Department of Emergency and Critical Care Medicine, Faculty of Medicine, Saga University, Saga City, Japan.
Community Medical Support Institute, Faculty of Medicine, Saga University, Saga City, Japan.
PLoS One. 2022 Sep 6;17(9):e0274159. doi: 10.1371/journal.pone.0274159. eCollection 2022.
To conduct an appropriate medical interview, education and clinical experience are necessary. The usefulness of computer-based medical diagnostic support systems has been reported in medical interviewing. However, only a few reports have actually applied these systems and noted changes in the quality of the medical interview of residents. We aimed to examine how the use of a medical interview support application changes the medical interviews of residents. The study was conducted on 15 residents (with less than two years post-graduation) and ran from November 2020 to March 2021. Faculty members played the role of simulated patients in 20 cases, and the residents conducted the medical interviews. In 10 of the 20 cases, a medical interview support application was used. After the interview, the residents were asked to list up to 10 differential diseases; the interview was considered appropriate if it included the disease portrayed by the simulated patient. Furthermore, the duration of the medical interview, the number of questions asked, and changes in stress parameters were evaluated. The use of a medical interview support application increased the percentage of appropriate medical interviews. Considering the frequency, the use of a medical interview support application increased the rate of appropriate medical interviews in the rare disease group, as well as the number of questions and duration of the interviews. No stress reduction was observed. The medical interview support application may be a useful tool in identifying appropriate differential diseases during medical interviews by residents.
进行适当的医学访谈需要教育和临床经验。已经有报道称，基于计算机的医学诊断支持系统在医学访谈中是有用的。然而，实际上只有少数报告应用了这些系统，并注意到住院医师医学访谈质量的变化。我们旨在研究使用医学访谈支持应用程序如何改变住院医师的医学访谈。该研究于 2020 年 11 月至 2021 年 3 月期间对 15 名（毕业后不到两年）住院医师进行，由教员扮演 20 例模拟患者，住院医师进行医学访谈。在这 20 例中的 10 例中使用了医学访谈支持应用程序。访谈后，住院医师被要求列出最多 10 种鉴别诊断疾病；如果访谈包括模拟患者所描述的疾病，则认为是合适的。此外，还评估了医学访谈的持续时间、提出的问题数量以及应激参数的变化。使用医学访谈支持应用程序提高了适当医学访谈的百分比。考虑到频率，医学访谈支持应用程序增加了罕见病组中适当医学访谈的比例，以及问题的数量和访谈的持续时间。未观察到应激减轻。医学访谈支持应用程序可能是住院医师在医学访谈中识别适当鉴别诊断疾病的有用工具。
