Key Aspects of Medical Interviews and Consultations

What percentage of diagnoses are made during history-taking?

82% of diagnoses are made during history-taking, with the remaining 18% from examination and investigations.

What are the two parts of the medical interview?

The two parts are CONTENT (the 'What' - the patient's story) and PROCESS (the 'How' - Calgary Cambridge model of consultation).

What is a medical consultation?

A medical consultation is a conversation between a patient and a clinician about their health or reasons for seeking medical attention.

What are the settings in which a medical interview can take place?

Settings include the bedside, clinic, corridor, telephone, or remotely (e.g., video-conferencing).

How should you approach a patient's story during a medical interview?

Listen to the patient's story first, then take the history. Consider their agenda, why they think they're there.

What does 'health literacy' mean?

Health literacy refers to the individual's capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.

What does empathy mean in a medical interview?

Empathy is the ability to understand and share the feelings of another, demonstrated by attentive listening, good eye contact, and acknowledgment.

What is the first step in initiating a medical interview?

Establish rapport by greeting the patient, obtaining their name, introducing yourself, and explaining the nature of the interview.

How do you identify the reason for the consultation?

Ask the opening question (e.g., 'What problems brought you to the hospital?' or 'What would you like to discuss today?') and listen attentively.

What is the focus of Phase 2: Gathering Information in the Calgary Cambridge model?

Encourage the patient to tell their story from the beginning to the present, using open and closed questions, while picking up verbal and non-verbal cues.

What is 'signposting' during a medical interview?

Signposting is a transitional statement that guides the interview, such as 'Now I would like to ask you about your family's medical history, if I may.'

What are non-verbal communication techniques in a medical interview?

Non-verbal techniques include eye contact, posture, facial expression, and vocal cues like tone, volume, and rate.

What is the goal of Phase 5: Closing the Session?

Summarize the session briefly, clarify the plan of care, and confirm that the patient is comfortable with the plan, addressing any questions or corrections.

What is active listening in a medical interview?

Active listening involves using both verbal (e.g., minimal encouragers, summarizing) and non-verbal (e.g., nodding, leaning forward) cues to show attentiveness.

What is the purpose of Phase 3: Physical Examination?

The physical examination phase follows gathering information and helps confirm, refute, or clarify the patient's story.

What should be done at the end of Phase 2: Gathering Information?

Periodically summarize what the patient has said to confirm understanding, clarify any unclear statements, and invite further information.

What is an essential skill in the Calgary Cambridge model during the interview process?

Building rapport is essential, including showing empathy and respect for the patient's views and concerns.

What is the role of empathy in the medical interview process?

Empathy allows the clinician to demonstrate understanding, offer support, and establish a relationship, especially when discussing sensitive or distressing issues.