University of Ciego de Ávila Máximo Gómez Báez

ISSN: 2309-8333

RNPS: 2411

|14|2026|

This is an Open Access article under the license CC BY-NC-SA 4.0 (https://creativecommons.org/licenses/by-nc-sa/4.0/)

Estrategia y Gestión Universitaria EGU

Scientific and technological

research article

How to cite:

Díaz-Calzada, M., Herrera

Miranda, G. L., Fuentes Reinoso, A., &

Cecilia Paredes, E. E. (2026). Didactic

strategy for developing interviewing skills

in the Health Promotion course.

Estrategia

y Gestión Universitaria

, 14, e9190.

https://doi.org/10.5281/zenodo.21135274

Received: 27/06/2026

Accepted: 02/09/2026

Published: 15/09/2026

Corresponding author:

marveliadiazcalzada@gmail.com

Conflict of interest:

the authors declare

that they have no conflict of interest,

which may have influenced the results

obtained or the proposed interpretations

Didactic strategy for developing

interviewing skills in the Health

Promotion course

Estrategia didáctica para la formación

de la habilidad de entrevistar en la

asignatura Promoción de Salud

Estratégia didática para a formação da

habilidade de entrevistar na disciplina

Promoção da Saúde

Abstract

Introduction: the ability to conduct interviews is essential for

medical students and constitutes an effective strategy to

promote health. Therefore, it is crucial to design didactic

strategies that integrate this skill in a planned manner into the

Health Promotion course. Objective: to design a didactic

strategy to develop the interviewing skill in the Health

Promotion course. Method: the qualitative phase of an

action‑research study conducted at the University of Medical

Sciences of Pinar del Río was presented, using theoretical and

empirical methods. Results: a didactic strategy was designed

with three formative dimensions—cognitive, educational, and

curricular—structured in four stages: diagnosis, planning,

implementation, and evaluation. Didactic actions were

developed that included the restructuring of lesson plans,

problem‑based learning, and an elective course on the

medical interview. Conclusion: the didactic strategy

addresses the identified training needs in the Health

Promotion course. Its organization by dimensions and stages

makes it a viable proposal for developing the interviewing skill

within the Health Promotion curriculum.

Keywords: higher education, interview, strategy, health,

promotion

Resumen

Introducción: la habilidad de entrevistar es fundamental para

los estudiantes de medicina y es una estrategia efectiva para

promover la salud. Por ello, es crucial diseñar estrategias

didácticas que integren esta habilidad de manera planificada

para la asignatura Promoción de Salud.

Marvelia Díaz-Calzada

Universidad de Ciencias Médicas de Pinar

del Río

https://orcid.org/0000-0002-0148-5914

marveliadiazcalzada@gmail.com

Cuba

Guillermo Luis Herrera Miranda

Universidad de Ciencias Médicas de Pinar

del Río

https://orcid.org/0000-0002-5366-3030

glherreramiranda@gmail.com

Cuba

Angelica Fuentes Reinoso

Universidad de Ciencias Médicas de Pinar

del Río

https://orcid.org/0000-0002-6394-256X

fuentesreinosoangelica@gmail.com

Cuba

Eduardo Enrique Cecilia Paredes

Universidad de Ciencias Médicas de Pinar

del Río

https://orcid.org/0000-0002-0613-5075

eecp98@gmail.com

Cuba

Estrategia y Gestión Universitaria

ISSN

: 2309-8333

RNPS:

2411

| Vol. 14|2026|

| Marvelia Díaz-Calzada | Guillermo Luis Herrera Miranda |

Angelica Fuentes Reinoso |

Eduardo Enrique Cecilia Paredes |

Objetivo:

diseñar una estrategia didáctica para desarrollar la habilidad de

entrevistar en la asignatura Promoción de Salud.

Método:

se presentó la fase

cualitativa de un estudio de investigación-acción desarrollado en la Universidad

de Ciencias Médicas de Pinar del Río utilizando métodos teóricos y empíricos.

Resultados:

se diseñó una estrategia didáctica con tres dimensiones formativas:

cognitiva, educativa y curricular, la que se estructuró en cuatro etapas:

diagnóstico, planificación, ejecución y evaluación. Se desarrollaron acciones

didácticas que incluyeron la reestructuración de planes de clase, aprendizaje

basado en problemas y un curso optativo sobre la entrevista médica.

