An evaluation of residency training in interviewing skills and the psychosocial domain of medical practice

Competent use of interviewing skills is important for the care of all patients but is especially critical, and frequently deficient, in meeting the needs of patients experiencing emotional distress. This study presents an evaluation of a curriculum in communication and psychosocial skills taught to...

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Bibliographic Details
Published inJournal of general internal medicine : JGIM Vol. 5; no. 4; p. 347
Main Authors Roter, D L, Cole, K A, Kern, D E, Barker, L R, Grayson, M
Format Journal Article
LanguageEnglish
Published United States 01.07.1990
Subjects
Chest Pain - psychology
Clinical Competence - standards
Communication
Counseling
Curriculum
Evaluation Studies as Topic
Female
Humans
Internship and Residency - standards
Interviews as Topic - methods
Interviews as Topic - standards
Medical History Taking - standards
Middle Aged
Mood Disorders - diagnosis
Pilot Projects
Primary Health Care - standards
Randomized Controlled Trials as Topic
Role Playing
Self Disclosure
Videotape Recording
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Summary:Competent use of interviewing skills is important for the care of all patients but is especially critical, and frequently deficient, in meeting the needs of patients experiencing emotional distress. This study presents an evaluation of a curriculum in communication and psychosocial skills taught to first-year medical residents. A randomized experimental design compared trained and untrained residents' (n = 48) performances with a simulated patient presenting with atypical chest pain and psychosocial distress. Evaluation was based on analysis of videotapes, simulated patient report of residents' behaviors, and chart notation. Trained compared with untrained residents asked more open-ended questions and fewer leading questions, summarized main points more frequently, did more psychosocial counseling, and were rated as having better communication skills by the simulated patient. The use of more focused and psychosocially directed questions, and fewer leading and grab-bag questions, was associated with more accurate diagnoses and management recorded in the medical chart. However, no significant difference was found in the charting practices of trained versus untrained residents.
ISSN:0884-8734
DOI:10.1007/BF02600404