History Taking Self-Assessment Project

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The ability of a medical practitioner to elicit a sound and thorough chief complaint and history is essential in treating patients. During the first encounter with the patient, medical practitioners should be able to treat based on the information the patient provides. On December 13, 2013, the Physician Associate class of 2015 had the opportunity to interview standardized patients. This encounter was videotaped for self-analysis. I was able to reflect and improve on interviewing skills from watching my own patient interview. My critiques and thoughts are delineated in this essay from which I hope to improve upon.
The patient whom I encountered during the standardized patient interview was Phil. Despite my failure to inquire how to address the patient, my initial encounter with Phil started smoothly with proper introductions, negotiating priorities, and agenda setting. Within minutes of greeting Phil, I was able to demonstrative active listening by nodding my head and keeping direct eye contact with the patient to ensure comfort. While Phil was informing me of his concerns, I leaned forward to show that I was listening and encouraged the patient to continue discussing the matter with open body language and appropriate hand gestures. Overall, I tried my best to stay engaged with the patient and believe that I built a rapport with Phil.
Although I was able to build a professional patient-physician relationship with Phil, I did struggle in characterizing the symptoms related to the main concern in addition to the patient and emotional story. Phil’s chief complaint was his inability to hear out of his left ear. He also wanted to discuss his lightheadedness. I began by asking Phil an open-ended question, and it was not until a minute a...

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...ns that are more open-ended and responding with the NURS model. Reflecting on the patient’s emotions by asking more questions that are open-ended would help in the interview as it shows a mutual understanding of the patient’s feelings. I also want to pay closer attention to emotional cues that could help explain the patient’s diagnosis. These components can carry the patient interview forward.
Overall, I feel that the interview went well, but there can be definite improvements. After watching the video a few times, I noticed weaknesses in the interview including callousness and brevity. With practice, I hope to improve on these aspects and utilize supportive comments to demonstrate empathy and obtain a thorough patient interview. These features of a patient interview are essential as the patient is providing the necessary information to form an accurate diagnosis.

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