Medical Interviewing I: The Basics Flashcards Preview

NB 3 Dev & Psych > Medical Interviewing I: The Basics > Flashcards

Flashcards in Medical Interviewing I: The Basics Deck (16):
1

describe nonverbal (data gathering technique)

head-nodding and silence

2

describe checking (data gathering technique)

reviewing/repeating to ensure accuracy

3

describe clarification (data gathering technique)

asking the patient to restate or give examples

4

describe interruption (data gathering technique)

redirecting the patient they are rambling/tangential; restructuring the conversation

5

describe transition (data gathering technique)

politely changing topics to gather relevant information

6

describe reflection (data gathering technique)

paraphrasing to show attention/understanding

7

describe information sharing (data gathering technique)

interpretations, explanations, expectations for outcomes

8

describe giving directions (data gathering technique)

assigning responsibility for tasks

9

describe define the problem (step 1 in clinical decision-making)

  • take into account referral question and chief complaint
  • internal problem list: signs, symptoms, history
  • develop hypotheses that can be tested by info from problem list
  • iterative process of refining hypotheses based on new info.

10

describe define outcome goals (step 2 in clinical decision-making)

  • what is the desired health condition at conclusion of treatment?
  • the stage of illness will inform treatment goals
    • prevention/early intervention at early stages
    • methods for managing complex treatment regimen at mid-stages
    • family decisions, hospice care at late stages
  • provider and patient negotiate achievable goals
    • weekly exercise regimen
    • dietary changes
    • family therapy to reduce stress at home

11

describe generate alternative treatment solutions (step 3 in clinical decision-making)

  • treatment interventions must consider how to:
    • alter biological functioning
    • modify behavior and cognition
    • facilitate changes in the environment
    • utilize social resources

12

describe finalize treatment plan (step 4 in clinical decision-making)

  • finalize treatment plan
    • select optimal interventions
    • prioritize interventions
    • keep goals clear, focused and achievable
    • confirm patient's and patient's family members' understanding and commitment to plan
    • provide oral and written communication

13

describe implement treatment plan (step 5 in clinical decision-making)

  • implement treatment plan
    • establish method for communicating unexpected obstacles to implementation (i.e. side effects, insurance denial, family resistance)
    • set a follow-up appointment with expectation that progress will be reviewed

14

describe evaluate the outcome (step 6 in clinical decision-making)

  • evaluate the outcome
    • are symptoms resolved/reduced?
    • establish outcome criteria (i.e. lower scores on depression/anxiety measures, changes on lab reports)
    • in the case of diseases without a cure, positive outcomes can include symptom reduction and maintenance of good quality of life in spite of disease

15

describe sources of error in decision-making

  • theoretical and personal biases
  • forced categorization
  • over-optimism or pessimism
  • too many hypotheses (use rule-outs)
  • oversimplification
  • normalizing abnormalities
  • letting attitudes towards patient influence judgement
  • mistaking correlation for causation

16

describe medical interviewing of children and adolescents

  • avoid open-ended questions
  • seek collateral information from parents, teachers, caregivers
  • use pictures, toys to elicit info.
  • maintain non-judgemental attitude with adolescents