CLINICAL COMMUNICATION SKILLS: HOW TO STRUCTURE A CLINICAL INTERVIEW?

Introduction and Objective: Clinical Interview is a key tool in the clinician’s everyday work, being that patient satisfaction is closely related to the effectiveness of the clinician-patient communication. The aim of this review is to present a structure of an organized clinical interview, supporting the patient‘s narrative and managing the available time. Methods: Literature review in sites of evidence-based medicine. The search was conducted using the MeSH keywords: “Communication", "Consultation" and “Patients”. Results and Conclusions: The clinical interview is structured in six steps: start the interview, collect information, perform the physical examination, share information, make decisions and plan, and close the interview. In “Start the interview”, the context is prepared, the patient is admitted and a consultation plan must be established. There follows “Collect Information”, focused on the patient and on the clinician. After the “Physical Examination”, the "Information Sharing" takes place, using the "Ask-Tell-Ask" technique. Then it is time for the "Decision Making and Planning", where the patient should have an active part in choice of an appropriate plan for the problem. Finally, in "Closing Interview", the clinician should summarize and review the plan, verify that it was understood, schedule the next interview and reassure the patient. "Giving Structure" is one of the key elements a clinician should promote in the interview and contributes to a better management of the available time, address the issues defined as priorities either by the patient or the clinician, guide the interview without taking the patient protagonism and maintain a therapeutic relationship.