Direct Observation Learner Expectations

Psychiatry Direct Observation of History Taking Skills Learner Expectations

Scenario: You will be asked to interview a patient who was accompanied to the psychiatry clinic by a family member, caregiver or friend.

The student is expected to demonstrate the following behaviors:

• Setting the stage/preparation

  • Student reviews the presenting scenario and the patient information prior to the encounter.

• Greeting the patient/Establishing initial rapport

  • Student introduces self using first and last name.

  • Student states their current level of training as a medical student.

  • Student states their role in the patient's care.

  • Student actively verifies the patient name and date of birth.

• Initiating information gathering

  • Student asks the presenting problem or reason for the patient to present to the care site.

  • Student asks about any recent experience of passive suicidal ideation.

  • Student asks about any recent experience of active suicidal ideation.

  • Student asks about any recent thoughts about a specific plan for committing suicide.

  • Student asks about any recent action to commit suicide.

  • Student asks about any passive or active suicidal ideation at present.

• Exploring biomedical perspective of disease including relevant background and content

  • Student asks at least five key and relevant acute risk factors for presenting problem.

  • Student asks at least four key and relevant chronic risk factors for presenting problem.

• Exploring patient’s perspective of illness

  • Student acknowledges difficulty of sharing painful thoughts and feelings.

  • Student demonstrates respect towards patient through behaviors, words and demeanor.

  • Student demonstrates empathy towards patient through behaviors, words and demeanor.

  • Student acknowledges feelings, concerns and anxieties of patient by verbally recognizing and legitimizing them.

• Closing the encounter

  • Student verbalizes appropriate wrap-up and reference to next steps.

  • Student clarifies that the patient’s safety is the primary concern.

  • Student recommends the most appropriate next step and conveys the choice to the patient.

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Psychiatry Direct Observation of Mental Status Examination Skills Learner Expectations

Scenario: You will be asked to interview a patient who was accompanied to the psychiatry clinic by a family member, caregiver or friend.

The student is expected to demonstrate the following behaviors:

• Setting the stage/preparation

  • Student reviews the presenting scenario and the patient information prior to the encounter.

• Greeting the patient/Establishing initial rapport

  • Student Introduces self using first and last name.

  • Student states their current level of training as a medical student.

  • Student states their role in the patient’s care.

  • Student actively verifies the patient name and date of birth.

• Initiating information gathering

  • Student asks the presenting problem or reason for the patient to present to the care site with an open-ended statement.

  • Student asks patient to elaborate further regarding the presenting problem.

  • Student asks about current mood state.

  • Student assesses orientation to time, location, and person.

  • Student asks at least one question that assesses attention/concentration.

  • Student asks at least one question that assesses short term memory.

  • Student assesses abstraction.

• Exploring biomedical perspective of disease including relevant background and content

  • Student asks at least one question that explores possible delusions

  • Student asks about delusions of reference

  • Student asks about delusions of grandeur

  • Student asks about persecutory delusions

  • Student asks about visual hallucinations

  • Student explores visual hallucinations

  • Student asks about current visual hallucinations

  • Student asks about auditory hallucinations

  • Student explores auditory hallucinations

  • Student asks about current auditory hallucinations

  • Student asks specifically about command hallucinations

  • Student asks about consequences of command hallucinations

  • Student asks about any recent thoughts of committing suicide

  • Student asks about ideas of harming others

  • Student asks about any recent action plan to harm others