Biomedical subjects

K Weil

Publications and source records attributed to K Weil.

3 recordsLinked to original sources

PubMed2000

[Improving the quality of clinical interview teaching: evaluation of an intervention with medical students].

BACKGROUND: Quality of clinical interview is a key issue both for patient satisfaction and for diagnostic efficiency. Its adequacy relates to better clinical diagnosis treatment plans and patient compliance. AIM: To measure the quality of interviews performed by medical students in three Chilean medical schools before receiving specific training on the subject and to compare the scores obtained after introductory courses on interview. MATERIAL AND METHODS: The interviews were videotaped and then evaluated using an objective scale, that measures 33 skills grouped in six areas: opening, problem exploration, non verbal facilitation, interpersonal patient reaction and closing. The students were assigned to an experimental group that received an interactive workshop with role-plays, vignettes and videotape feedback, and to a non intervention group that received the usual bedside training on medical interviews. RESULTS: Both groups shared the same skill level before the training, with better scores on nonverbal, patient reaction and problem exploration, and worse ones on closing and interpersonal skills. Comparing pre and post-test results, the overall score improved in the experimental group (from 33.2 to 38.3, p = 0.002) and worsened among non intervened students. There were statistically significant changes for opening (p < 0.002), problem exploration (p < 0.05), non verbal facilitation (p < 0.0001) and closing (p < 0.0001). CONCLUSIONS: It is important to train students not only in specific knowledge contents but in the process of interview. This training should encourage the development of empathy and closing skills.

Education, Medical, Undergraduate↗

PubMed1998

[Communications difficulties during the medical interview].

The aims of medical interview are to obtain diagnostic information, to obtain an empathetic communication with the patient, to educate him about his disease and to establish a personal link allowing a lasting relationship. We analyze some features of communication with patients. Individualized communication, recognizing his identity and personal aspects, "looking from the patient". Context, a shared but not mentioned value, part of the world of emotions and ideas. An analog and digital language, the former precise in words and the latter more diffuse, with gestures, not verbal. Coherence, as the similitude between what we think, feel and say. If there is no coherence, communication is impaired. Emotions, always present, rending communication more valid and real. We need to recognize, express and respond to emotions. An emotionless patient becomes a distant and impersonal object, an "it". When emotions are incorporated the patient is a "him" with whom I share and dialog. Empathy is an emotional comprehension, a personal bond. It improves relationships and creates links. Compassion is a variation of empathy that includes spiritual aspects and values. Negative emotions as rage, frustration and aggression creates communicational difficulties. We must recognize, express and clarify them to improve the situation. Difficult patients with whom communication is difficult such as confuse, agitated, terminal, elder, manipulating or hypochondriac subjects. The idea of transference and counter transference in these complicated situations is analyzed.

Communication↗

PubMed1978

Problems in the control of hypertension in the community.

A hypertension survey was conducted in Montreal to determine the extent, nature and distribution of the control of hypertension. Of the 12 055 persons screened in shopping centres, workplaces and a random sample of homes in four census tracts the hypertension was not controlled in 69.0% to 80.3% of those with the condition in each setting. Nearly two thirds of those with hypertension were aware of their condition, 13% were aware but had never been treated, 13% were receiving treatment inadequate to control their hypertension, and 11% had discontinued treatment, most reporting that they had done so on the advice of their physician. Among those screened in their home, discontinuance of therapy was most often reported by those with a low income, but lack of awareness of their condition was no more prevalent in this group than in the other income groups. Efforts to control hypertension should be directed to the variety of causes of lack of control, which may occur with various frequencies in different communities, and for which screening alone may be inadequate.

Adult↗