Chapter 1: Approach to the Clinical Encounter - Summary
Foundational Skills in the Clinical Encounter
Clinical skills encompass taking history, performing examinations, and
implementing interventions. These skills evolve with practice and are
critical for building patient relationships and clinical competence.
Integrating biomedicine within patients' personal, cultural, and social
contexts is vital.
Approaches to the Clinical Encounter
1. Clinician-Centered Approach: Focuses on symptoms and disease
diagnosis but may overlook personal dimensions of illness.
2. Patient-Centered Approach: Prioritizes patients' personal concerns,
emotions, and the illness's impact on their lives.
oEffective care merges both approaches to balance understanding
of disease (clinical perspective) and illness (patient’s
experience).
Structure of the Clinical Encounter
Based on the Enhanced Calgary-Cambridge Guides, clinical encounters
consist of five stages:
1. Initiating the Encounter:
oBuild trust and rapport.
oSet the stage by preparing the environment and reviewing
clinical records.
oGreet the patient respectfully and establish initial rapport.
oDetermine the agenda collaboratively.
2. Gathering Information:
oUse open-ended questions to elicit the patient’s story.
oExplore the patient’s perspective of illness, including concerns,
expectations, and emotional responses.
3. Performing the Physical Examination:
oConducted systematically and respectfully.
