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Which employment interview skills best predict the employability of schizophrenic patients?

To examine the effects of verbal and nonverbal interview microbehaviors and interview characteristics on employability, Simulated Employment Interviews were conducted with 46 psychiatric inpatients who each met the DSM-III criteria for a diagnosis of schizophrenia. Each interview was videotaped and shown to two raters, who generated independent ratings for six microbehaviors (eye-contact, facial gestures, body posture, verbal content, voice volume, and length of speech) and six subject characteristics (motivation, self-confidence, ability to communicate, manifest adjustment, manifest intelligence and overall interview skill). A panel of three Commonwealth Employment Service psychologists viewed the same videotaped interviews and generated employability ratings. Verbal and nonverbal microbehaviors were relatively independent while subject characteristics were highly interdependent. Microbehaviors and characteristics correlated at a high level. Of the 12 interview microbehaviors and characteristics, manifest adjustment and ability to communicate accounted for 64% of the total variance in predicting employability. Interviewees who were perceived as behaving in an adjusted manner and as being good communicators were rated as more employable.

Adult↗

What you ask is what you get: learning from interviewing in qualitative research.

This paper outlines some important issues discovered about undertaking qualitative interviews. A description of a study that involved interviewing the authors' students is followed by discussion of aspects of the interviewing process that became apparent during analysis of those interviews. Problems that were encountered with retrospective interviews, power differentials, question sequencing, some interview techniques, and a prior knowledge of the students are illuminated to assist other qualitative interviewers to be aware of these potential areas of difficulty.

Clinical Nursing Research↗

Suburban versus urban: does it matter where the residency interview begins?

Geographic location is an important factor in students' ranking of residency programs. Our program's inner city location has a negative impact on our recruitment efforts. In an attempt to assess the impact of geography, we started half of the residency interview days at our suburban community medical center and then measured the effect on the applicant's perception of the program. During the 1998-1999 residency interview season we alternated the site at which the day began. Students were randomly assigned based on interview date requests to starting the day at the urban hospital or at the community hospital. At the conclusion of the day the students completed a questionnaire regarding various components of the interview day and how their perception of the program was influenced by the experience. Of 206 students asked to complete the questionnaire, 188 (91%) completed the survey. The degree to which the students' perception of the program was affected was remarkably similar regardless of where the interview day began; however, significant differences were found between the Chairman's Talk, the Teaching Session, and talking with current residents when compared by univariate analysis. We concluded that students' perception of the program at the conclusion of the interview day was similar regardless of whether the interview day began at an urban or suburban medical center.

Career Choice↗

Extended psychiatric interview and medical students: a tool for teaching psychotherapeutic skills.

BACKGROUND: There is difficulty in teaching medical students clinical psychiatric skills, specifically the clinical interview and general psychotherapeutic technique. We present a way to convey to students the ability to assess and make contact with patients while being aware of and utilizing their own presence as part of the therapeutic process. We describe a model for teaching these skills based on a prolonged clinical interview. METHODS: Medical students in their second clinical year interview new attenders at a public mental health clinic treating a range of neurotic and personality related disorders. Each student is assigned one patient whom he interviews independently at three weekly sessions lasting an hour. The students remain the sole therapeutic contact and are instructed to conduct an open interview with the purpose of maintaining therapeutic contact while gathering relevant information and assessing psychopathology. Supervision is conducted in a group session each week. RESULTS: It is our impression that despite initial resistance, the students display a remarkable ability to conduct the prolonged interview in the form of a very brief therapeutic encounter. They show considerable appreciation of the basic issues involving transference and counter-transference. Over 20 years experience, there have been no reported adverse reactions in patients assessed in this process. CONCLUSIONS: The supervised experience of an extended psychiatric interview, performed independently by medical students, facilitates the learning and acquisition of basic psychotherapeutic concepts and skills. We propose this model as an effective way of introducing medical students to the psychotherapeutic aspects of psychiatry.

Educational Measurement↗

The cognitive interview: does it successfully avoid the dangers of forensic hypnosis?

Seventy-two undergraduates viewed a videotape of a bank robbery that culminated in the shooting of a young boy. Several days later, participants were interviewed about their recollection of events in the film through baseline oral and written narrative accounts followed by random assignment to a hypnosis (HYP) condition, the cognitive interview (CI), or a motivated, repeated recall (MRR) control interview. Participants also completed a forced interrogatory recall test, which indexed potential report criterion differences between the interview conditions. In terms of information provided for the first time during treatment interviews, HYP led to greater productivity than the CI or the MRR interview, which did not differ significantly from each other. Evidence that these differences in recall resulted primarily from report criterion differences rather than differences in accessible memory was obtained from the forced interrogatory recall test. In this test, no differences were observed between the three interview conditions. Finally, the data revealed that participants' hypnotic ability was associated with the recall of erroneous and confabulatory material for those tested in the HYP and CI conditions but not those in the MRR condition. This suggests that some CI mnemonics may invoke hypnotic-like processes in hypnotizable people.

Adult↗

Introduction of bias in residency-candidate interviews.

We have developed, as part of our resident applicant ranking process, a computerized weighted scoring system incorporating, among other variables, the interview score (IS). This study was undertaken to test the IS as a dependent variable when the applicant file is available during the interview. Over a 3-year period, each of two faculty members interviewed 133 candidates in a "blinded" fashion (file unavailable) or 290 candidates with an "open" file. The mean discrepancy between paired interviewers (1 to 10 scale) was 1.34 +/- 0.10 for the blinded group versus 0.93 +/- 0.06 for the open group (p less than 0.001). Individual and multiple regression analysis were used to test the IS as a dependent variable in the open group, with the blinded group as a control. In each instance (except clerkship grades), the IS correlated more closely with other parameters (p less than 0.05) in the open group. Correlation coefficients were 0.27 (blinded) and 0.64 (open) for weighted scores combining all parameters (p less than 0.001) and 0.39 (blinded) and 0.65 (open) for multiple linear regression analysis (p less than 0.001). We conclude that the IS is significantly influenced if other objective variables are at hand, thus deflating the actual weight of the interview. To accurately quantify the value of the interview, a correction factor must be applied, or, more appropriately, the interview must be conducted blindly.

Academic Medical Centers↗

[The modified psychiatric interview: a study of reliability].

In order to estimate the prevalence of mental disorders in epidemiologic studies in the community, our department has designed the Modified Psychiatric Interview (MPI), a semi-structured interview derived from the Standardized Psychiatric Interview by Goldberg et al. This instrument confirms the presence of "psychiatric cases" and is applied by interviewers with clinical experience. The purpose of this article is to evaluate the degree of agreement between clinical interviewers (using an interviewer-observer design), utilizing MPI in an out-patient population attending a general hospital, as part of an investigation on prevalence of mental disorders at a 2nd. level of medical care. The degree of agreement was calculated in the different sections of the instrument by Pearson's product-moment correlation, Kappa statistic and Yule's "Y" coefficient. The results showed a high level of reliability among the clinical interviewers in each section of the MPI.

Evaluation Studies as Topic↗

Characteristics of the residency interview process preferred by medical student applicants.

This study elucidates the characteristics of the interview day preferred by medical students applying to family practice residencies. Interviews and informal meetings with residents were regarded as being the most helpful, followed by interviews with the director or faculty. Perceptions of other components of the interview day are also described. October was the month most students preferred, and two interviews each lasting 20 to 30 minutes were considered ideal. Group interviews were regarded negatively. The results of this survey are generalizable to other residency programs and could be helpful in planning the interview day.

Attitude of Health Personnel↗

Structured oral interview. One way to identify family physicians' educational needs.

OBJECTIVE: To design and test a structured oral interview that would elicit information on the educational needs of physicians in order to help them plan individualized continuing education. DESIGN: Seven different sets of problems were prepared, each including 40 cases, of which 26 are common. Each pilot test candidate was interviewed by two physician-interviewers during a 1-day session. After each answer, candidates were told the predetermined correct answer. PARTICIPANTS: Six candidates were selected at random from among Montreal physicians aged 50 and older with no hospital privileges. All had to have no history of professional complaints or prosecution and to be unknown to the interviewers. MAIN OUTCOME MEASURES: Inter-rater reliability and perceived difficulty of the cases. RESULTS: Candidates rated the interview process and cases used pertinent, credible, and not too difficult. Candidates' performance level was about 50%. Agreement between interviewers averaged 91.2%. CONCLUSIONS: A structured oral interview appears to be a credible instrument for helping determine practising physicians' deficiencies in clinical knowledge and reasoning.

Curriculum↗

A computer-based interview to identify HIV risk behaviors and to assess patient preferences for HIV-related health states.

We developed a computer-based utility assessment tool to assess the preferences of patients towards HIV-related health states and identify risk behaviors (both sexual and drug related) of the patient being interviewed. The reliability of the computer-based interview was assessed through comparison with person-to-person interviews. Our pilot study included 22 patients. Twelve of these patients were also interviewed by the research assistants in person-to-person interviews. The agreement between the person-to-person and computer-based interviews was excellent (3 discrepancies of 180 compared answers), and the majority of the patients preferred to use the computer to disclose sensitive information regarding risk behaviors. Our study suggests that assessment of patient preferences and risk factors can be performed reliably through a computer-based interview.

Adult↗

[Initial contact in clinical interview with patients suffering from chronic insomnia].

One of the most controversial issue concerning chronic insomnia is its association with psychopathology. Many patients tend to present their sleep disturbances as isolated, whereas others admit that they have difficulties in other sectors of their life too. If psychopathology exists in chronic insomnia, it should manifest itself in the form of defensive mechanisms which can be clinically observed. In order to have information concerning this problem, the initial interview of patients with chronic insomnia has been analysed in every details, in order to detect behavioural features and characteristics of verbal expression, indicating that defense mechanisms are working. A group of 100 patients from the specialized consultation for sleep disorders has been studied They were referred by their physicians. The patients with a somatic disease or a psychiatric condition corresponding to a diagnostic on axis I of DSM III-R were not included. The patients with a form of insomnia corresponding to psychophysiological insomnia, idiopathic insomnia or sleep state misperception of the international classification were included in this sample. For all patients except 2 of them, the initial interview was audiovisually recorded. This interview aimed at establishing the clinical features of the disturbance, the psychiatric and somatic condition as well as the history of the trouble and the treatment taken at the time or attempted in the past. After an initial open query: "what seems to be the problem?", a semi-structured interview was conducted to obtain information about nocturnal sleep, daytime condition, dream and parasomnia, the history of the disturbance and the treatment. Anxiety and depression, as well as other psychiatric conditions were systematically investigated. Under these conditions, the patients showed from the very beginning of the interview, noticeable characteristics in their behaviour and verbal expression. Therefore, it is essentially the first 10 minutes of the interview that have been analysed. One exception was regressive weepiness, which usually appeared later in the interview. The audio-visual recording was analysed two times, two months apart, and a number of individual traits have been scored for presence or absence. Only the most obvious traits have been scored. In the behavioural presentation of the patient, detachment, eye avoidance and distant attitude were most commonly observed. Many patients also showed some signs of tension and anxiety. The other traits were smile, immobility of the body posture, incessant movements and tics, bored attitude, mannerism, difficulties to concentrate, retardation or weepiness. The formal characteristics on verbal expression can indicate logorrhea, or in contrast very parcimonious expression, precipitated elocution which makes the patient difficult to understand, or montonous voice. From the point of view of verbal content, the speech is often vague, hesitant, dispersed or superficial, the patient going rapidly from one line to the next one. Some patients have problems to focus on what they want to explain.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗

Influence of gender on outcomes of medication-history interviewing.

This study investigated the influence of patient and provider gender on the outcomes of medication-history interviewing. In a previous study, 112 pharmacy students conducted medication-history interviews with 2 simulated patients. A secondary analysis was accomplished using complete data from 85 of the original 112 pharmacy students. The other 27 students were eliminated because of missing data. Factor analysis and canonical correlation were used to assess associations between the prior study's set of predictor variables and measures of interview completeness and patient satisfaction with the interview. Female and male pharmacy students appear to use different expressive, interactive, and interrogative skills. Allergy-asking was more complete when female pharmacy students interviewed a male patient. Emotive patient satisfaction was found to be associated more positively with a female student and female patient while teleological patient satisfaction between a male student and male patient was nearly double the result of the female-female dyad. Medication-history interview outcomes appear to differ as a consequence of the use of different sets of skills during same-sex or opposite-sex interviews.

Clinical Competence↗

Training quality job interviews with adults with developmental disabilities.

Supported work models of vocational integration have increased the employability of individuals with developmental disabilities. Interview questions most frequently used and corresponding responses considered most beneficial to job applicants were derived from an empirical analysis of the "hiring community" and served as a basis for the development of the verbal job interview skills training package evaluated in this research. Dependent measures were objective, behavioral indices of the quality of job interview responses. One-to-one training by a direct training staff, job coach, and a trained behavior analyst resulted in improved responding by all subjects as indicated in a multiple baseline design across interview questions. Improved quality in responding to questions generalized to variations in interview questions, to a novel interviewer, and in an in vivo interview situation. Finally, global measures of social validity support the value of the quality-of-response training.

Adult↗

A survey of children's acute, recurrent, and chronic pain: validation of the pain experience interview.

The ultimate objective of our epidemiological research is to complete a longitudinal population-based study to document the prevalence and impact of acute, recurrent, and chronic pain in children and adolescents. As the first phase of our epidemiological research, we developed a comprehensive screening instrument for identifying children with acute, recurrent, and chronic pain, the Pain Experience Interview. We designed this interview to provide information about the lifetime and point prevalence of various pains, and also to provide information about the intensity, affect, duration, and frequency of children's pain. The primary objective of this study was to validate the Pain Experience Interview using the discriminant validation procedure of group differences. The secondary objectives of our study were to obtain descriptive data on children's acute, recurrent, and chronic pain experiences and to conduct exploratory analyses on age- and gender-related differences in children's pain experiences. We interviewed 187 children from five different health groups (arthritis, cancer, enuresis, recurrent headaches, and healthy) to provide distinct subsets of children with respect to their acute, recurrent, and chronic pain experience, and from four different age groups (5-7, 8-10, 11-13, and 14-16 years) to provide distinct subgroups with respect to children's developmental level. To test the interview we determined a priori several study predictions about children's pain experiences. These included four predictions about the common response patterns that we would expect to observe for all children based on our understanding of acute pain caused by trauma/disease, and six predictions about the distinct response patterns that we would expect to observe based on the known differences among children in their experiences of headache, acute treatment-related pain, recurrent pain, and chronic pain. All study predictions were confirmed, demonstrating that the Pain Experience Interview is a valid screening instrument for differentiating children with different types of pain problems. The interview can provide estimates for the lifetime and point prevalence of various pains in children, and data on the intensity, affect, duration, and frequency of their pain experiences.

Acute Disease↗

Agreement between the pharmacy medication history and patient interview for cardiovascular drugs: the Rotterdam elderly study.

AIMS: To study whether there is agreement between cardiovascular drugs presented at patient interview and pharmacy records in an elderly population. SETTING: The Rotterdam Elderly Study, a prospective population based cohort study of people older than 55 years of age. METHODS: We compared cardiovascular drug use as presented during patient interview with the computerized pharmacy medication history. Concordance of cardiovascular drug use in patient interview and pharmacy data was measured by merging the two data sets and assessed in two episodes: in a period of 6 months before patient interview and within the legend duration of each cardiovascular drug. RESULTS: We found 2706 concordant pairs in a total of 3365 prescriptions (80.4%) in the merged data. There were 195 prescriptions presented at patient interview which had not been filled at the pharmacy, and 464 which had been filled but were not presented by the patient. The percentage of concordant pairs slightly increased to 80.6% (2275 of a total of 2824) for prescriptions of which the legend duration included the date of patient interview. The highest agreement was noted with beta-adrenoceptor blocking agents with Kappa statistics of 0.97 for atenolol and metoprolol. The lowest Kappa statistic was found for organo-heparinoid, mainly as ointments against haemorrhoids (0.26). CONCLUSION: The agreement between patient interview and pharmacy records is good for prescription only drugs, and pharmacy records are a useful resource for pharmacoepidemiological studies on cardiovascular agents.

Adult↗

Assessing nursing students' basic communication and interviewing skills: the development and testing of a rating scale.

This study explores the communication skills of a group of nursing students who were required to interview a simulated client as part of their studies. In order to assess the students and to improve the process of learning discrete skills, an instrument was developed and tested as part of this process. The subjects were 212 nurses enrolled in a bachelor of nursing programme, in New South Wales, Australia, who were studying a problem-based learning package the focus of which was 'alcohol early intervention'. The sub-groups within the sample included registered nurses, a significant percentage of whom had completed their basic nursing education in overseas countries. The Simulated Client Interview Rating Scale (SCIRS) was developed to assess basic humanistic communication skills as well as beginning motivational interviewing skills. The students were required to interview a simulated client and demonstrate competence in interviewing. This was assessed by the SCIRS which was completed by the students and the simulated clients. The instrument proved to be a reliable and valid means of assessing student interview technique as well as a flexible educational tool, while valuable insights into students' interviewing techniques were gained.

Alcoholism↗

The use of focus group interviews in Asian medical education evaluative research.

OBJECTIVE: To evaluate the use of focus group interviews in Asian medical education evaluative research. METHODS: Randomly selected medical students were invited to participate in 30 focus group interviews to provide in-depth data about the effect on their learning of the introduction of early clinical skills. Efforts were made to meet all the students to help them understand the objectives of the focus group. Confidentiality was emphasised and a non-faculty interviewer was recruited for the interviews. RESULTS: The students considered the use of focus groups to be a more meaningful way of collecting students' opinions than other methods, for example structured questionnaire, because it allowed an interactive discussion. They also felt that having an independent non-faculty interview moderator had encouraged them to express their opinions more candidly during the interviews. CONCLUSION: The use of focus group interviews among Asian medical students for evaluative research is practical and efficient.

Asia↗

[Effects of interviews during body weight checks in general population surveys].

While surveying actually measured body weight is largely impractical in national surveys, self-reported weight is a simple and inexpensive method of collecting data. Previous research shows that data on reported body weight are falsified by systematic mis-reporting. This bias is said to be the consequence of the sensitive nature of information on body weight. Numerous studies on survey response suggest that certain modes of data collection are more conducive than others for probing sensitive information. This paper investigates the effect of the anonymous interviews, characteristics of the interviewer and respondents' familiarity with the survey, as factors that may impinge on reported body weight. Findings of this paper show that refusals to state the body weight are rare. Moreover, characteristics of interviewers account for only a small fraction of the variance in reported body weight. Yet the hypothesis that the absence of an interviewer in self-administered interviews increases reported body weight can be confirmed. This interview effect, however, occurred in men only. On average, male respondents in anonymous interview settings report on a body weight which is 1 kg more than they would report in other settings. The repeated participation of respondents in the Socio-Economic Panel Study (SOEP) increases their reported body weight accuracy which suggests a positive panel effect on respondents' willingness to disclose sensitive information.

Adolescent↗