Interview Basics Flashcards
What is the student doctor opening remark?
Hello my name is student doctor__. I am working with your doctor today as part of your healthcare team. I’m here to collect some information about why you are here today, perform a basic physical exam, and then report back to your doctor. Is that alright with you? Before we begin, may I confirm your first and last name as well as your date of birth? How old does that make you? Thank you. Lastly, how would you like me to address you? How can I help you today?
Which does the patient perceive as more time spent with them, sitting or standing?
Sitting
What is patient center interviewing?
Centers on the patients needs not the disease or what the physician wants. It engages the patient to play a larger role and allows the physician to obtain a more thorough history. Elicit data efficiently and seek patients agenda and set it jointly and negotiate priorities together.
What is physician centered interviewing?
Traditional way of interviewing, focused on history taking and making way through a “laundry list” of items to ask. Items pertain to organ systems and this can cause the physician to jump to conclusions and loose valuable information from the patient.
After you introduce yourself to your patient what do you do next?
History of present illness (HPI). Ask open ended questions avoid yes or no answers. Continue asking is there anything else until the patient says no. Negotiate the agenda using phrases such as which is the most concerning to you, or I would also like to discuss __ with you today. Next ask more open ended questions about the cc. OLDCARTS and summarize.
Describe how to actively listen to your patient.
Smile, eye contact, posture, mirroring, minimize distractions such as note taking
NURSE?
Acronym for expressing empathy:
Naming: it seems like you are feeling, i can see this makes you fee..
Understand: I can understand why you would be__ given what you are going through. I can see this has been a hard time for you.
Respect: It must be a lot of stress to deal with__. I’m impressed with how you have handled this. You did the right thing by coming in
Support: I want to help in any way I can. I will be with you every step of the way.
Explore: How are you coping with this? What has happened since last time I saw you?
SOAP?
Subjective: what you learn by taking hx
Objective: physical exam findings including structural findings lab and radiology data
Assessment: what you think is going on
Plan: what you and the patient agree to do about the issue including any OMT
What does Subjective encompass?
CC, HPI. Review of systems (ROS), Past medical hx (PMH), Past surgical hx (PSH), meds, ALL, FH, SH
OLDCARTS?
Onset: when cc starated what you were doing, has it happened before
Location
Duration: constant or come and go? how long does it last or how long btw occurrences? In general getting better or worse?
Character: sharp dull achy throbbing…
Alleviating, Aggravating, Associated symptoms: what makes symptoms better or worse, anything else related to chief complaint.
Radiation
Timing: Is cc worse at any part of the day
Severity: 0-10, how is this affecting daily life?
PMH?
Illnesses the patient has had or currently has, may not have been diagnosed by dr, is it controlled meds or lifestyle changes? Uncontrolled?
PSH?
most dental surgeries and sutures for minor injuries DO NOT count, Tonsillectomy and appendectomy and C sections do.
What is required to ask about for medications?
Rx, OTC, and supplements.
You have to record the dosing and time taken
ask about birth control
What is required information for taking ALL?
Medications, environmental, and food. Must record the reaction
What do you ask about for a FH?
parents and siblings and children
also about things that run in the family such as cancers, mental health issues and cardiac issues
What are the elements of a SH?
FEDTACOS Food-dig deeper Exercise Drug use Tobacco Alcohol Caffeine Occupation Spirituality
How much exercise does the CDC recommend for adults and children?
adults need 150 min of exercise per week and children need 1 hour of daily activity
What do you ask in regards to drugs?
Make sure you state what you are about to ask and why. Ask how often/much/administration.
Don’t use the phrase “illegal drugs” stick to recreational and street drugs. Make sure to ask specifically about prescription drug use as well.
What do you ask in regards to tobacco?
What kind of tobacco do you use? Do you smoke eCigs or vape? How many ppd duration and if the patient has quit smoking find out pack years. (ppd x years)
What is the AAA screening?
Abdominal aortic aneurysm, men who have ever smoked ages 65 and up are screened with ultrasound.
What is the LDCT?
Lung cancer low dose CT to test for cancer in adults aged 55-80 who have a 30 pack year smoking history and currently smoke or have quit within the last 15 years
What do you ask with alcohol?
How much do you drink and how often and what? AUDIT and CAGE if necessary
C: cut back
A: annoyed if asked about your drinking
G: guilty about drinking
E: do you need a drink in the morning to steady nerves
For women and those 65+ what is considered low risk drinking?
no more than 3 drinks/day and no more than 7/ week
What is considered low risk drinking for men?
No more than 4 drinks/day and no more than 14/week
Caffeine?
How much how often and what
Spirituality?
Where do you get your strength
Safety?
seatbelts, helmets, car seats, lifejackets, vaccines etc…
Living environment?
who do you share a home with
Support system?
Who can you count on if you have a problem
Domestic violence?
Disguise pamphlets, ask about dangerous situations in the home guns or weapons who else is in danger. SAFE Stress/safety Afraid/abused Friends/family Emergency plan
