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Patient Interviewing - #41040


 

 

Katie Burns-Ryan, DC
1.0
15.0
2.0
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T5 chiropractic students will learn the elements of the patient interview through lectures, simulated patient interviews, small group sessions, and a video taped interview of a mock patient.

Please select from the list on the right.

The Institution-wide learning goals define the common ground that unites the programs within the university. They are purposefully broad so that the various colleges and schools can continue to develop their unique identities through varying ways in which the goals are met.

  1. Effective Communication
    Graduates will demonstrate effective verbal, non-verbal, and written communication skills in a wide variety of contexts, including collaborative activities.
  2. Self Directed and Lifelong Learning
    Graduates will be aware of the limits of one’s personal knowledge and experience and have an intellectual interest in scholarly and creative endeavors. Graduates will actively set appropriate learning goals, pursue them, and apply the knowledge gained.
  3. Ethical Reasoning
    Graduates will demonstrate a willingness to recognize the values of others while maintaining one’s own integrity, and act ethically and professionally in all endeavors.
  4. Individuals, Communities and Cultures
    Graduates will demonstrate awareness and sensitivity to the cultural and health practices of individuals and communities. Graduates will be able to identify appropriate health related resources.
  5. Service to the Community
    Graduates will understand and value the benefits of service to the community.
  6. Influence of Mind, Body and Spirit on Health
    Graduates will recognize the inter-relationship of the mind, body and spirit and the influence of extrinsic factors on an individual’s health.
  7. Critical Thought and Knowledge Acquisition
    Graduates will acquire, appraise and apply scientific information. Graduates will contextually organize and synthesize relevant information to address an issue or problem.
  8. Competence in one's Discipline
    Graduates will demonstrate competence of appropriate depth and scope for one's discipline.

Course Objectives
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  1. Perform simulated patient histories in class to develop personal style and flow of the interview.
  2. Perform a video taped patient history which will be peer reviewed for both weakness and strengths of the individual performing the patient interview.
  3. Write up a narrative report based on the video taped patient history which will then be evaluated for completion of material and clinical thought process.
  4. Evaluate the patient interview for differential diagnosis and clinical thought process.
  5. Learn appropriate patient interviewing techniques for those patients with special needs or for individuals with diverse cultural backgrounds. 
Materials
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A. Required Text(s):

None


B. Recommended Text(s):
  1. Differential Diagnosis for the Chiropractor, Second Edition, Thomas Souza, 2001
  2. The Medical Interview: The Three Function Approach, Second Edition, Steven Cole and Julian Bird, 2000

C. Required Materials for Lab:

Patient Interviewing #41040 Course Manual

Assignments
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  1. Come prepared to class-Read the Patient Interviewing Course Manual  
  2. Read handout materials
  3. Review information listed above in A & B
  4. Practice history-taking regularly
  5. Complete a written CHH narrative based on information gleaned from taped session
  6. Complete simulated patient interview worksheets
  7. Complete HPI and CHH in class assignments
Attendance
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  • Attendance is required during scheduled class time for which there is no make-up available. The student is responsible for anything that transpires during each session, even if the student is not able to attend.  In the event that a class session is missed, the student is responsible for obtaining information regarding schedule changes and/or other announcements that may have been made.
  • Attendance is required for scheduled video taped patient interview. If the student does not attend this session a make-up session will be provided. However, the student will receive partial credit 25/50 for unexcused absence. 
Grading Criteria
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  • A total of 200 points are possible in this class.
  • 3-10pt in class assignments covering materials presented in class. These assignments review patient interviews of past T7 students performing history of present illness and comprehensive health history. All assignments are to be turned in at the end of the lecture. No credit is awarded for late assignments.
  • 2-10pt small group assignments in which students form groups of two and perform HPI and comprehensive health history on each other. The student performing the patient interview will then be critiqued by the simulated patient. All assignments are to be typed with proper grammar and spelling and are due at the beginning of the next class session.
  • 3-10pt video reviews of past T5 students performing A Comprehensive Health History
  • 20pt cafeteria experience provides feedback from supervising faculty who present simulated cases to groups of 6 students.
    • Each student will perform a 10pt HPI and receive feedback from their fellow group members as well as the supervisor.
    • A 10pt comprehensive health history of a simulated patient will be performed in a group setting with various parts of the history assigned to specific students. Each student will receive feedback from fellow group members as well as the supervisor.
    • HPI
      10 points
      Excellent 10
      Good 8
      Average 6
      Poor 4
      Inadequate 0
      CHH
      10 points
      Excellent 10
      Good 8
      Average 6
      Poor 4
      Inadequate 0

