Adolescent Interview

We had an Objective, Structured Clinical Encounter (OSCE) exercise on Monday where we ran through 5 different patient scenarios. Yesterday, I reviewed my performance with a simulated "well visit" by an adolescent - I believe she was supposed to be 16 years old. Today, we talked a bit about child psychology and interviewing adolescents. I'm glad I still remembered some of the key points in adolescent health - "HEADS" is the acronym they teach us: Home, Education/Environment, Activities, Drugs/Alcohol, Sex/Suicide/Safety. I hit most of the key points, but the entire exercise was rather carefree in stark contrast to previous OSCEs I've taken. Much of the relaxed atmosphere came from knowing that this exercise was neither graded nor critical for passing the course - we merely had to be present. Ironically enough, it was this low-key atmosphere that made the entire interview rather pleasant and felt "real". I found myself easily discussing things like illicit drug abuse (she tried coke once), quitting smoking, sex, etc. and in the end I felt I learned something. I learned that people do not like to be lectured - they want to be informed, but not judged. I found that it was very easy to talk about the dangers of marijuana or cocaine abuse, and not be judgemental. I consistently reiterated that I'm not their parents, and I'm not there to tell them right from wrong. I'm a resource, I told her - a fund of knowledge from which she may ask any questions she wants without fear of disclosure (of course, I did insert the typical disclaimers regarding hurting someone). From there it was an easy step to talk about the consequences of certain actions and to put it in a very objective, unpersonal manner. I feel that this let the adoscelent teen put her guard down as I encouraged more participation from her in the interview versus me lecturing her on the do's and don'ts.