Pro forma: impact on communication skills?

Background: A doctor performs 160 000-300 000 interviews during a lifetime career, thus making the medical interview the most common procedure in clinical medicine. It is reported that 60-80 per cent of diagnosis is based on history taking, yet there is little published data advising on the best method for medical students to initially attain and further refine these core skills during their medical degree.

Methods: Medical students interviewed two patients: using an open interview first, based on the Calgary-Cambridge approach, and then using a structured pro forma. The students' medical data were assessed by a senior lecturer, and their communication skills were assessed by a behavioural scientist and by the patients.

Results: An exact Wilcoxon paired signed rank test was conducted to determine whether there was a difference between the open interview and pro forma methods for history taking and communication skills. The test yielded p-values of 0.0017 and 0.069, respectively, with the pro forma method providing a statistically significantly higher history-taking score and communication score than the open interview method. Subjectively, patients reported the pro forma method as being preferable.

Conclusion: Medical students in the early years of training benefit from a structured history-taking pro forma to assist them gather an accurate data set without compromising their interpersonal and communication skills.