The definition and evaluation of the skills required to obtain a patient's history of illness: The use of videotape recordings

Abstract

Videotape recording apparatus was used to make records of case histories obtained from patients by students and doctors. These records were studied in order to identify the skills required to obtain a patient's history of illness. Each skill was defined. A questionnaire was developed in order to assess these skills and three independent observers watched the records of eighteen students and completed a questionnaire for each. The results of this were analysed for reliability and reproducibility between examiners. Moderate reliability and reproducibility were demonstrated. The questionnaire appeared to be a valid method of assessment and was capable of providing significant discrimination between students for each skill. A components analysis suggested that the marks for each skill depend on an overall impression obtained by each examiner and this overall impression is influenced by different skills for each examiner.