Conclusión:

la estrategia didáctica responde a las necesidades formativas identificadas en la

asignatura Promoción de Salud. Su estructura por dimensiones y etapas, la

convierte en una propuesta viable para la formación de la habilidad entrevistar

en la asignatura Promoción de Salud.

Palabras clave:

educación superior, entrevista, estrategia, promoción, salud

Resumo

Introdução: a habilidade de entrevistar é fundamental para estudantes de

medicina e constitui uma estratégia eficaz para a promoção da saúde. Por isso, é

crucial elaborar estratégias didáticas que integrem essa habilidade de forma

planejada na disciplina Promoção da Saúde. Objetivo: elaborar uma estratégia

didática para desenvolver a habilidade de entrevistar na disciplina Promoção da

Saúde. Método: foi apresentada a fase qualitativa de um estudo de pesquisa‑ação

desenvolvido na Universidade de Ciências Médicas de Pinar del Río, utilizando

métodos teóricos e empíricos. Resultados: foi elaborada uma estratégia didática

com três dimensões formativas — cognitiva, educativa e curricular — estruturada

em quatro etapas: diagnóstico, planejamento, execução e avaliação.

Desenvolveram‑se ações didáticas que incluíram a reestruturação de planos de

aula, aprendizagem baseada em problemas e um curso optativo sobre a entrevista

médica. Conclusão: a estratégia didática responde às necessidades formativas

identificadas na disciplina Promoção da Saúde. Sua estrutura por dimensões e

etapas a torna uma proposta viável para a formação da habilidade de entrevistar

na disciplina Promoção da Saúde.

Palavras-chave:

educação superior, entrevista, estratégia, promoção, saúde

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Introduction

The interview is a data-collection tool that, owing to its flexibility, allows

detailed information to be obtained while adapting to the context and

characteristics of the interviewee. The medical interview not only identifies

problems but also seeks to understand the patient and their life context, factors that

contribute to the genesis and maintenance of the problem (Díaz-Bravo et al., 2013)

The evolution of educational approaches to teaching interviewing skills has

moved from teacher-centered instruction toward experiential learning. A historical

analysis shows that, throughout history, medical students managed to acquire

interviewing skills without any defined methodology. During the 1970s, curricula

began to shift toward a skills-based orientation (González-Veja et al., 2022;

Rodríguez-Castillo & Cruz-Flores, 2025).

In the health sciences, communication is established as paramount in clinical

practice. Fava et al. (2024) point out that the clinical interview is a basic procedure

that is nonetheless continually neglected. Gómez et al. (2012), for their part, noted

that it provides the channel of communication between physician and patient.

Practical skills should progress from familiarization and reproduction in the

basic-training block to a productive level in the basic-clinical block. This, in turn,

makes it possible to develop creativity within the community context of Primary

Health Care (PHC) (Ojeda González et al., 2022). This is consistent with what was

described by Denizon et al. (2021), for whom learning to conduct interviews, as well

as taking clinical histories, improves student learning. In line with this, Tan et al.

(2021) view the strategy as an effective way to develop communicative skills in

medical contexts, specifically at the postgraduate level.

The curriculum of the Medicine program takes as its starting point the

difficulties and shortcomings in health-related teaching and learning. The current

Plan E curriculum connects students with the health field from the first year onward

through the Health Promotion (HP) course, allowing them to address the health-

disease process and develop the interviewing skill through its assessment system.

When the topic was systematically reviewed, deficiencies were detected in the

development of the interviewing skill, limiting the comprehensive preparation of

future professionals (Cantillo & Gainza, 2022).

Recent research has shown that active methodologies are effective for

communicative development. For Kerr et al. (2026), medical students' perspectives

on communicative skills reveal unmet needs that call for specific didactic

interventions. Dubé et al. (2000), for their part, had already laid the groundwork for

communication skills in preventive interventions, underscoring the importance of

the interview as a tool for modifying risk behaviors.

