DocCom Module 8: Gather Information|with everything you need

Questions for Reflection: 1. What attitudes, thoughts and behaviors enable you to really listen to another? 2. What attitudes, thoughts and behaviors impede your ability to really listen to another? 3. How do people know when you are not only listening to them, but also understanding them? 4. What are your skills in facilitating patients' telling their stories of illness? 5. What attitudes and skills do you need to learn or improve that would enhance your ability to interview patients? Key Principles: 1. The key to effective information gathering is seeking to understand the details of patients' symptoms in their psychosocial and emotional contexts. 2. Communicating an understanding of the patient’s experience and concerns is associated with improved clinical outcomes. 3. You can maximize your efficiency by using specific interviewing strategies, such as active listening, open and closed questions, clarifying, summarizing, and transitioning. 4. You can encourage active patient participation and improve clinical outcomes by sharing control of discussion topics and talk time during interviews. 5. You can understand patients’ concerns and emotional reactions to their symptoms by asking directly, and by exploring and responding to their verbal and nonverbal clues. Learning goals: At the conclusion of this module, you will be able to: Describe the primary goals of relationship-centered information gathering. Describe and demonstrate relationship-centered strategies for gathering information. Describe and demonstrate strategies for encouraging patient participation in gathering information. Use your knowledge and skills to gather information effectively from a patient. INTRODUCTION You can greatly improve your patients’ outcomes when you jointly construct the story of the illness, weaving the patient’s elaboration of the biomedical and psychosocial threads together with your own hypotheses. The medical encounter begins when two people enter into a relationship with hopes of understanding, help, and healing. One of the major functions of all medical encounters is the development of a relationship between the physician and patient that enables them both to realize these hopes. Skillful physicians efficiently gather accurate biomedical and psychosocial information to generate hypotheses about possible causes of the patient’s symptoms, while gaining an understanding of the patient’s experience of illness. They listen for and develop the “narrative threads,” (1) or subplots and clues about the patient’s disease and the personal meaning o