02 MRS – History taking: Special Skills

Main Scale

The doctor’s history taking tends to follow a rigid approach. Sometimes psychological and  social factors are not effectively pursued and psychiatric symptoms are not thoroughly investigated. The doctor’s history taking is flexible. Psychological and social factors are followed up where appropriate and psychiatric symptoms are thoroughly investigated.
1 2 3 4 5 6 7 8 9 10
Has little understanding of this. Attempts to do this but is not yet skilful and sometimes runs into difficulty. Attempts to do this and is usually successful but recognises his/her limitations. Perfect

Subscales

The doctor:

Rarely Occas
ionally
Fairly
frequently
Often Usually
(a) Demonstrates interviewing skills in gathering inform ation on psychological and social factors, besides organic symptoms, where appropriate.
(b) Demonstrates skill in discussing sensitive and personal matters with a wide range of patients.
(c) Can vary effectively his/her approach according to the age, sex, educational and occupational background of the patient.*

Notes for raters

This area of behaviour can only be assessed when the rater has spent sometime either directly observing consultations or by the use of audiotape orvideotape recordings. Inventories such as the Goldberg Questionnaire are usefulboth in the training and assessment of the doctor’s performance in gatheringinformation about psychiatric symptoms.

* If there is a difficulty in this area please refer to AppendixA for an expanded list of circumstances.

Comments:

 

References

  • Goldberg D P, Steel J, Smith C et al (1980) Training family doctors to recognise psychiatric illness with increased accuracy. Lancet 2,521-3.
  • Marks J, Goldberg D P and Hillier V F (1979) Determinants of the ability of general practitioners to detect psychiatric illness. Psychological Medicine 9,337-53.
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