CONSULTING SKILLS TRAINING AND MEDICAL-STUDENTS INTERVIEWING EFFICIENCY

In more traditional medical education, medical students took a patient 's medical history by asking a series of sequenced, routine questions, covering presenting medical problem(s); medical history; social and p ersonal history; systems review; and physical examination. Following t his process, the student then attempted to derive the patient's medica l problems. This inductive problem-solving paradigm may not assist stu dents to prepare for their future interviewing needs, given doctors us e a hypothetico-deductive, problem-solving approach when interviewing patients and numerous researchers have developed specialized communica tion skills training programmes designed to enhance students' intervie wing skills. Students given specific consulting skills training have t ended to show significantly greater interpersonal effectiveness and im proved interview behaviours compared with students who experience trad itional patient clerking training. These improvements in interviewing tend to persist over the period of students' medical training. The aim of the present study was to determine whether specialized communicati on skills training helped students elicit greater quantity and quality of information from patients and if so, whether such information assi sted students in improving their diagnostic skills. Videotaped history -taking interviews conducted by students trained in communication skil ls and untrained (control) students were rated for their interview eff iciency. A comparison of ratings given by experimentally naive, indepe ndent observers revealed that trained students were more efficient, bu t took no longer than their control group counterparts to elicit fulle r, more relevant information. However, the student groups did not diff er in the accuracy or scope of their medical diagnoses. It is argued t hat students' lack of medical knowledge in this early phase of their c linical training militated against their being able to use their inter viewing competence to derive more potentially accurate medical diagnos es.