Every pediatrician encounters vexing interview situations such as confronting parents with child abuse, conveying news of a child's impending death, discussing noncompliance with a chronically ill adolescent, and suggesting a psychosocial explanation for an illness perceived to be organic by the patient and family. In these situations the experienced interviewer will employ specific techniques and address certain focal points to enhance effective communication.
How do physicians develop these skills? The model of "See one, do one, teach one" pervades in medicine. However, students and residents see (and perform) far more lumbar punctures and neurologic examinations than they do interviews regarding child abuse, dying children, and psychosomatic illness. Apparently, it is expected that trainees will perform competently in complex interview situations without the same exposure to models and practice under observation that they receive in more "purely medical" or procedural situations. We believe this expectation is erroneous. Werner and Schneider1