  • 20pt video taped self review performed outside of class time in the UHS clinic. During this assessment the student will use a fellow T5 student as the patient and perform a comprehensive health history onhim/her. The student will then perform a self review and critique for content, professionalism, and areas of strengths or weakkness. This assigment is designed to prepare the student for the Final Video taped assessment as well as to provide the student with a chance to familiarize him/herself with the UHS rooms and paperwork. Self review rubric due 3/5/2007
  • 30pt video taped comprehensive health history assessment. This interview will be performed on volunteer simulated patients who will present with specific findings.
    • 10pts based on completion of all areas of the comprehensive health history.
    • 10pts based on peer review of the interview.
    • 10pts based on simulated patient's scoring of the interview
  • 20pt peer review of the videotaped assessment designed to give the student more feedback as to strengths and weakness of the interview as well as to allow another opportunity for an individual to see another style of interview.
  1. All DVD will be distributed for peer review on 3/19/2007.
  2. All peer reviews and tapes are due by 5:00pm on Friday, 3/23/2007 with the tapes to be returned to Dr Burns Ryan UHS office 26
  • 30pt narrative report based on the findings from the video taped patient interview. This narrative report will be graded on content, clinical though process, spelling, and grammar. The report is due by 4/2/2007 UHS office 26.

    Excellent 27-30
    Good 24-26
    Average 21-23
    Poor 18-20

  • There are no formal quizzes or examinations

     

Evaluation

Excellent 90%-100% The student has demonstrated mastery in patient interviewing skills. The student is prepared for T6 internship and may be expected to work successfully with minimal supervision in a clinical situation.

Good 80%-89% The student has demonstrated a clear understanding of patient interviewing skills. The student is prepared for T6 internship and may be expected to work successfully with moderate supervision in a clinical situation.

Average 70-79% - The student has demonstrated a basic comprehension of patient interviewing skills. The student is prepared for T6 internship and may be expected to perform adequately given close supervision in a clinical situation.

Failure to accrue at least 70% (or 140pts) of total points will result in failure.

Poor 60%-69%- The student has demonstrated only an elementary familiarity with patient interviewing skills. The student may be expected to be able to perform only the most rudimentary of tasks and only with constant supervision in a clinical setting.

Unacceptable 0%-59%- The student has not demonstrated knowledge or understanding of any meaningful portion of patient interviewing. The student is not qualified to engage in a clinical setting.

Note:  At the end of week two of the following trimester, all paperwork that has been turned in to the instructor during the course of the term will be shredded. 

Guaranteed grades are as follows:

A =

90 - 100% of the 200total points
B = 80 - 89% of the 200 total points
C = 70 - 79% of the 200 total points
D = N/A
F =

Failure to accrue at least 70% of the 200 total points

Course Competencies
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-

COGNITIVE DOMAIN


1. Know the components of a comprehensive health history of an adult and how to transition from segment to segment:

Identifying data CHH-Current health history
CC-Chief complaint PH/SH-Psychosocial history
HPI-History of present illness FHH-Family history
PHH-Past health history ROS-Review of Systems

 

2. Understand the causes of difficult doctor/patient interactions and steps that should be taken to alleviate the problem:

Patient who:

Hearing loss Language barrier
Memory/cognitive loss Cultural barrier
Vague or rambling Noncompliant
Cries Questions the physician recommendations
Demanding Asks personal questions
Interviewing the child  


Topics:

Sensitive issues Adequate time and privacy
Distractions Poor behavior


3. Understand the function of the medical record, format of the written health history, content of the history, recording personal or sensitive information.



