Instrumental strategy: A stage in students’ consultation skills training?

Figures & data

Table I.  A framework of the focus-group analysis process.

Elements of meaning (examples)	Subcategory	Category	Theme
…they looked, with respect to their body language, as if they were listening closely … engaged posture … were very listening from the beginning…	Inviting body language	Initially attentive
…open questions … they listened to the patients and often let them finish what they had to say…	Open questionsListening	Listening attitude	Open invitation
…with this type of wide-open attitude, no boundaries are set, so the patient is abandoned instead … they play a waiting game…	Patient left in interview structure	One-sided collection of medical facts	Instrumental strategy
…some kind of medical checklist, you must not forget anything… questions such as ‘What medication are you taking?’ ‘Do you have any illnesses? ‘, aimed at objects or facts…	Following a medical checklist
…they do not regard the patient as a person; he/she is a symptom…	Patient's life experiences absent
…not so spontaneous, more fixed by rules and norms…	Lack of spontaneity	Relationship building cost
…you are somewhat replaceable in the encounter … anyone could meet this patient and ask the same questions…	Replaceability
….they so completely overlook the patients’ anxiety, actually, even when it's severe…	Emotions not noticed

Figure 1. An hourglass as a tentative metaphor for physicians’ development of communication strategies. An instrumental influence seems to occur during undergraduate clinical education that affects students’ communication strategies. The widening in the lower part of the hourglass may depend on postgraduate consultation training.