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The Calgary Cambridge consultation model was developed by Suzanne Kurtz and Jonathan Silverman in 1996.
True
According to the Calgary Cambridge model, the first step is to establish a rapport with the patient.
True
The Pendleton Model is the only other consultation model mentioned alongside the Calgary Cambridge model.
False
Summarising findings is an important part of the consultation process in the Calgary Cambridge model.
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The Calgary Cambridge model ignores the patient's ideas, concerns, and expectations.
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Establishing rapport begins with greeting the patient and asking for their name.
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Patients often ask if they have cancer during a consultation.
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It is important to interrupt the patient when they talk about their presenting complaint to guide the conversation.
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The Calgary Cambridge Consultation Model focuses on effective communication with patients.
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The acronym SOCRATES is used to gather information about pain.
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An open question allows the patient to answer in a detailed manner.
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It is unnecessary to summarize during a consultation.
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SOCRATES helps in gathering information about the site of pain.
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Non-verbal behavior does not affect patient communication.
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Closed questions are designed to elicit detailed personal stories from the patient.
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In the SOCRATES method, 'E' stands for exacerbating factors.
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Empathy is not important in developing a relationship with patients.
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Severity in the SOCRATES framework is graded from 1 to 5.
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One of the purposes of agenda setting is to understand both the patient's and the clinician's needs.
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The 'C' in the SOCRATES acronym stands for character, referring to how the pain feels.
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It is essential to take a patient's medical history during the consultation.
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The 'R' in SOCRATES refers to radiating symptoms.
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It is unnecessary to gain consent before asking a patient about their history and complaint.
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Timing in the SOCRATES method only concerns the duration of symptoms.
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The history taking sequence includes a systems review.
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Asking patients for their opinions is discouraged in consultations.
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Current medications should include both prescribed drugs and herbal remedies.
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In past medical history, it is important to ask about closed questions only.
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Allergies are only concerned with reactions to food items.
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The doctor's first step is to ensure the patient is seated comfortably.
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The doctor should not listen attentively during the patient's opening statement.
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An open question might be 'Does your cough get worse when you exercise?'
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The Calgary Cambridge Consultation Model focuses on communication skills during patient consultations.
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It is essential for a doctor to use jargon when communicating with patients.
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Summarizing the patient's statements is a way to show that the doctor is attentive.
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A concern of the patient might include worries about their symptoms.
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Clarifying unclear statements from the patient is unnecessary in a consultation.
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The Calgary Cambridge Consultation Model was created to assist in structuring interactions with patients.
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In the Calgary Cambridge model, it is essential to summarize findings only once at the end of the consultation.
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Identifying a patient's ideas, concerns, and expectations is not a priority in the Calgary Cambridge Consultation Model.
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Closed questions are used in the Calgary Cambridge model to gather detailed personal narratives from patients.
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The first step in the consultation process involves initiating the session and establishing rapport with the patient.
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The Calgary Cambridge Model emphasizes the importance of effective communication in patient consultations.
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Empathy is considered a trivial aspect of building relationships with patients according to communication models.
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The SOCRATES framework is a method used to assess the characteristics of a patient's pain.
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Closed questions are more effective than open questions in allowing patients to provide detailed personal stories during a consultation.
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In the Calgary Cambridge Model, establishing rapport is not seen as an initial step in the consultation process.
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The term 'severity' in the SOCRATES method uses a scale typically ranging from 1 to 10.
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Health professionals should actively interrupt patients to steer the conversation during consultations.
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The principles of pharmacology are included in the learning outcomes of communication skills courses.
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It is essential to gain consent before asking a patient about their history and complaint.
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Non-verbal behavior does not affect patient communication.
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The Calgary Cambridge Consultation Model emphasizes effective communication with patients.
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Agenda setting is only focused on the clinician's needs during a consultation.
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An open question can be 'Does your cough get worse when you exercise?'
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It is unnecessary to summarize during a consultation.
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The 'C' in the SOCRATES acronym stands for character, referring to how the pain feels.
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Current medications should include both prescribed drugs and herbal remedies.
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The 'A' in the SOCRATES framework stands for associated symptoms.
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Exacerbating factors in the SOCRATES method refer to the severity of the pain.
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In SOCRATES, the character of the pain describes when the pain started.
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The timing in the SOCRATES framework includes considerations for when symptoms worsen, such as at night.
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Non-verbal behavior, such as eye-contact and facial expression, plays a significant role in communication with patients.
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Current medications should only include prescribed drugs and not herbal remedies.
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The Calgary Cambridge Consultation Model focuses primarily on medical history without regard for effective communication.
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The 'R' in SOCRATES relates to whether symptoms radiate to other parts of the body.
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It is essential to gain patient consent before discussing their medical history and presenting complaints.
