Physician, Schpiel Thyself (The Pediatric Interview) | Everything You Always Wanted to Know About Pediatric Health and Development (But Were Too Afraid To Ask) (Pediatric Health/Development) | 5 Simple Trick to Relate to Pediatric Patients That Medical School Administrators Very Much Want You To Know (Exam Room Skills) |
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Doctor-Parent-Patient Triad Relationship?
Pediatricians are unique in that they must build this type of multi-facing relationship during patient interactions.
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behavioral and developmental problems
A component of the pediatric interview is addressing purely medical concerns, however, more and more children are being seen for this.
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Everyone; Build Rapport with child and family. (even if the patient is an infant you can address them specifically by saying something like “Look at you! You’re getting so big”)
When entering the room, the pediatrician should acknowledge this individual first.
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Address the child by name, Invite the child to state the problem, Ask direct questions to the child, Give advice and explain treatment plans to the child in words they can understand?
Pediatricians often use these interview strategies to better help children express themselves.
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Adolescents (13 yrs and up)
These individuals are able to integrate multiple factors to understand illness and see its cause to be from a physiologic organ or process experiencing a dysfunction internally, in which symptoms are seen externally
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At their eye level
When speaking to a child, pediatricians often position themselves in this manner to make them (the child) feel more comfortable and less afraid?
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Preschool (3-5 years old)
Direct history-taking from the pediatric patient can begin at around this age range.
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School aged children (6- 12 yrs)
This age group will be able to distinguish what is internal and external to self and state the the illness was caused by a person, object or action external to themselves
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Play (ex. You can playfully ask the patient if he has a coin in his ear or if he has icecream in his belly)
This “central metaphor” is an effective way for pediatricians to communicate with kids in a fun, friendly manner.
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Who lives with you at home, who takes care of you, what are things that make you happy or sad, what do you like to do with your mom and dad, what do you like to do with your friends etc.
These simple, social questions can be directed toward children who are preschool age and up.
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Preschool children (3-5 yrs)
At this stage of development, a child may see medical procedures as a punishment and see the cause of their illness to be by an external concrete phenomenon like “from the sun”
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Distraction
This “simple trick” is often used by pediatricians to help young children get through potentially difficult or scary parts of the doctor visit such as the vaccination process.
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Small Adults
If you want to make it past your Pediatrics rotation, be sure to never address children as this 2-word phrase
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Fluoride/pathogen/chemical exposure of child
Why is asking about the house’s water source (city water/well water) important?
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Seated in Parent’s lap or arms or on the exam table
Toddlers are notoriously mobile and love to yell, open and close drawers, and abscond with loose medical equipment. They can be placed in this position to minimize chaos.
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