Farsad P, Galliguez P, Chamberlin R, Roghmann K J
Pediatrics. 1978 Mar;61(3):384-8. doi: 10.1542/peds.61.3.384.
Interviewing skills of 34 pediatric house officers were compared with those of five practicing members of the clinical faculty. Interviews with a programmed mother were videotaped to evaluate physician-patient interaction, data gathering, hypothesis formation and provision of therapy education, reassurance, support, and anticipatory guidance. In addition, eight pediatric interns (PL-Is) were assigned to a study group and five to a control group at the beginning of their outpatient department rotation. The study group received feedback after the videotaped interviews and a 1 1/2-hour didactic session designed to teach interviewing skills. The control group received neither feedback nor the didactic session. Both groups were reevaluated at the end of the outpatient department rotation, again using the videotaped interview technique. Results showed that data-gathering ability increased significantly; that the focus of attention shifted from a more disease-oriented to a more patient-oriented interview; that data were obtained by means of less direct, less leading questions; and that more support and reassurance were provided as the level of training and experience increased. After the outpatient department rotation, members of both the study group and the control group of PL-1s had improved significantly and approached the proficiency-level of practicing pediatricians.
研究人员将34名儿科住院医师的问诊技巧与5名临床教员进行了比较。对一位设定好情况的母亲进行的问诊过程被录像，以评估医生与患者的互动、数据收集、假设形成以及治疗教育、安慰、支持和预期指导的提供情况。此外，8名儿科实习生（PL-Is）在门诊轮转开始时被分配到研究组，5名被分配到对照组。研究组在录像问诊后接受了反馈，并参加了一场为时1个半小时、旨在教授问诊技巧的教学课程。对照组既没有收到反馈，也没有参加教学课程。两组在门诊轮转结束时再次使用录像问诊技术进行重新评估。结果显示，数据收集能力显著提高；注意力焦点从更以疾病为导向的问诊转向更以患者为导向的问诊；通过不那么直接、不那么引导性的问题来获取数据；并且随着培训水平和经验的增加，提供了更多的支持和安慰。门诊轮转结束后，研究组和对照组的PL-1成员都有了显著改善，并接近执业儿科医生的熟练水平。
