3 Taking a History from the Challenging Patient in the Emergency Department

Abstract

This exhibit will use DVD footage, written material, and live real‐time interaction to demonstrate an innovative methodology to teaching residents and medical students to gain comfort and expertise in communicating with and taking a history from challenging patients in the ED. I teach this course at our institution every year. Professional actors with improvisational experience play out unscripted interactions with students based on a character or characters, a set scene, and predefined goals and endpoints. Their dialogue and choices evolve from the student's response and the tone, direction, and approach that the student takes. These scenarios are much more realistic and educational than OSCEs which are often described as artificial and flat. Some of the scenarios that I will present include: Daughter trying to make End‐of‐life choices for her mother, type A man with chest pain trying to sign out, a woman with “dental pain” who is seductive and drug‐seeking, an intoxicated attending MD brought in from a motor vehicle crash (MVC) who uses power in a manipulative way. Many of the scenarios contain potential ethical, sexual, gender, racial issues that the student must address along with the medical problems.