Need help with history taking

[beastmaster]

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I'm an MS2, and we have our history-taking textbooks and such. But they all deal with generalities and theory. And the quotes that they propose are in language too formal to be used in a conversation (ie, medical interview).

Are there any online sources to watch or listen to real doctor-patient encounters (specifically the history taking portion)?

 

[Paws]

Hey beast,

Well, this is something that I have struggled with as a reasonably still new third year. I think it is a hard thing to learn for some people, and maybe everyone does it differently. There are books like Schwarz' Physical Diagnosis which is really a great book, and then other pocket sort of books you can read through. I say read, because I found that it was sort of just a weird format that had to be memorized, burned into my brain.

The review of systems seems inherently awkward to do, but once you have memorized the huge list of stuff to ask, then it sort of comes out easier.

For me, the hard part was actually sitting down with a real, live patient and then going through my history and physcial. I felt awkward and fumbling, but as I say, you somehow do get better at it. For web sites, I thought UCSD site (http://medicine.ucsd.edu/clinicalmed/links.html) was good and there is another at I think, Virginian Commonwealth? I just did a google search and browsed through the different sites. As for the weird, stilted language, welcome to medicine! That was very hard for me to learn but after a while you become more fluent in 'med-speak.'

 

[fang]

I'm an MS2, and we have our history-taking textbooks and such. But they all deal with generalities and theory. And the quotes that they propose are in language too formal to be used in a conversation (ie, medical interview).

Are there any online sources to watch or listen to real doctor-patient encounters (specifically the history taking portion)?

I don't have any links to web sites, and I used handouts from my internal medicine clerkship as a resource. What helped me was watching my attendings and residents do it a bunch of time... you'll get lots of practice next year.

 

[ericdamiansean]

Don't worry, it'll come with time, actually, after a while, you'll probably get sick and tired of it.

Learn from how others do it, the senior students, residents..but honestly, the more experience you get, your history becomes more brief because you'll know what to pinpoint

 

[DragonWell]

A book I saw recommended on SDN called "The Clinical Encounter" by Billings and Stoeckle has been helping me as an MS-1. We have Mosby's for class which is good for theory, but the Clinical Encounter is much more practical in terms of actually telling you what questions to ask, how to ask them, etc. It's sort of become my Idiot's Guide to Taking a History.

 

[anon-y-mouse]

I'm an MS2, and we have our history-taking textbooks and such. But they all deal with generalities and theory. And the quotes that they propose are in language too formal to be used in a conversation (ie, medical interview).

Are there any online sources to watch or listen to real doctor-patient encounters (specifically the history taking portion)?

do you guys have some sort of mnemonic to remember all the things you should be asking about? like how often, what makes it worse, what makes it better, etc? Just drill down that list... ask the patient what brings them in and get them to talk. also, make sure you're getting your chronology correct, and so that you have it fully in your head, say "just to make sure I have this correct..." and go through their version of the events from beginning to end. we receive a pocket card for history taking with a list of the most important things to talk about with mnemonics to remember... perhaps you can make one for yourself and keep practicing with it.

 

[ericdamiansean]

When taking HPC, remember to make a timeline, it'll help you focus your thoughts and prevents you from missing out on vital information. The patient's problems may have started ages before his presenting complain.

After a while, you'll also learn that parts of social history can be put into your HPC, like smoking in someone with COPD or alcohol in cirrhosis

 

[Medpilot]

It's just like everything else... you will be bad at it until you have done it several hundred times. Experience on the wards is key.