ARIZONA CLINICAL INTERVIEW RATING SCALE

A
A
V
B
E
O
R
OUTSTANDING (5) V SATISFACTORY (3) NON-COMPETENT (1-2)
A
E
G
E
(4)
ITEM 1 - ORGANIZATION
(5) (4) (3) (2) (1)
The interviewer imposes The interviewer seems to The interview seems to jump
structure and organization to follow systematically a series around from topic to topic,
the interview. The purpose, of topic or agenda items most returning to issues that have
agenda, intent, plan, and/or of the time. However, parts of already been concluded. The
expectation for today’s the interview might be better interview seems disjointed and
meeting are made clear as the organized. unorganized.
interview unfolds.
ITEM 2 – TIMELINE
(5) (4) (3) (2) (1)
The interviewer obtains At times, the interviewer does The interviewer obtains
information pertaining to the not obtain information information pertaining to the
Chief Complaint and History pertaining to Chief Complaint Chief Complaint and History
of Present Illness in a and History of Present Illness of Present Illness in a
chronological progression, in a chronological order. haphazard and unrelated
starting with the first signs and fashion.
symptoms of current illness
and following their
progression to the present.
ITEM 3 – TRANSITIONAL
STATEMENTS
(5) (4) (3) (2) (1)
The interviewer always The interviewer sometimes The interviewer progresses
utilizes transitional statements introduces subsections with from one subsection to another
when progressing from one effective transitional in such a manner that the
subsection to another, which statements, but fails to do so at patient is left with the feeling
assures the patient that the other times. Some of the of uncertainty as to the
information being sought is transitional statements used purposes of the questions. (No
necessary and important, e.g., are lacking in quality e.g., transitions.)
“Now I’m going to ask you “Now I’m going to ask you
some questions about your some questions about your
family, because we find that family.”
there are certain diseases that
occur among blood relatives,
and it will help us to know
what health risks are in your
family.”
 ITEM 4 – QUESTIONING
SKILLS – TYPE OF
QUESTION
(5) (4) (3) (2) (1)
The interviewer starts The interviewer often fails to The interview asks many
information gathering with an begin a line of inquiry with leading questions, why
open-ended question. For open-ended questions but questions and multiple
areas where the interviewer is rather employs direct and questions, e.g., “Your child
required to deal with a large forced-choice questions to has never had diarrhea, has
amount of potential obtain information. he?” “You want your child to
information (e.g., History of have a tetanus shot, don’t
Illness and Review of you?”
Systems), this is followed by
direct and forced-choice
questions which will allow
him to narrow in on the
pertinent positive and negative
points that need further
elaboration.
ITEM 5 – PACING OF
INTERVIEW
(5) (4) (3) (2) (1)
The interviewer is attentive to The pace of the interview is The interviewer frequently
the responses of the patient comfortable some of the time, interrupts the patient, not
and allows him to complete but the interviewer allowing him/her to complete
statements and answer occasionally interrupts the statements or answer
questions. The interviewer patient and/or allows questions; and/or there are
avoids unnecessary delays in occasional delays to break the uncomfortable pauses, which
dialogue. If there are pauses, flow of the interview. break the flow of the
they are used deliberately as interview.
an effective interviewing
technique.
ITEM 7 – QUESTIONING
SKILLS SUMMARIZING
(5) (4) (3) (2) (1)
At the end of each major line The interviewer sometimes At the end of any specific line
of inquiry or subsection (i.e., summarizes the data at the end of inquiry, the interviewer
History of Present Illness, Past of some lines of inquiry but fails to summarize the data
Medical History), the fails to do it consistently. obtained.
interviewer summarizes the
data obtained in an effort to
verify and/or clarify the
information or as a precaution
to assure that no important
data is omitted.

