Abstract
BackgroundThis paper is an up-to-date systematic review on educational interventions addressing history taking. The authors noted that despite the plethora of specialized training programs designed to enhance students‘ interviewing skills there had not been a review of the literature to assess the quality of each published method of teaching history taking in undergraduate medical education based on the evidence of the program’s efficacy.MethodsThe databases PubMed, PsycINFO, Google Scholar, opengrey, opendoar and SSRN were searched using key words related to medical education and history taking. Articles that described an educational intervention to improve medical students’ history-taking skills were selected and reviewed. Included studies had to evaluate learning progress. Study quality was assessed using the Medical Education Research Study Quality Instrument (MERSQI).ResultsSeventy-eight full-text articles were identified and reviewed; of these, 23 studies met the final inclusion criteria. Three studies applied an instructional approach using scripts, lectures, demonstrations and an online course. Seventeen studies applied a more experiential approach by implementing small group workshops including role-play, interviews with patients and feedback. Three studies applied a creative approach. Two of these studies made use of improvisational theatre and one introduced a simulation using Lego® building blocks. Twenty-two studies reported an improvement in students’ history taking skills. Mean MERSQI score was 10.4 (range 6.5 to 14; SD = 2.65).ConclusionsThese findings suggest that several different educational interventions are effective in teaching history taking skills to medical students. Small group workshops including role-play and interviews with real patients, followed by feedback and discussion, are widespread and best investigated. Feedback using videotape review was also reported as particularly instructive. Students in the early preclinical state might profit from approaches helping them to focus on interview skills and not being distracted by thinking about differential diagnoses or clinical management. The heterogeneity of outcome data and the varied ways of assessment strongly suggest the need for further research as many studies did not meet basic methodological criteria. Randomized controlled trials using external assessment methods, standardized measurement tools and reporting long-term data are recommended to evaluate the efficacy of courses on history taking.
Highlights
This paper is an up-to-date systematic review on educational interventions addressing history taking
Review objectives This review aims to answer the following questions: (1) What interventions to teach history taking to medical students exist? (2) How has the effectiveness of these interventions been measured? (3) What is the quality of evidence for these interventions?
Two were modified cohort controlled studies and one a nonrandomized, three-group post-test. Of those studies reporting the duration of their educational interventions, the shortest intervention took two hours and the longest took seven 4-hour sessions (28 h)
Summary
This paper is an up-to-date systematic review on educational interventions addressing history taking. The authors noted that despite the plethora of specialized training programs designed to enhance students‘ interviewing skills there had not been a review of the literature to assess the quality of each published method of teaching history taking in undergraduate medical education based on the evidence of the program’s efficacy. Scientific discoveries and technological innovations of the last decades fundamentally changed diagnostics and treatment of diseases. Interview skills contribute significantly to problem detection, diagnostic accuracy, patient and physician satisfaction, patient adjustment to stress and illness, patient recall of information, patient adherence to therapy and patient health outcomes [7,8,9,10,11]. Accuracy of diagnoses and the establishment of a good physician-patient relationship depend on effective communication within the medical interview [12, 13]. Physicians garner 60–80 % of the information that is relevant for a diagnosis [13,14,15,16,17] and the history alone can lead to the final diagnosis in 76 % [13]
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