Block M R, Coulehan J L
J Med Educ. 1987 Jan;62(1):35-40. doi: 10.1097/00001888-198701000-00005.
A module dealing with the difficult patient interview is part of a required medical interviewing course for second-year students. Using a classification of difficult doctor-patient interactions, students identify what goes wrong during interviews with simulated patients and then learn techniques to remedy these problems in order to obtain reliable medical histories. Skills taught to the students include identifying the specific problem within an interview and recognizing and using their own feelings as information about the patient. Attitudes encouraged in students include recognizing that the source of the problem may be the patient, the interviewer, or both; that the physician rather than the patient may be the so-called "poor historian"; and that the goal of managing a difficult patient interview is not counseling but rather the acquisition of accurate and precise information.
一个处理与难缠患者面谈的模块是二年级学生必修的医学面谈课程的一部分。通过对医患之间困难互动进行分类，学生们识别在与模拟患者面谈过程中出现的问题，然后学习解决这些问题的技巧，以便获取可靠的病史。教授给学生的技能包括在面谈中识别具体问题，以及认识并利用自身感受作为有关患者的信息。鼓励学生具备的态度包括认识到问题的根源可能在于患者、面谈者或双方；医生而非患者可能才是所谓的“糟糕的病史提供者”；以及处理与难缠患者面谈的目标不是咨询，而是获取准确精确的信息。
