Eliciting the patient's perspective: does experience or type of case make a difference?

OBJECTIVE Patient-centered interviewing is an increasingly important aspect of medical education. One way to quantify this skill is the Four Habits Model, which helps to organize medical interviewing. The Four Habits are: invest in the beginning, elicit the patient's perspective, demonstrate empathy and invest in the end. In a previous study at our institution, students were competent in all of the habits but "eliciting the patient's perspective" during a standardized patient case. Based on this study, we hypothesized that the students' poor performance could be related to the type of case or to clinical experience. METHODS We placed three "eliciting the patient's perspective" items on the checklist for two standardized patients, one with and one without a clear diagnosis. We planned to compare group performance between cases and semesters of the third year. We hypothesized that students would be more patient-centered earlier in the year and with an ambiguous diagnosis. RESULTS Students were more patient-centered with the ambiguous diagnosis and later in their third year. Patient-centeredness was measured by an eliciting the patient's perspective (EPP) score based on the checklist items. CONCLUSION Our results provide information that may help guide curriculum development and future study to advance patient-centered interviewing skills.

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