Hi, this is Kota, a fourth-year intern student. 

I had a valuable opportunity to practice a medical interview in English with Ns. Rossi, as a nurse at the University of London. On my first trial, things did not go as planned, which made me frustrated to some extent. That’s why I took this lesson again!. 

 

The followings are the reflections of my last time lesson.

・Interrupting the patient 

・Talking about information that the patient does not need or want.

・being too formal to talk with my patient.

・giving a wrong diagnosis.

No good. Lol. If I were a patient, I would not want to see a doctor like me! LOL

 

The followings are the points that I would like to addressin this time lesson

1. Listen as much as possible to the patient. Asking as many open questions as I can
2. Use a variety of phrases that means empathy.
3. Do not make a final diagnosis not to disturb the patient.

 

The case of this lesson is as follows.

 

Setting: Emergency Department

You have received an 18 years old woman who is feeling mentally quite low and also has a worrying BMI ( BMI is 6). She collapsed at school today. Her mother advised the triage nurse that she hasn’t been eating properly for at least 6 months. Her mother believed that something happened between her friends at school. she has never mentioned it to her family. Her mother has complained to the school but it didn’t investigate her allegation. 

Task:  

Start investigations for patient
Give her and her mother the proposed treatment plan

 

At first, speaking of the point I would like to improve, I was able to ask many open questions to the patient, use some kinds of empathetic phrases, and avoid making a final diagnosis. Probably, I could do what I would like to, and this was a good point for me. 

 

When it comes to the lesson’s content, I found it very difficult dealing with the situation. Only patient‘s mother came to the hospital, so I spoke to the patient’s mother, not the patient. She said that her daughter had lost her appetite for the past 6 months and she had changed mentally. She also said that she encouraged her daughter to come to this hospital with her mother, but she refused. According to her, it seemed almost impossible for me as a doctor to contact the patient in the hospital. What should I do???

 

On the basis of the information I gathered from her, the points are

・It is essential to have a chance to talk directly with the patient in person, no matter however difficult it may be

・I would like to do a blood test and imaging study to make a diagnosis and rule out possible diagnosis.

I have to consider the fact that the patient would not come to hospitals. 

 

My answer was the following (This is what I said in the lesson).

Your daughter may be in a severe condition. I can cure her as a doctor. I would like to visit your house and have a talk with your daughter when she is in a better mood. Is it OK with you? 

 

What do you think about my conclusion?? Is my ideabetter than your answer? Or is it worse?? 

 

 

Every topic we practice in this lesson is made by Ns. Rossi, based on the actual situations that she experienced in London. The original case of this topic is that the patient BMI was 6, and her mother refused to contact her child with doctors. So, Ns. Rossi and her team suspected maternal abuse, planning to reach her child in the absence of her mother. In the end, they called the mother to the hospital, and created a situation intentionally where the mother was not at home. During the time, they entered the house to meet the child and successfully rescued her. They behaved as if they had been thieves! If they had failed the plan or her mother had known the plan in advance, they might have been accused. It was quite thought-provoking, wasn’t it?

 

 

This interactive English interview lesson is held regularly. 

If you find this lesson interesting, please come on in!!