Skip to main content
PMC home page
Journal of the Royal Society of Medicine logoLink to Journal of the Royal Society of Medicine
. 1987 Jun;80(6):343–346. doi: 10.1177/014107688708000606

Teaching students of medicine to listen: the missed diagnosis from a hidden agenda.

S Menahem
PMCID: PMC1290851  PMID: 3625687

Abstract

This paper describes the ability of 4 senior students to recognize and deal therapeutically with the hidden agenda of patients--the covert concerns or second diagnosis other than the presenting problem. This naturalistic study was hospital-based and used ambulatory patients with common paediatric problems. The patient encounter was videotaped and subsequently analysed to determine the patient's hidden agenda. The findings indicated that the students had some difficulty in correctly diagnosing the patient's presenting problem or primary diagnosis. They also failed to recognize and deal with their patients'/parents' hidden agendas. The relevance of these findings to patients care is discussed.

Full text

PDF
343

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Engel G. L. Care and feeding of the medical student. The foundation for professional competence. JAMA. 1971 Feb 15;215(7):1135–1141. [PubMed] [Google Scholar]
  2. Farsad P., Galliguez P., Chamberlin R., Roghmann K. J. Teaching interviewing skills to pediatric house officers. Pediatrics. 1978 Mar;61(3):384–388. doi: 10.1542/peds.61.3.384. [DOI] [PubMed] [Google Scholar]
  3. Helfer R. E. An objective comparison of the pediatric interviewing skills of freshman and senior medical students. Pediatrics. 1970 Apr;45(4):623–627. [PubMed] [Google Scholar]
  4. Kassirer J. P., Kuipers B. J., Gorry G. A. Toward a theory of clinical expertise. Am J Med. 1982 Aug;73(2):251–259. doi: 10.1016/0002-9343(82)90187-5. [DOI] [PubMed] [Google Scholar]
  5. Kent G. G., Clarke P., Dalrymple-Smith D. The patient is the expert: a technique for teaching interviewing skills. Med Educ. 1981 Jan;15(1):38–42. doi: 10.1111/j.1365-2923.1981.tb02313.x. [DOI] [PubMed] [Google Scholar]
  6. Korsch B. M., Gozzi E. K., Francis V. Gaps in doctor-patient communication. 1. Doctor-patient interaction and patient satisfaction. Pediatrics. 1968 Nov;42(5):855–871. [PubMed] [Google Scholar]
  7. Maguire G. P., Rutter D. R. History-taking for medical students. I-Deficiencies in performance. Lancet. 1976 Sep 11;2(7985):556–558. doi: 10.1016/s0140-6736(76)91804-3. [DOI] [PubMed] [Google Scholar]
  8. Meadow R., Hewitt C. Teaching communication skills with the help of actresses and video-tape simulation. Br J Med Educ. 1972 Dec;6(4):317–322. doi: 10.1111/j.1365-2923.1972.tb01862.x. [DOI] [PubMed] [Google Scholar]
  9. Menahem S. Interviewing and examination skills in paediatric medicine: videotape analysis of student and consultant performance. J R Soc Med. 1987 Mar;80(3):138–142. doi: 10.1177/014107688708000304. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Menahem S., Julian J. C., Skoroplas A., Driver S. C. Video recording in paediatric medicine--technique and educational benefits. J Audiov Media Med. 1984 Oct;7(4):124–126. doi: 10.3109/17453058409155943. [DOI] [PubMed] [Google Scholar]
  11. Menahem S. Therapeutic concern for the "nonpresenting symptom" in pediatric practice. Child Psychiatry Hum Dev. 1983 Winter;14(2):87–96. doi: 10.1007/BF00707673. [DOI] [PubMed] [Google Scholar]
  12. Raimbault G., Cachin O., Limal J. M., Eliacheff C., Rappaport R. Aspects of communication between patients and doctors: an analysis of the discourse in medical interviews. Pediatrics. 1975 Mar;55(3):401–405. [PubMed] [Google Scholar]
  13. Rutter M., Cox A. Psychiatric interviewing techniques: I. Methods and measures. Br J Psychiatry. 1981 Apr;138:273–282. doi: 10.1192/bjp.138.4.273. [DOI] [PubMed] [Google Scholar]
  14. Sanson-Fisher R., Fairbairn S., Maguire P. Teaching skills in communication to medical students--a critical review of the methodology. Med Educ. 1981 Jan;15(1):33–37. doi: 10.1111/j.1365-2923.1981.tb02312.x. [DOI] [PubMed] [Google Scholar]
  15. Sanson-Fisher R., Maguire P. Should skills in communicating with patients be taught in medical schools? Lancet. 1980 Sep 6;2(8193):523–526. doi: 10.1016/s0140-6736(80)91844-9. [DOI] [PubMed] [Google Scholar]
  16. Stillman P. L., Fulginiti V. A., Rousseau E., Sabers D. L. Results of a survey of pediatric clerkship programs in American medical schools. Am J Dis Child. 1981 Apr;135(4):348–351. doi: 10.1001/archpedi.1981.02130280038013. [DOI] [PubMed] [Google Scholar]
  17. YUDKIN S. Six children with coughs. The second diagnosis. Lancet. 1961 Sep 9;2(7202):561–563. doi: 10.1016/s0140-6736(61)90519-0. [DOI] [PubMed] [Google Scholar]

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press

RESOURCES