[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Clinical exam](https://durgical.com/en/clinical-exam/) › [History taking and the interview](https://durgical.com/en/clinical-exam/#a-history) › The medical interview: rapport, open questions and listening [Clinical exam](https://durgical.com/en/clinical-exam/) · [History taking and the interview](https://durgical.com/en/clinical-exam/#a-history) # The medical interview: rapport, open questions and listening - History The interview is the conversation in which the clinician gets to know the patient and the problem; almost the whole diagnosis depends on it. Updated 2026-11-01 ## Key points - Start with open questions ('What brings you in?') and finish with closed ones ('Does the pain go to your arm?'). - Leading questions ('The pain is pressing, isn't it?') bias the answer and are avoided. - Useful techniques: facilitation, silence, echoing or reflection, clarification, empathy and a final summary. - 'Why' questions sound like an interrogation and make the patient defensive. - Exploring the patient's ideas, concerns and expectations improves agreement on the plan. ## What it is The clinical interview is the encounter in which the history is obtained and the relationship with the patient is built. It combines open questions at the start, which let the patient tell the story, with closed questions at the end, which pin down details. A good interview gathers more complete data, improves adherence and reduces errors. Therapeutic communication techniques are taught the same way in medicine and nursing. ## What it must include - Privacy, seats at the same height and no physical barriers; the phone and the screen do not interrupt. - Plain language without jargon, adapted to age and education. - Consistent non-verbal communication: open posture, eye contact, calm tone. - Avoid judgment, false promises, personal advice and abrupt changes of subject. - A summary at the end and a check that the patient understood. ## How to ask - Introduce yourself by name and role, greet the patient by name and explain the purpose and length of the visit. - Open: 'Tell me, what brings you here today?' and let the first account run without interrupting. - Facilitate: 'Go on, please', nod, keep eye contact and allow silences. - Reflect and clarify: 'You say you get breathless climbing stairs; after how many floors?' - Explore the patient's view: 'What do you think is happening? What worries you most? What do you hope for from this visit?' - Fill the gaps with closed questions. - Summarise: 'Let me repeat what I understood; please correct me if anything is wrong.' - Close: 'Is there anything else you would like to tell me or ask me?' ## Memory aid First open the door, then light the room: open questions let the patient in, closed ones show the details. ## Test yourself Think of the answer, then tap the question to see it. ## Why does the interview start with open questions? Because they let the patient tell the problem in their own words and order, which brings out data the examiner would not have thought to ask about. ## What is a leading question and why is it avoided? One that suggests the answer, such as 'It hurts here, right?'. Patients tend to accept the suggestion, so the answer loses value. ## Which technique repeats the patient's last words to invite them to continue? Echoing or reflection; it shows the examiner is listening and helps go deeper without steering the answer. ## Which three aspects of the patient's perspective are worth exploring? Their ideas about what is happening, their concerns and their expectations of the visit. [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/clinical-exam/the-medical-interview-rapport-open-questions-and-listening/) ## Related - [The clinical history: its parts and their order](https://durgical.com/en/clinical-exam/the-clinical-history-its-parts-and-their-order/) - [Chief complaint and history of present illness](https://durgical.com/en/clinical-exam/chief-complaint-and-history-of-present-illness/) - [Interviewing in special situations: interpreters and breaking bad news](https://durgical.com/en/clinical-exam/interviewing-in-special-situations-interpreters-and-breaking-bad-news/) - [Nursing assessment: head-to-toe and focused assessment](https://durgical.com/en/clinical-exam/nursing-assessment-head-to-toe-and-focused-assessment/) [← All of the clinical exam](https://durgical.com/en/clinical-exam/) Educational content on the clinical exam; it is learned and practised under supervision. It does not replace assessment by a health professional and is not for self-diagnosis. Sources: [2.4 Therapeutic Communication - Fundamentals of Nursing | OpenStax](https://openstax.org/books/fundamentals-nursing/pages/2-4-therapeutic-communication) (OpenStax, Rice University, 2024); [Talking With Your Doctor: MedlinePlus](https://medlineplus.gov/talkingwithyourdoctor.html) (U.S. National Library of Medicine, 2025). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/clinical-exam/the-medical-interview-rapport-open-questions-and-listening/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/clinical-exam/the-medical-interview-rapport-open-questions-and-listening/