My first "patient"

I had my first pretend patient interview the other day, and boy am I glad it was pretend! I volunteered to go first because I figured the expectations would be low and I kind of wanted to fail spectacularly so I could learn from my mistakes. Well all of these things happened. I’ll admit that failing horribly in front of everyone was embarrassing but I feel like I have learned so much more by getting a hard case from the start, trying to run with it, and falling flat on my face. The second person to interview a patient that day did remarkably well, but I don’t think they will learn nearly as much from their success as I did from my failure. The goal of this interview was NOT to diagnose anything, but simply to communicate with the “patient,” and figure out why they were at the doctor’s office and try and get a history. Basically I was talking to a young girl who was thinking about going into medical school and she wanted to talk to the doctor about “other things” but was too uncomfortable to say them at first (it turns out she wanted birth control). It took me a long time to work it out of her.

So here is what I learned, briefly…

• Just because a patient’s concern has nothing to do with medicine, does not mean it isn’t important. (I was talking to the standardizes patient (SP) about school and friends and hobbies but in the back of my mind I kept thinking ‘when do I get to the medicine part of this’ – I was so busy trying to do everything I thought I should do that I forgot to listen to the SP and talk about what was on their agenda)

• Interviews should proceed in a logical fashion (I jumped around a lot and asked some very random questions out of the blue, when I should have been asking good follow up questions to get more specific information) Ex. If a patient says they have a boyfriend you should find out more relevant information like how many relationships they have had in the past, what is the boyfriend like, how old is he, etc – this is very important for teenage patients when it might be their first sexually active relationship. I missed a lot of golden opportunities to ask really probing questions because I wasn’t taking the next logical step
• It’s ok to talk to a patient like you would a friend ( I was so wrapped up in trying to be a professional that I missed opportunities to share some of my own relevant life experiences like how I got into med school! – I mistakenly thought that the only advice I could give a person had to be based on statistics)
• Let the patient tell their story
• Reassure the patient that you will not judge them and will keep everything confidential (this can help people open up more and talk about uncomfortable issues especially when it comes to teenagers and sex!)
• Don’t make assumptions! (I made the mistake of skipping a lot of simple questions because I thought I knew what the answers would be already, sometimes I was right but I was also guessing wrong a lot of the time)
• Relax!

I have learned so much from this experience and I am so excited to tackle my next “patient.” Interviewing is a lot harder in practice than it is in theory. Hopefully by the time I talk to real people I will feel less like a fake and more like I know what I am doing.