Conditions:
N/A

PSYCHOMOTOR DOMAIN


Perform a minimum of 3 comprehensive health history's on simulated/authentic patients. During these encounters the student will introduce him/herself, speak clearly, slowly, enunciate, use appropriate questioning techniques (open vs closed-ended), appropriate language and tone of voice, body language (e.g., good posture, eye-contact) and dress, and elicit patient feedback.

AFFECTIVE DOMAIN


Students will demonstrate integrity, sensitivity, respect, courtesy, compassion and professionalism at all times, both in lectures and during simulated/authentic patient encounters. Students will be able to react to simulated difficult doctor-patient encounters appropriately. Students will improve their listening skills, confidence in patient encounters, empathy, and body language.
Weekly Calendar of Learning Objectives
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Week Dates Topics/Learning objectives
Week 1 5/3/2007
  • T3 and T5
  • Introduction to Patietn Interviewing
  • Verbal and nonverbal communication
  • Review HPI before next class and complete small group assignment for next class (10pt)

 

Week 2 5/10/2007
  • T3 and T5
  • History of present illness/injury (HPI)
  • Demonstration of HPI (10pt in class assignment)
Week 3 5/17/2007
  • T3 Lecture and Complete small group assignment for next class
  • T5 HPI Cafeteria Experience

 
Week 4 5/24/2007
  • T3 HPI Cafeteria Experience (10pts)
  • T5 Lecture and Complete small group assignment for next class
Week 5 5/31/2007
  • T3 and T5
  • Comprehensive Health History
Week 6 6/7/2007
  • T3 and T5
  • Demonstration of CHH (10pt in class assignment)
  • 5/31/07-6/13/07 perform a DVD self review-you will sign up for a room in UHS. Choose a partner from class to act as a simulated patient
Week 7 6/14/2007
  • T3 Hand in DVD self review rubric (20 pts)
  • Lecture- Complete small group assignment. Focused CHH performed during class time with typed HPI and DDX which includes the appropriate hx findings that lead you to the DDX (10pt). Hand in at next class
  • T5 No class due to midterms
Week 8 6/21/2007
  • T3 Cafeteria experience covering CHH (10pts)
  • T5 Hand in DVD self review rubrics (20pts)
  • Lecture- Complete small group assignment. Focused CHH performed during class time with typed HPI and DDX which includes the appropriate hx findings that lead you to the DDX (10pt). Hand in at next class
Week 9 6/28/2007
  • T3 no formal class
  • T5 Cafeteria Experience covering CHH(10pts)
Week 10 7/5/2007
  • T3 and T5
  • Patient Interview and Cultural differences, hearing impaired, translator, child/parent visit, difficult patient, SOAP note

 
Week 11 7/12/2007
  • No formal class due to Appreciation Day
Week 12 7/19/2007
  • T3 and T5
  • Meet in class to pick up DVD for peer review due by Friday, 7/24/2007
  • Patient Interview and the ROF
Week 13 7/26/2007
  • T3 and T5
  • Dr Larry Spicer-Minnesota Board presentation
  • Distribute original DVD back to owner
  • Narrative report due August 2, 2007 by 5:00pm (30pts)
Week 14 8/2/2007
  • Narrative report due to Dr KBR by 5:00pm
Week 15
  • N/A
Please Note
This schedule of lecture and lab topics and quizzes and exams may be changed during the course of the trimester as circumstances require. Whenever possible, such changes will be announced in class before the date and time in question. You are responsible for anything that transpires during lectures and labs, even when you are unable to attend. In the event that you miss a class session, make sure you check with a classmate about any announcements or schedule changes which may have been made. Makeup exams are allowed only according to the policies described in the current student handbook, which is available in the Student Affairs office.
Maintained by Northwestern College of Chiropractic
Last updated: 1 May, 2007
 

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