Lecture 4: Interview Basics I and II

Question 1

Personal Space Distances (intimate, personal, social)

Answer 1

intimate: 1.5 feet
personal: 4 feet
social: 10 feet

Question 2

Patient-Centered Interviewing

Answer 2

• centers on patients needs (not disease/physician)
• patient plays bigger role
• more thorough and accurate history
• better patient-physician rapport

Question 3

Physician-Centered Interviewing

Answer 3

• laundry list of items to ask
• items pertain to organ systems
• may lose important info and change history
• jump to conclusions (interrupts patient 18 sec after they speak)

Question 4

Expressing Empathy through NURSE

Answer 4

N - name (underlying emotion)

U - understand (confirm you know how they feel)

R - respect (accept and acknowledge their feelings)

S - support (give help and availability)

E - explore (target questions to that person and elicit interest in their emotions)

Question 5

What is Patient Centered Medical Home?

Answer 5

• model of care which allows patient and sometimes family to be a partner in treatment plan
• coordinated through primary provider and clinical care team in a way that the patient understands

Question 6

What does SOAP stand for?

Answer 6

S - subjective (learn through patients history)

O - objective (physical examination)

A - assessment (what you think is going on w/patient)

P - plan (what you and patient agree to do about it)

Question 7

What information is included in Subjective section?

Answer 7

• Chief Complaint (CC)
• History of Present Illness (HPI)
• Review of Systems (ROS)
• Past Medical History (PMH)
• Past Surgical History (PSH)
• Medications (Meds)
• Allergies (ALL)
• Family History (FH)
• Social History (SH)

Question 8

What information is included in Objective section?

Answer 8

• physical exam findings (including vital signs)
• Laboratory Data
• Radiology Data

Question 9

What information is included in Assessment section?

Answer 9

• NOT ALWAYS a diagnosis
• basic description of problem
• differential diagnosis: most likely cause to least likely cause

Question 10

OLDCARTS and what it stands for

Answer 10

O - onset (when, what doing, has happened before?)

L - location

D - duration

C - character

A - alleviating, aggravating, associated symptoms

R - radiation

T - timing

S - severity (pain scale)

Question 11

Location

Answer 11

Where does the symptom occur?

• use directional terms

Question 12

Duration

Answer 12

• is the symptom constant or does it come and go?
• how long does it last between occurrences?
• generally getting better or worse?

Question 13

Characterization

Answer 13

• how would you describe your symptoms?

- DO NOT put words in their mouth

Question 14

Aggravating Factors vs Alleviating Factors

Answer 14

Aggravating - what makes the symptoms worse?

Alleviating - what makes the symptoms better?

Question 15

Associated Symptoms

Answer 15

• anything else going on that might be related to the chief complaint?

Question 16

Radiation

Answer 16

• does the pain/discomfort go anywhere else in the body?

- clarify between continuation of same pain or another, separate pain

Question 17

Timing

Answer 17

• when is the symptom most likely to happen