Patient History Taking: A Critique of Craig's Nursing Guide
This paper summarizes and critiques Craig's (2007) article "A Guide to Taking a Patient's History," published in Nursing Standard. The critique examines Craig's recommendations for establishing rapport, using open-ended and closed questioning, and gathering comprehensive medical, social, and psychiatric histories. It identifies gaps in Craig's framework, including insufficient attention to cultural factors, the absence of a mental status assessment component, and the potential efficiency gains of structured patient surveys and checklists. Drawing on supplementary sources such as Alarcón (2009), Bickley and Szilagyi (2007), and McKenna et al. (2011), the paper argues that a more complete approach to patient history taking combines trained interview skills with systematic data-collection tools.
- Introduction: The Importance of Patient History Taking: Context for critiquing Craig's 2007 nursing guide
- Craig's Approach to the Interview Environment and Rapport: Environment, privacy, and rapport-building recommendations
- Questioning Strategy and Structure of the History: Open-ended, closed, and clarification questioning sequence
- Gaps in Craig's Framework: Cultural Factors and Mental Status: Missing cultural sensitivity and mental status screening
- The Case for Surveys and Checklists in History Taking: Efficiency gains from structured surveys and checklists
- Overall Evaluation of Craig's Guide: Summary judgment on Craig's strengths and limitations
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What makes this paper effective
- The paper stays tightly focused on a single source (Craig, 2007), using a clear summary-then-critique structure that makes the argument easy to follow.
- It integrates multiple supporting references (Alarcón, 2009; McKenna et al., 2011; Bickley & Szilagyi, 2007) to substantiate each critique, lending credibility to the evaluative claims.
- The author moves beyond pure critique by offering practical alternatives, such as structured surveys and mental status screening, showing applied clinical thinking.
Key academic technique demonstrated
The paper demonstrates source critique within a scholarly review format: it first summarizes the target article's strengths before systematically identifying omissions and limitations, each grounded in peer-reviewed evidence. This pattern — acknowledge merit, then qualify with evidence-based critique — is a core skill in health sciences academic writing.
Structure breakdown
The paper opens with a rationale for patient history taking and identifies the article under review. It then walks through Craig's recommendations in roughly the same order Craig presents them, inserting evaluative commentary at each stage. The middle sections raise two major critiques — cultural sensitivity and mental status assessment — before proposing the use of surveys and checklists as a practical supplement. A brief concluding evaluation summarizes Craig's overall utility and limitations.
Introduction: The Importance of Patient History Taking
Taking the history of a patient is a crucial aspect of patient assessment and treatment. A good history can mean the difference between a successful patient outcome and an unsatisfactory one. However, taking a complete and useful history is a skill developed through training and practice; it is not an innate talent (Bickley & Szilagyi, 2007; McKenna et al., 2011). According to Craig (2007), nurses are increasingly being asked to take patient histories. Given these growing responsibilities, nurses need training and clear guidelines for obtaining an adequate patient history. The following is a summary and critique of Craig, L. H. (2007), "A Guide to Taking a Patient's History," in Nursing Standard, volume 22, issue 13, pages 42–48.
Craig (2007) takes a comprehensive approach to explaining the interview and history-taking process. This approach is applicable to most patient populations; however, Craig does not address certain cultural issues that could be important in obtaining an accurate and complete history, especially when discussing sexual issues, psychiatric concerns, and other aspects of a patient's background that might create cultural tensions. Alarcón (2009) offers some insights into how to handle these issues. That notwithstanding, Craig provides very useful information regarding how to take a complete patient history.
Craig's Approach to the Interview Environment and Rapport
Craig (2007) begins by discussing issues that many other articles on this topic overlook or perhaps take for granted, despite their importance in completing an accurate patient history. For instance, Craig rightly points out that the environment in which the history is taken should be safe and private, allowing the patient to feel at ease when providing information. Craig emphasizes the importance of early rapport-building through genuine concern, proper self-introduction, and explaining the purpose of the upcoming questions before beginning the actual assessment.
Moreover, Craig stresses that the nurse-assessor should be a good listener, allowing patients or family members to relay information at their own pace, and should remain non-judgmental regarding the information shared. Simply attending to these factors will often result in patients or their relatives revealing information they would not otherwise disclose without specific prompting (McKenna et al., 2011).
References
Alarcón, R. D. (2009). Culture, cultural factors and psychiatric diagnosis: Review and projections. World Psychiatry, 8, 131–139.
Bickley, L. S., & Szilagyi, P. G. (2007). Bates' Guide to Physical Examination and History Taking (9th ed.). Lippincott, Williams & Wilkins.
Craig, L. H. (2007). A guide to taking a patient's history. Nursing Standard, 22(13), 42–48.
McCain, R. F. (1965). Nursing by assessment — not intuition. American Journal of Nursing, 65, 82–84.
McKenna, L., Innes, K., French, J., Streitberg, S., & Gilmour, C. (2011). Is history taking a dying skill? An exploration using a simulated learning environment. Nurse Education in Practice, 11(4), 234–238.
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