Stuck with the patient--what would my colleague have done? A videorecorded consultation experiment with an actor simulating as the same patient for different doctors.
The aim of the experiment, in which four general practitioners met an actress who played a patient, was to explore how different doctors approach an identical patient problem. According to the patient role the actress had two reasons for encounter: (i) tachycardia and (ii) fear of HIV infection, which she had great difficulty in telling and presented only by indirect cues. The doctors knew they were meeting an actress, but the patient role description was unknown. Most of the time in each consultation was spent on tachycardia, the first presented symptom. None of the doctors paid real attention to the patient's signals of emotional distress and did not discover her fear of being HIV positive. Evaluation of the recordings and transcripts revealed some keys to understand why the doctors missed essential signals from the patient and felt stuck. It was difficult for the doctors to see their own role in blocking communication until the patient perspective was fully explored during the process of evaluation.
Aaraas
I
I
Institute of Community Medicine, University of Tromsø, Norway.
Lundevall
S
S
Njølstad
I
I
Melbye
H
H
D003657:Decision Making; D005194:Family Practice / Q000379:methods*; D006679:HIV Seropositivity / Q000175:diagnosis; D006801:Humans; D016544:Patient Simulation; D010817:Physician-Patient Relations; D012017:Referral and Consultation; D013610:Tachycardia / Q000175:diagnosis; D014743:Videotape Recording