All of the foregoing confirms the need for proposals that integrate clinical

communication into the student's training process. For this reason, the present study

set out to design a didactic strategy aimed at developing the interviewing skill

through the HP course, with the medical student at its center.

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Methods and materials

The study followed an action-research approach and presented a qualitative

phase for the design and grounding of the didactic strategy, conducted at the

University of Medical Sciences (UCM) of Pinar del Río from January to December

2025. The quantitative component, aimed at validation, was conceived for a later

stage of the research. The sample included twelve faculty members teaching the HP

course. The 195 students were selected through purposive sampling.

Design phases: the study was organized into sequential phases, ensuring its

logical, consistent, and contextualized character. Phase one was aimed at diagnosis,

for the identification of training needs. Document analysis, interviews, and a focus

group were employed.

Document analysis examined the program's Plan E curriculum to identify the

presence of the interviewing skill. Semi-structured interviews were also

administered to professors to explore their perceptions on the matter, as well as to

identify difficulties stemming from the physician-patient relationship and the

potential of the curriculum. A focus group with students was likewise conducted to

gain deeper insight into their skills.

All of the data obtained made it possible to integrate the results and

establish the regularities of the diagnosis. Triangulation was also used to identify

points of convergence.

In phase 2, the theoretical-methodological grounding was described,

integrating the results obtained in the diagnosis with the corresponding theoretical

references. Theoretical methods such as the historical-logical method were used,

along with its procedures of analysis and synthesis, as well as induction and

deduction.

In phase 3, the theoretically grounded didactic strategy was designed across

its cognitive, educational, and curricular dimensions, in keeping with the

comprehensive notion of the interviewing skill; the general objective was formulated

in conjunction with the needs identified, along with the stages conceived for

diagnosis, planning, implementation, and evaluation, which ensure its organization.

In phase 4, the didactic actions aligned with the dimensions and the proposed

objective were conceived. The ethical principles of scientific research were

observed, ensuring the truthfulness and reliability of the information. Participants

provided informed consent after being informed of the research objectives, in

accordance with the Declaration of Helsinki.

Results and discussion

Phase 1. Diagnostic analysis

Document analysis of the Plan E curriculum for the HP course showed that

the development of the interviewing skill is explicitly stated but is not systematized

across the different thematic units, even though the medical interview is an

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assessment present in every activity of the evaluation portfolio.

The interviews with professors revealed similar views regarding the need to

develop the interviewing skill, along with shortcomings in its performance. Among

the main difficulties identified were iatrogenic errors, lack of empathy, non-use of

simulators, and insufficient preparation for managing the stages of the clinical

method. Four professors suggested including an elective course in the first-year

medical curriculum, using active teaching methods to provide knowledge about the

medical interview and the correct use of communication.

Table 1

Content analysis of the interviews with professors

Category

Content

Reflections

Experiences in

the

communication

process when

conducting

interviews

Insecurity, fear

of making

mistakes

-During history-taking we feel a great deal of

insecurity.

-We become agitated when speaking with

patients.

-We are afraid of saying something wrong.

-In most cases we wish the tutors were the ones

conducting the medical interview.

Preparation

received

during the

degree

program

Perception of

insufficiency

-The HP course is our first contact with

conducting a medical interview, and there is no

content related to this topic.

-It is learned through each professor's individual

experience.

-No specific preparation for the medical

interview is received, except in the medical

office.

Empathy and

iatrogenesis

Management of

emotions, use

of language,

and how to

create empathy

-Sometimes I do not know how to treat certain

patients.

-It is difficult to explain treatments without

using technical terms.

Learning needs

regarding the

interviewing

skill

Demand for

practice and

tutor guidance

-It is important to learn how to conduct the

medical interview.

-The use of simulators would be beneficial for

practice.

-Professors should do it first, teach us, and then

we would go to the community to conduct the

medical interviews.

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Expectations

regarding their

training

Interest in

actions to

support their

training

-It would be extraordinary to have dedicated

spaces in classes and in the medical offices,

with tutors, solely to learn the interviewing

skill.

Assessment of

active

strategies

Acceptance and

motivation

-Practical activities would help us feel more

confident in the physician-patient relationship

at all times.

-I would be ready to enroll in courses on

developing the interviewing skill.

