Approaches to History Taking in Medical Education

Niall Watts

University College Dublin

Many medical students find it difficult to take patient case histories. This is particularly the case when dealing when sensitive areas such as mental health and fertility. Traditionally in this university taking of case histories was taught by lecture. Instructivist methods of teaching are not the most effective or appropriate way of developing the skills and sensitivity required.
Accordingly, it was decided to take a technology-enhanced approach to the teaching of patient history taking in psychiatry and gynaecology. These case studies make extensive use of video clips where actors play the role of patients and doctors take the part of medics. They are available to students through the university VLE.
Such case studies can take different either a problem-solving or narrative approach (Bearman et al, 2001). In the gynaecology case study the students are presented with a range of answers to key questions and are encouraged to try all options, while the psychiatry case takes a more narrative approach with students answering questions based on information presented in the video clips.  In both cases the focus is on the use of appropriate interview techniques. Students can record their observations, reflect on their learning and communicate with their tutor in a virtual notebook.
Initially, Flashform from Rapid Intake was used as a rapid elearning development tool. Recent psychiatry case studies have been developed with Articulate. The presentation will compare the two tools and discuss issues involved in tool selection and standards compliance.  Both SCORM and the MedBiquitous standard (Ellaway et al, 2008) for developing virtual patients will be discussed. Our aim is to share our recent resources with other medical schools and teaching hospital both through exchange and repositories.
Bearman, M et al (2001) Random comparison of `virtual patient’ models in the context of teaching clinical communication skills, Medical Education;35:824±832.
Ellaway, R et al (2008) Building a virtual patient commons, Medical Teacher; 30:2,170 — 174.

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