to reference Palmer P. The Courage to Teach. San Francisco: Josey-Bass; 1998. Palmer P. The Courage to Teach. San Francisco: Josey-Bass; 1998.
48.
go back to reference Brookfield S. Becoming a Critically Reflective Teacher. San Francisco: Josey-Bass; 1995. Brookfield S. Becoming a Critically Reflective Teacher. San Francisco: Josey-Bass; 1995.
49.
go back to reference Cole KA, Barker LR, Kolodner K, et al. Faculty development in teaching skills: an intensive longitudinal model. Acad Med. 2004;79:469–80.PubMedCrossRef Cole KA, Barker LR, Kolodner K, et al. Faculty development in teaching skills: an intensive longitudinal model. Acad Med. 2004;79:469–80.PubMedCrossRef
50.
go back to reference Smith RC, Marshall AA, Lyles JS, Frankel RM. Teaching self-awareness enhances learning about interviewing. Acad Med. 1999;74:1242–8.PubMedCrossRef Smith RC, Marshall AA, Lyles JS, Frankel RM. Teaching self-awareness enhances learning about interviewing. Acad Med. 1999;74:1242–8.PubMedCrossRef
51.
52.
go back to reference Davis DA, Mazmanian PE, Fordis M, et al. Accuracy of physician self-assessment compared with observed measures of competence: a systematic review. JAMA. 2006;296:1094–102.PubMedCrossRef Davis DA, Mazmanian PE, Fordis M, et al. Accuracy of physician self-assessment compared with observed measures of competence: a systematic review. JAMA. 2006;296:1094–102.PubMedCrossRef
53.
go back to reference Williams GC, Deci EL. Internalization of biopsychosocial values by medical students: a test of self-determination theory. J Pers Soc Psychol. 1996;70:115–26.PubMedCrossRef Williams GC, Deci EL. Internalization of biopsychosocial values by medical students: a test of self-determination theory. J Pers Soc Psychol. 1996;70:115–26.PubMedCrossRef
54.
go back to reference Hewson MG, Copeland HL. Outcomes assessment of a faculty development program in medicine and pediatrics. Acad Med. 1999;74:S68–S71.PubMedCrossRef Hewson MG, Copeland HL. Outcomes assessment of a faculty development program in medicine and pediatrics. Acad Med. 1999;74:S68–S71.PubMedCrossRef
55.
go back to reference Hewson MG, Copeland HL, Fishleder AJ. What’s the use of faculty development? Evaluation using retrospective self-assessments and independent performance ratings. Teaching and Learning in Med. 2001;13:153–60.CrossRef Hewson MG, Copeland HL, Fishleder AJ. What’s the use of faculty development? Evaluation using retrospective self-assessments and independent performance ratings. Teaching and Learning in Med. 2001;13:153–60.CrossRef
56.
go back to reference Naji SA, Maguire GP, Fairbairn SA, Goldberg DP, Faragher EB. Training clinical teachers in psychiatry to teach interviewing skills to medical students. Med Educ. 1986;20:140–7.PubMed Naji SA, Maguire GP, Fairbairn SA, Goldberg DP, Faragher EB. Training clinical teachers in psychiatry to teach interviewing skills to medical students. Med Educ. 1986;20:140–7.PubMed
57.
go back to reference Gask L, Goldberg JB, Craig T, et al. Training general practitioners to teach psychiatric interviewing skills: an evaluation of group training. Med Educ. 1991;25:444–51.PubMed Gask L, Goldberg JB, Craig T, et al. Training general practitioners to teach psychiatric interviewing skills: an evaluation of group training. Med Educ. 1991;25:444–51.PubMed
Metadata
Title
Teaching the Medical Interview: Methods and Key Learning Issues in a Faculty Development Course
Authors
David S. Hatem, MD
Susan V. Barrett, MS
Mariana Hewson, PhD
David Steele, PhD
Urip Purwono, Drs, MS, MSc
Robert Smith, MD
Publication date
01-12-2007
Publisher
Springer-Verlag
Published in
Journal of General Internal Medicine / Issue 12/2007
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-007-0408-9

Other articles of this Issue 12/2007

Journal of General Internal Medicine 12/2007 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.