-These strategies make learning accurate and

effective for the student.

Source: Authors’ own elaboration.

The triangulation of document analysis, professor interviews, and the

student focus group made it possible to identify points of convergence and to

complement aspects of the object of study. Document analysis revealed the absence

of an explicit and systematic formulation of objectives and content in the

curriculum. This shortcoming was confirmed by the professors, who pointed out

limitations in the core processes. The convergence of these regularities underpins

the relevance of the strategy designed (Table 3).

Table 3

Data triangulation across document analysis, interviews, and focus group

Aspects analyzed

Document

analysis

Interviews with

professors

Student focus

group

Presence of the

interviewing skill in the

curriculum

Present, not

systematized

Present, but

insufficient

Observed as

underdeveloped

Level of development of

the interviewing skill

Not explicitly

assessed

Insufficient in

practice at

medical offices

Insecurity and

fear

Main difficulties

Not described

Technical

language,

empathy

Lack of

preparation

Learning needs regarding

the interviewing skill

Evidenced by its

absence in the

curriculum

Request for

intentional

training

Request for

practical training

Need for intervention

Neglect exists in

the curriculum

Perceived by

tutors

Requested by

students

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Relevance of active

methodologies

Not described

Positively

valued

Very good

acceptance

Justification of the

strategy

Due to its

absence in the

curriculum

Pedagogical

demand

Training

expectation

Source: Authors’ own elaboration.

Phase 2. Theoretical-methodological grounding

The didactic strategy was aimed at planning and directing actions to achieve

objectives and transform the object of study. Didactic strategies used in education

have often failed to yield the expected results owing to factors compromised during

teaching and learning.

As a result of this phase, the following were defined as the strategy's didactic

principles: systemic, reflective, conscious, and interdisciplinary character. These

principles, together with the diagnosis performed, constituted the reference points

for developing the strategy's didactic actions.

Phase 3. Structural design of the didactic strategy

The structural design of the strategy defined three formative dimensions:

cognitive, educational, and curricular, making it possible to address the interviewing

skill comprehensively, allowing for the acquisition of theoretical knowledge and

reflective practical demonstration. The strategy was structured into four stages:

diagnosis, planning, implementation, and evaluation, ensuring its systemic

organization and flexibility.

• Dimension 1. Curricular: a set of normative, methodological, and

organizational elements that plan, regulate, and evaluate the development

of the interviewing skill.

• Dimension 2. Cognitive: the process of actions and operations involved in

strategic formulation according to the educational objective.

• Dimension 3. Educational: the level of self-regulation of the student and the

group, with formative intent, arising from what is communicated and

exchanged, reflecting the expected professional and human behavior.

 General Objective: to implement the didactic conception for developing the

interviewing skill through the HP course.

Phase 4. Conception of the didactic actions

• Strategic action 1. Enhancement of the development of the interviewing skill

and its stages, through didactic redesign.

• Strategic action 2. Design of an elective course that links the development

of the interviewing skill with the stages of the clinical-epidemiological

method.

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• Strategic action 3. Training of the teaching staff.

In addition to these principal actions, workshops focused on the interviewing

skill and its sub-skills, discussion forums, and active methods such as collaborative

learning and the flipped classroom can be organized.

The behavioral interview is fundamental to assessment in clinical contexts.

Implementing it requires basic clinical skills such as establishing relational

components, identifying and characterizing the problem, and closing the interview,

in such a way that guidance from a psychological perspective is essential (Becerra-

Gálvez et al., 2025). Along the same lines, Fava et al. (2024) emphasize that the

clinical interview constitutes an essential yet frequently neglected method in

contemporary medical practice, which reinforces the need for systematic training

from the early stages of the degree program.

Medical Education, in its comprehensiveness, regards health as a social

process that takes into account biological, economic, ecological, and psychosocial

determinants. Hence the training of a broadly profiled graduate whose modes of

professional practice correspond to the particularities and social progress of the

context (Silva-Velasco et al., 2023). This has been expressed by Carreño and Salgado

(2005), who argue that the development achieved by Cuban Medical Education has

earned it a prominent place within the Higher Education subsystem in Latin America.

In this context, researchers agree that training in communicational skills, within such

a framework, must be aligned with the contextual needs of the population to be

served.

