Today we had our first of 6 practical sessions in Health Psychology. This is pretty exciting because up until now, the majority of what we've been doing has been theory through lectures, with the exception of anatomy labs (for now just looking at bones --> real ones not models, but still not that crazy yet), and physiology labs (though hematology didn't include much work, and our spirometry lab was also mostly answering questions, not much practical application yet). So I'm pretty excited to actually start doing some practical work.
The class started with a "short" lecture about naturopathic intake interviews from Dr. Creech (1 hour, but that's short compared to the normal 3 hour one). We then split into a bunch of groups and went off to different rooms (my group unfortunately had to stay in Classroom 4, especially bad because it was really cold today), each group getting assigned a TA who is an ND. My TA for the class is Dr. Rajesh Ragbir. He's a pretty interesting guy, considering that he was some sort of mechnical engineer before he changed his career path to become an ND (he used to fix and automate A/C and heat systems).
The class was relatively easy-going for today. We just got into a circle and all introduced ourselves, talked about what our experience in health psychology was and what we were hoping to get out of the class. Then we talked about some different strategies when speaking with patients, the one that really stood out to me is from the acronym OARSS.
O - Open-ended questions. Dr. Ragbir really emhpasized that we should ask questions with a genuine type of curiosity. Even if you know the answer to something, you should still ask as if you don't know, because this way you get the most information from a patient that can be helpful to the case. For example, if a patient comes in and tells you that their family doctor recently diagnosed them with type II diabetes, obviously a naturopathic doctor knows what this means. But by asking a question like, "what does that mean to you?" you are able to learn how much the patient knows about the disease and how it will affect them, and even draw out other information about emotional and spiritual effects. Open-ended questions are very powerful, and definitely have a very important place in the naturopathic interview.
A - Affirmations. It is important to affirm what the patient says because it provides them with an understanding that you as the doctor trust and believe in them. This helps to build rapport and more importantly, strengthen the relationship between doctor and patient that can lead to successful treatment.
R - Reflections. It is also important to provide the patient with reflective statements on what they have told you, because it is an effective way of communicating empathetically, and this obviously has a lot of merit in practice.
S - Summarize. This is a very key step to interviewing, because it shows the patient that you were listening and helps them to feel "heard." This is a very important aspect of the naturopathic interview, because many patients come in feeling that they haven't been fully heard, and by summarizing you can validate their feelings. In addition, this step allows you to confirm if you understand what the patient has told you, allows them to correct any mistakes in the information you have taken down, and finally, it may draw out more information that they didn't think about at the time.
S - Silence. This last S is actually an addition (the real acronym for motivational interviewing is OARS), but Dr. Ragbir liked to add this one because silence is also a key aspect. Many interviewers can get worried and uncomfortable about silence, but it actually has a lot of power if used effectively, and can strengthen the doctor-patient relationship. "Silence is golden," can really be true in this situation, as effective use can provide a lot of benefits during the interview.
That's it for today, looking forward to the next practical where we'll focus on automatic reactions (which I bet I have some serious trouble with, body language!), and hopefully get into even more role playing and examples.
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