The keys to a successful subjective interview

The subjective interview is undoubtedly the most important aspect of a physiotherapy assessment. Without it, we're shooting in the dark when it comes to our objective. There's an art to interviewing, and it requires a skill set that takes decades to properly hone. The most important skill in that set is the ability to stop talking and truly listen. Even when we aren't talking it's difficult to not let our minds wander or to look ahead to the next question.

Pay close attention the next time you're watching an interview on TV--it will become painfully obvious when the reporter has lost focus. The interviewee will have been talking for a few minutes and the next question will seem out of the blue or will be one that has already been answered. I am guilty of doing this as well. This became apparent when interviewing subjects for my research project. I did well to let subjects talk without interruption, but as soon as they drifted from directly answering my question, I found myself planning my next question instead of listening to what they had to say. This decreased the flow of our interviews, making my transcripts choppy and hard to read.

As a whole, we as clinicians often struggle with the listening aspect of interviewing. We've got questions to ask and we need answers. A study published in the Journal of General Medicine found that, on average, patients are given 11 seconds to describe the purpose of their visit before they are interrupted by their doctor. While we have time constraints that require efficient interviewing skills, 11 seconds is far too little time to understand our patients complaint, motivation, and expectations.

I listened to a great TEDx talk by journalist, author, speaker, and musician, Celeste Headlee. She interviews people every day to help them to tell their story. She spoke of a few techniques that she uses to create high quality interviews and meaningful conversations. To her, the ingredients of a great conversation are honesty, brevity, clarity, and a healthy amount of listening.

First, it is important to be able to go with the flow when interviewing a patient. When your patient is speaking and questions come to mind, let them come and go so you are able to listen more fully. As clinicians there are important things to address in our assessments, but if we are too rigid in our questioning our rapport will suffer. Patients will tell you how to fix them if you give them the time to speak freely.

Secondly, don't equate your experience with theirs. This advice struck me to be a bit funny when I first heard it but the more I've thought about it, the more sense it has made. Empathizing does not mean "I've experienced that as well and here's how". It's understanding their feelings and experience without comparing them to our own. It's not about us, and the more we make the interview about them, the more likely they will be able to feel comfortable and open up.

As a physiotherapist, these two tips have drastically improved my subjective interviews, helping me to better understand each of my patients and direct their care. I highly recommend checking out the talk yourself. I found it on TED Talks Daily on Spotify.

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