Calgary–Cambridge model

The Calgary–Cambridge model (Calgary-Cambridge guide) is a method for structuring medical interviews. It focuses on giving a clear structure of initiating a session, gathering information, physical examination, explaining results and planning, and closing a session. It is popular in medical education in many countries.

Method

The Calgary–Cambridge model involves:

  • initiating a session:[1][2] This involves preparation by the clinician, building rapport with the patient, and an understanding of why the interview is needed.[1]
  • gathering information:[1][2] This may be split into a focus on a biomedical perspective, the patient's experience, and contextual information about the patient.[1][2] Contextual information may include personal history, social history, and other medical history.[2]
  • a physical examination of a patient:[1][2] This varies based on the purpose of the interview.
  • explaining results and planning:[1][2] This aims to ensure a shared understanding, and allowing for shared decision-making.[1]
  • closing a session:[1][2] This may involve discussing further plans.[1]

This is designed to give a clear structure to the interview, and to help to build the relationship between the clinician and the patient.[1] The importance of nonverbal communication is noted.[1]

The model is based on 71 skills and techniques that improve patient interviews.[2] These include maintaining eye contact, active listening (not interrupting, giving verbal cues), summarizing information frequently, asking about patient ideas and beliefs, and showing empathy.[2]

Advantages

The Calgary–Cambridge model was developed based on evidence from interviews of patients, and what made them successful.[3] It is generally focussed on the patient and their experience.[4] The guide of skills and techniques is generally seen as comprehensive.[5]

Disadvantages

The Calgary–Cambridge model has been criticized for creating a separation between the process of interviewing a patient and the information gained.[1] The 71 skills are very difficult to incorporate simultaneously, making it more difficult to learn for clinicians than other techniques.[5]

History

The Calgary–Cambridge model is named after Calgary, Canada, and Cambridge, United Kingdom where the three authors worked.[6] It is popular in medical education in many countries.[1][7] It has also been adapted for veterinarians.[8] Other models, such as the Global Consultation Rating Scale, have been based on the Calgary–Cambridge model.[9]

References

  1. ^ a b c d e f g h i j k l m Kurtz, Suzanne; Silverman, Jonathan; Benson, John; Draper, Juliet (August 2003). "Marrying Content and Process in Clinical Method Teaching: Enhancing the Calgary–Cambridge Guides". Academic Medicine. 78 (8): 802–809. doi:10.1097/00001888-200308000-00011. ISSN 1040-2446. PMID 12915371. S2CID 13557877.
  2. ^ a b c d e f g h i Main, Chris J.; Buchbinder, Rachelle; Porcheret, Mark; Foster, Nadine (April 2010). "Addressing patient beliefs and expectations in the consultation". Best Practice & Research Clinical Rheumatology. Back Pain and Non-Inflammatory Spinal Disorders. 24 (2): 219–225. doi:10.1016/j.berh.2009.12.013. ISSN 1521-6942. PMC 2896476. PMID 20227643.
  3. ^ Adams, Cindy L.; Kurtz, Suzanne M. (2006-03-01). "Building on Existing Models from Human Medical Education to Develop a Communication Curriculum in Veterinary Medicine". Journal of Veterinary Medical Education. 33 (1): 28–37. doi:10.3138/jvme.33.1.28. ISSN 0748-321X. PMID 16767635.
  4. ^ Sommer, Johanna; Lanier, Cédric; Perron, Noelle Junod; Nendaz, Mathieu; Clavet, Diane; Audétat, Marie-Claude (April 2016). "A teaching skills assessment tool inspired by the Calgary–Cambridge model and the patient-centered approach". Patient Education and Counseling. 99 (4): 600–609. doi:10.1016/j.pec.2015.11.024. ISSN 0738-3991. PMID 26680755.
  5. ^ a b Mehay, Ramesh; Beaumont, Robin; Draper, Juliet; Lamb, Iain; Moulton, Liz; Kenny, Damian (2012). "Revisiting Models of the Consultation". The Essential Handbook for GP Training and Education (PDF). CRC Press. ISBN 978-1-84619-593-8.
  6. ^ Silverman, Jonathan; Kurtz, Suzanne; Draper, Juliet (2013-09-28). Skills for Communicating with Patients (3 ed.). London: CRC Press. doi:10.1201/9781910227268. ISBN 978-0-429-09124-7.
  7. ^ Burt, Jenni; Abel, Gary; Elmore, Natasha; Campbell, John; Roland, Martin; Benson, John; Silverman, Jonathan (2014). "Assessing communication quality of consultations in primary care: initial reliability of the Global Consultation Rating Scale, based on the Calgary-Cambridge Guide to the Medical Interview". BMJ Open. 4 (3) e004339. doi:10.1136/bmjopen-2013-004339. ISSN 2044-6055. PMC 3948635. PMID 24604483.
  8. ^ Englar, Ryane E.; Williams, Melanie; Weingand, Kurt (2016). "Applicability of the Calgary–Cambridge Guide to Dog and Cat Owners for Teaching Veterinary Clinical Communications". Journal of Veterinary Medical Education. 43 (2): 143–169. doi:10.3138/jvme.0715-117R1. ISSN 0748-321X. PMID 27075274.
  9. ^ Burt, Jenni; Abel, Gary; Elmore, Natasha; Campbell, John; Roland, Martin; Benson, John; Silverman, Jonathan (March 2014). "Assessing communication quality of consultations in primary care: initial reliability of the Global Consultation Rating Scale, based on the Calgary-Cambridge Guide to the Medical Interview". BMJ Open. 4 (3) e004339. doi:10.1136/bmjopen-2013-004339. ISSN 2044-6055. PMC 3948635. PMID 24604483.

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