, Volume 5, Issue 4, pp 347-354

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

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Abstract

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 cbest pain and psychosocial distress. Evaluation was based on analysis of videotapes, simulated patient report of residents’ behaviors, and cbart 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 baving 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.

Presented in part at the Mental Disorders in General Health Care Settings Research Conference, Seattle, Washington, June 25–26, 1987.
Supported in part by a residency training grant from the Bureau of Health Professions, Health Resources and Services Administration; by an institutional grant from The Chesapeake Educational and Research Trust, Chesapeake Physician, Pa; and by the National Institute of Mental Health.