Clinical training, an indispensable element of Medical Education, requires

didactic planning and direction of the training process, turning it into a

transformative activity that takes into account the results of diagnosing the

performance of physicians, professors, and students, adjusting strengths and

weaknesses to needs and shortcomings in medical care (Escobar Yéndez et al., 2022).

Significant regularities are drawn from the fact that the development of the

interviewing skill should not be fragmented, but rather a holistic form of learning

connected across different disciplines, following a gradual and sequential approach

(Díaz et al., 2023).

The clinical interview is the first and most important encounter between

physician and patient. Through it, the clinical history is obtained, the patient's

concerns are explored, bonds of trust are established, and the foundations are laid

for diagnosis and the treatment plan. Moreover, its quality has an impact on the

accuracy of the diagnosis, its correspondence with the treatment, and subsequent

patient satisfaction (Dubé et al., 2000; Kerr et al., 2026).

From another perspective, Gilligan et al. (2025) identified the existence of

significant gaps in students' preparation for information gathering. In keeping with

this, Koerfer and Albus (2025) developed a comprehensive handbook addressing the

theoretical foundations, didactics, practice, and evaluation of the medical

interview, which is essential for training processes in medicine. In the view of Díaz

and Delgado (2020), these should be organized from the curriculum across the

different disciplines as a system, establishing strategy and tactics to shape

professional modes of practice.

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The essential condition for satisfactory learning is that the content be

meaningful, linking to prior knowledge in a comprehensible and representative way.

If what is learned is not soon applied, it will almost certainly be forgotten; therefore,

the retention of learning must be promoted, along with opportunities for its constant

use, and practice adjusted accordingly (Navarro Piñeyro & Umpiérrez, 2026).

The university in general, and the UCM in particular, calls for a highly

qualified professional distinguished by a leading role in social transformation, in

keeping with present-day Cuban society's commitment (Fernández-González et al.,

2025). This social commitment of the medical university has likewise been

documented in Latin American contexts, where training in the medical interview is

closely linked to health equity (Wilcaso Cando et al., 2025).

Moreover, the internal articulation of the skills-development process

requires understanding the sequenced transition of conceptual and practical actions

within medical education. In this regard, research on special didactics conducted by

Sixto and Márquez (2017) shows that professional skills should not be conceived in

an atomized or fragmented manner, but rather as forms of assimilation of socially

conditioned activity that respond to the profession's social mandate.

It is important to note that implementing strategies centered on simulation

and experiential learning constitutes a positive avenue for developing lasting

communicational capacities (Pérez Caldevilla et al., 2024). This is why one of the

current challenges of medical education lies in ensuring that the interviewing skill is

taught explicitly and systematically, with assessment that is both valid and reliable

(Cantillo & Gainza, 2022; Linares et al., 2022).

For Zemlin et al. (2024), who conducted a related study, improvements may

lie in empathy. In this regard, they succeeded in identifying genuine emotions in

patients. They further found that most students developed the ability to understand

the patient in emotionally charged contexts. This finding is especially relevant given

that students must face related situations both during their studies and after

graduation.

Furthermore, the interview in specific contexts, such as psychiatric settings,

has shown that structured repetition and feedback are basic mechanisms for

developing lasting competencies, as conceived by Hierlihy and Latus (2025), for

whom flexible repetition and immediate feedback from instructors are

indispensable. This confirms the relevance of the proposed didactic strategy,

particularly in its implementation dimension, which emphasizes systematic practice

with feedback.

Students' own perceptions of their training in communicational skills

constitute a fundamental input for the design of effective didactic strategies. Kerr

et al. (2026) longitudinally examined the perspectives of 273 third-year medical

students. The researchers reported greater confidence in communicational skills by

the end of the third year, particularly in formulating questions and responding to

them.

The rotations that received the highest ratings for satisfaction with

communicational training were emergency medicine, primary care, and family

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medicine, whereas general surgery rotations received the lowest ratings. Students

identified that successful interactions with patients were associated with fostering

therapeutic relationships and exchanging information, whereas unsuccessful

interactions were attributed to incompatible goals, violated expectations,

unpredictable interactions, and time constraints. This study underscores the need

to develop didactic strategies tailored to specific disciplines and centered on the

skills students consider most relevant to their future clinical practice.

