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Assessment of medical consultations performed by incoming residents in Pediatrics

Various authors have reported that medical consultations produce better results when based on the patient-centered model. OBJECTIVE: The objective of this study was to evaluate whether incoming residents in pediatrics conducted outpatient consultations according to the patient-centered model. METHODS: In 2007, ten residents in the early stage of their outpatient rotation were randomly selected to be filmed during a consultation. With the patient-centered model as the theoretical reference, the data were analyzed by means of a qualitative methodology using an exploratory technique, with three independent judges. RESULTS: The majority of the residents: explored the first complaint reported by the patient's parents too early, assuming that it was the principal complaint; failed to explore other complaints; made decisions and provided treatment instructions without sharing the process; spoke little with the children; left long periods of silence during the consultation; failed to explain the physical examination to the parents; and sometimes used the patient chart as their principal source of information. CONCLUSION: Residents conducted consultations without including the parents'perspective and thus failed to meet the central premises of the patient-centered model.

Patient-Centered Care; Videotape Recording; Interviewing; Communication; Doctor-Patient Relationship; Medical Education; Child


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