 ITEM 8 – QUESTIONING
SKILLS LACK OF
JARGON
(5) (4) (3) (2) (1)
Questions asked, as well as The interviewer occasionally Questions asked, as well as
information provided to the uses medical jargon during the information provided to the
patient during the interview, interview, failing to define the patient during the interview,
are easily understandable; medical terms for the patient are confusing because of the
content is free of difficult unless specifically requested use of difficult medical terms
medical items and jargon. If to do so by the patient. and jargon.
jargon is used, the words are
immediately defined for the
patient. Language is used that
is appropriate to the patient’s
level of education.
ITEM 10 – FACILITATIVE
BEHAVIOR
(5) (4) (3) (2) (1)
The interviewer uses The interviewer makes some The interviewer makes no
encouraging and supportive use of encouraging and attempt at encouraging and
gestures, body language and supportive gestures and supportive gestures and
remarks to facilitate remarks. Frequency of eye remarks; body language is
communication (e.g., Uh huh, contact could be increased. negative and closed; makes no
good, I see). The interviewer attempt to maintain eye
makes good use of eye contact contact.
and avoids placing barriers
(such as desk) between self
and patient, especially during
discussion of sensitive or
emotional issues. When
appropriate, physical contact is
made with patient.
ITEM 11 – RAPPORT –
POSITIVE VERBAL
REINFORCEMENT
(5) (4) (3) (2) (1)
The interviewer provides the The interviewer is neither The interviewer provides the
patient with intermittent overly positive nor negative in patient with little support or
positive verbal reinforcement dispensing feedback, doesn’t positive verbal reinforcement
and feedback, and displays display empathic behavior, and is a detached data
empathic behavior. (“That and doesn’t utilize verbal gatherer. The emphasis is on
must have been very reinforcement frequently the negative rather than the
difficult”). May verbally enough. positive attributes of the
praise the patient for proper patient (e.g., “I can’t believe
health care technique. (“It’s you smoked for twenty years
wonderful that you stopped before you stopped.”)
smoking.”)

 ITEM 12 – PATIENT
EXPECTATIONS AND
EDUCATION
(5) (4) (3) (2) (1)
The interviewer asks what the The interviewer responds to The interviewer neither elicits
patient hopes to get out of this expectations, beliefs, and nor responds appropriately to
visit, what he perceives the concerns about the illness and patient’s expectations, beliefs,
problem to be, what his treatment preferences concerns and treatment
treatment preferences are and expressed by the patient, but preferences. Is insensitive to
deals with these issues. The does not explicitly encourage degree of interest in patient
interviewer establishes the patient to express them. Makes educations (e.g., overwhelms
degree of interest in patient some attempt to determine patient by giving more
education and gives patient the degree of interest in patient detailed information than is
amount of information that is education but could be more welcomed or gives vague
comfortable. sensitive. information when patient asks
for more).
ITEM 16 – CHECKS
PATIENT
UNDERSTANDING
(5) (4) (3) (2) (1)
The interviewer uses In the courses of conversation, Does not assess patient’s level
deliberate techniques to check the interviewer attempts to of understanding and does not
patient’s understanding of check the patient’s level of effectively correct
information; e.g., asks patient understanding and clarifies misunderstanding when
to repeat information, asks for evident misunderstanding but evident.
additional questions, poses does not do it in a deliberate,
hypothetical situations, asks pre-planned manner.
patients to demonstrate
techniques. Clarifies any areas
of misunderstanding.
ITEM 17 – LISTENING TO
PATIENT’S CONCERNS
(5) (4) (3) (2) (1)
The interviewer provides the The interviewer provides some The interviewer provides no
patient with an opportunity to support for the patient to support for the patient to
express his emotions without express feelings and concerns express emotions.
interruptions and uses this in a but is not willing to hear all of
therapeutic sense to the concerns.
acknowledge the patient’s
distress and seek possible
solutions.

 ITEM 20 – CLOSURE OF
THE INTERVIEW
(5) (4) (3) (2) (1)
At the end of the interview, At the end of the interview, At the end of the interview,
the interviewer clearly the interviewer only partially the plans for the future are not
specifies future plan (e.g., details the plans for the future specified and the patient
What the interviewer will do, (e.g., “Some time you should leaves the interview without a
what the patient should do, bring in the name of the sense of what to expect.
and the time of the next medicine you received,” or,
communication). “Call my secretary when you
gather the information.”)