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Monday, December 11th 2006

To Recall What You Read On The Spot…

I took a psychopathology test today covering amongst other things interviewing skills.

The fact you need to be taught interviewing skills to begin with might seem a little off base. What exactly are you doing in medical school in the first place without at least minimum social skills goes the reasoning. But really, this isn’t a conversation on the street; learning how to maintain a professional demeanor under some stressors, learning how to elicit the best responses, learning how to keep a history on task takes some practice.

This comes with physically doing more and more H&Ps. What is odd though, is thinking about transitioning from what you’ve read to an actual performance.

I was studying before the test about how to handle an angry or upset patient. Looking at it though I cannot imagine myself actually remembering any of this when I meet my first hostile patient. My eyes will get big, I’ll stutter but I probably won’t think to “address the affect” and it probably won’t cross my mind to consider whether the patient’s motivation is for “primary or secondary gain,” etc.

At least not right away. Maybe after I’ve bungled through a few minutes. And when, and if, I do remember…I’d bet the way I address the anger, won’t come off exactly like I want it to. The second upset patient I meet? The process will probably work better.

I Often Run Into Zombie Angry Patients In Black Rooms

This isn’t a criticism of medical education, just a comment. Part of the journey of medical education is giving relevance to what you learn. In a way that’s what I’ve described above. Sure I needed to read about interviewing skills, but until you’re actually out there…it’s just words. How many other things from the first two years can I say that about?