Breaking bad news constitutes one of the clinical situations of greatest

communicational and emotional complexity. Goumas et al. (2024) conducted a

systematic review of medical education aimed at improving skills in communicating

bad news. The review included 21 relevant studies, of which 12 randomized studies

demonstrated improvements in students, while 8 studies described training courses

that helped build confidence in these skills.

The implementation of structured protocols for complex communicational

situations has proven effective in reducing anxiety, according to Polivka et al.

(2024), who developed and validated a protocol for communicating bad news that

integrates key components such as preparing the environment, assessing the

patient's perspective, the professional's presentation, managing emotions, and the

final summary. The authors implemented this protocol in a structured educational

program that included simulation sessions with standardized patients and OSCE-

based assessment, demonstrating significant improvements in students' relational

skills.

Adopting similar protocols in the Health Promotion course could help

systematize the teaching of the medical interview, providing students with a clear

and replicable framework for addressing complex clinical situations. Initially, such

programs were didactic in nature, that is, teacher-centered (Benbassat & Baumal,

2009). This evolution theoretically supports the proposed didactic strategy, which

integrates problem-based learning, simulation, and structured feedback.

The integration of validated psychotherapeutic approaches, such as

motivational interviewing, with structured guides such as the Calgary-Cambridge

model, has shown potential for improving medical students' communicational skills.

Lindhardt and Thygesen (2024) examined how, drawing on motivational-interviewing

theory, students who received specific training in motivational interviewing

demonstrated improvements in key aspects of their communicational style favorable

to the motivational approach, particularly in empathy and person-centeredness.

A troubling phenomenon documented in the literature is the decline in

history-taking skills during training. Pfeiffer (1998) reported that students' skills in

obtaining a clinical history peak at the start of the third year of medical school and

then decline significantly toward the end of the fourth year. In this regard,

Rieffestahl et al. (2024) carried out a study analyzing how medical students interact

with patients, finding that simulated interviews differ from the real experiences

students later encounter. This confirms the importance of developing didactic

approaches that take into account the real-world settings in which these students

will later carry out their work, with increasing complexity, as well as ongoing,

accompanied clinical feedback.

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Conclusions

A look at the current situation confirms the need to adopt a didactic strategy

that takes the interviewing skill into account and that is centered on the medical

student. The proposed strategy aligns with these contemporary trends, integrating

cognitive, educational, and curricular dimensions into a systematic and

contextualized training process. Overall, this strategic, relevant approach, grounded

in theoretical and methodological foundations and structured by dimensions and

stages that integrate active methodologies, constitutes a viable alternative within

the context of higher medical education in the present century, responding to the

training needs for the interviewing skill in the Medicine program at the University of

Medical Sciences of Pinar del Río.

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| Marvelia Díaz-Calzada | Guillermo Luis Herrera Miranda |

Angelica Fuentes Reinoso |

Eduardo Enrique Cecilia Paredes |

Estrategia y Gestión Universitaria EGU

About the main author

Marvelia Díaz

-Calzada:

Doctor of Medicine. Assistant Professor. Associate

Researcher. Holds Master’s degrees in Satisfactory Longevity and Medical Education.

Specialist (First and Second Degree) in Comprehensive General Medicine (MGI).

Serves as Postgraduate Methodologist at the “Luis Augusto Turcios Lima” University

Polyclinic.

Declaration of author responsibility

Marvelia Díaz

-Calzada 1: Conceptualization, Data Curation, Formal

Analysis,

Investigation, Methodology, Resources, Software, Supervision,

Validation/Verification, Visualization, Writing

/Original Draft, and Writing/

Review &

Editing.

Guillermo Luis Herrera Miranda

Data curation, Software, Validation/Verification,

Resour

ces, Supervision, and Writing, review, and editing.

Angelica Fuentes Reinoso 3: Software, Validation/Verification, Supervision, and

Writing, review, and editing.

Eduardo Enrique Cecilia Paredes 4: Resources, Supervision, and Writing, review,

and editing.

Financing:

Own resources

Special Acknowledgments: