Communicative difficulties perceived by medical students in their first interviews with patients: Presenter(s): Roger Ruiz Moral, Universidad Francisco de Vitoria, Spain

to explore the communicational difficulties that medical students experience previously going to their clerkships in their first interviews with patients with the main purpose of taking a medical history A qualitative and quantitative study in 126 3rd year medical students from a university. The students consecutively interviewed three simulated patients (SP) with the aim of taking the history and develop a professional conversation. After each interview, a workshop was held in small discussion groups where the problems experienced were systematically collected. These results were categorized by four faculties following an inductive process and corroborated by the students. Through scales, the SP valued the kindness, respect and interest in their concerns shown by the students. Students also reported the level of comfort perceived along the conversations. 84 students completed the three interviews and attended the three workshops. The reported difficulties were conversational and related to such basic aspects as: lack of medical knowledge and responding appropriately to situations such as changes of direction or interruptions in the conversation, the need to overcome presuppositions, prejudices, or avoid parallel internal dialogues that are not aligned with the main topic of the talk. The perception of the SP improved from the first (73.6) to the third interview (82) (95% CI, 2.9-14.1) (p:.003). Students are insecure in their knowledge and have difficulties to keep spontaneity and two way talks with patients. This prevents them from actively listening, affecting the natural flow of the conversation and the search for a balance to focus on the patient and at the same time to develop their own “agenda”. These findings, different from those usually communicated, must be confirmed with more powerful methodological strategies, and can guide more specific educational interventions at these academic levels to help students face more complex conversations.