Medical Interview Checklist

Beginning the Interview

Skill
Appropriate

USE
Not Appropriate

Not Done

Greets the patient

Introduces self
Explains role
Take Consent
Ensures privacy
Addresses confidentiality
Allows patient to complete opening statement
Information gathering and content of interview
Presenting complaint
Gathers basic patient details and statement of
presenting problem
Onset and duration
Where (location & radiation) if relevant
Progression
Quality
Quantity (severity)
Aggravating factors
Alleviating factors
Associated symptoms
Beliefs
Review of Systems
Other medical history

Past medical & surgical history

Medications & Allergy
Family history
Social history
Smoking and alcohol
Diet and exercise
Communication skills

Covered in
detail

Partially covered

Not covered

Covered in
detail

Partially covered

Not covered

Competent

Partially competent

Not competent

History-taking
very poorly
organised

History-taking
partially organised

History-taking
very wellorganised

Use of open-ended questions

Non-verbal skills (eg eye contact, posture,
gesture, position)
Verbal skills (e.g. reflective listening,
facilitation, avoiding jargon)
Summary & Presentation
Overall organization