title: How should trainees be taught to open a clinical interview?
abstract: OBJECTIVE
  To characterise the opening of secondary care consultations.
  
  
  METHODS
  We audio-taped 17 first consultations in medical clinics, transcribed them verbatim, and analysed verbal interactions from when the doctor called the patient into the consulting room to when she or he asked clarifying questions.
  
  
  RESULTS
  The interviews did not open with the sequence, reported by previous researchers, of 'doctor's soliciting question, patient's opening statement, interruption by the doctor'. Doctors (1) called the patient to the consultation; (2) greeted them; (3) introduced themselves; (4) made a transition to clinical talk; and (5) framed the consultation. They used a referral letter, the case notes, computer records and their prior knowledge of the patient to help frame the consultation, and did so informally and with humour.
  
  
  CONCLUSIONS
  These 5 steps could help trainees create a context for active listening that is less prone to interruption.
authors.affiliation: School of Medicine, University of Manchester, Manchester, UK.
authors.forename: Alex
authors.initials: A
authors.lastname: Walter
authors.forename: Chris
authors.initials: C
authors.lastname: Bundy
authors.forename: Tim
authors.initials: T
authors.lastname: Dornan
mesh_terms: D002983:Clinical Competence / Q000592:standards; D003142:Communication; D004504:Education, Medical, Undergraduate / Q000592:standards*; D006801:Humans; D007407:Interviews as Topic / Q000592:standards*; D010817:Physician-Patient Relations; D013663:Teaching / Q000379:methods* / Q000592:standards