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Severity in the SOCRATES framework involves grading the pain from 1 to 10.
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The history taking sequence includes a differential diagnosis as the final step.
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Allergies in patient history should only focus on medication reactions.
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Closed questions are often used in consultations to allow patients to elaborate on their symptoms and experiences.
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The acronym SOCRATES is used to gather information specifically about pain and its characteristics.
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Summarizing patients' statements is an unnecessary step during a consultation.
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Empathy is essential for developing a positive relationship with patients.
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The Calgary Cambridge Model in communication emphasizes the use of non-verbal communication only.
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Global trends in morbidity and mortality can be described using data from the Global Burden of Disease study.
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The principles of microbiological diagnostic investigation are not included in the learning outcomes for communication skills.
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Establishing professionalism, leadership, and resilience is unrelated to managing self and engaging with patients according to the learning outcomes.
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The characteristics of medically important microbiological organisms relate to the pathogenesis of viral infections only.
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The Calgary Cambridge Model neglects the concept of understanding a patient's ideas, concerns, and expectations.
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One learning outcome is to demonstrate appreciation for communication skills within the consultation.
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Discussing the application of personal identity constructs is irrelevant in clinical practice according to the learning outcomes.
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The first step in the Calgary Cambridge Consultation Model is to focus solely on medical history.
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An open question can prompt a patient to provide brief and specific answers.
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Empathy plays a crucial role in building the doctor-patient relationship according to communication models.
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Summarizing a patient's statements is unnecessary during a consultation.
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In the SOCRATES method, the letter 'O' stands for the origin of the pain.
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It is essential to gain the patient's consent before discussing their history and complaints.
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Closed questions are more effective than open questions in allowing patients to express their thoughts in detail.
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The Calgary Cambridge Consultation Model ignores the patient's ideas and concerns.
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The 'A' in the SOCRATES framework refers to associated symptoms, such as fever or sputum.
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Timing in the SOCRATES method encompasses both when symptoms occur and their duration.
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The 'C' in the SOCRATES acronym stands for chronicity, indicating the duration of pain.
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In the Calgary Cambridge Model, summarizing the patient's statements is significant for demonstrating attentiveness.
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The severity of pain in the SOCRATES framework is assessed on a scale from 1 to 10, where 1 represents maximum pain.
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The SOCRATES framework is applicable only for gathering information regarding musculoskeletal complaints.
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The Calgary Cambridge Consultation Model was developed to help clinicians understand patient concerns effectively.
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Open questions are less useful than closed questions in eliciting detailed personal histories during consultations.
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The primary purpose of agenda setting in patient consultation is to balance the patient's needs with the clinician's objectives.
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The 'O' in the SOCRATES framework refers to onset, addressing the timing of when the pain first began.
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An open question like 'Does your cough get worse when you exercise?' is an example of encouraging detailed patient narratives.
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In the context of the SOCRATES framework, 'C' stands for 'character', which describes the nature of the pain.
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Closed questions, such as 'Would you like to tell me more about that?', often invite expansive dialogue from patients.
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Engaging with the patient requires careful listening but does not necessitate gaining their consent before proceeding with questioning.
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Non-verbal behaviors, such as facial expressions and posture, do not play a significant role in communication with patients during consultations.
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The 'S' in SOCRATES for pain gathering refers to the severity of the pain, which is typically rated on a scale from 1 to 10.
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A mild reaction to medication includes symptoms such as vomiting and rash.
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In the context of social history, smoking history indicates a measure referred to as 'one pack year'.
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The Calgary Cambridge Consultation Model focuses solely on the patient's physical symptoms and ignores their ideas and concerns.
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Summarizing findings at the end of a consultation is an optional step in the Calgary Cambridge model.
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Family history is unrelated to the understanding of chronic conditions that may run in families.
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The Calgary Cambridge model was created primarily for the purpose of teaching medical students about effective treatment protocols.
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Non-verbal behavior significantly impacts how patients communicate during consultations.
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Alcohol history guidelines suggest that a male may safely consume up to 17 units per week.
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Study Notes
Initiating the Session: Establishing Rapport
- Greet the patient and ask their name.
- Introduce yourself and state your role.
- Ensure the patient is seated comfortably.
- Demonstrate interest and respect.
- Gain consent before proceeding: "Mr Brown, I am going to ask you a few questions about what brought you here today, about your past history and your family history, is that ok?"
Initiating the Session: Identify the Reason(s) for Consulting You
- Ask the opening question to identify the patient's problem(s): "Mr Brown, would you like to tell me why you are here today?"
- Listen attentively to the patient's opening statement without interrupting.
- Confirm the patient's problem(s).
- Negotiate an agenda with the patient, considering their needs and your own.
Gathering Information: Exploration of the Problems
- Encourage the patient to tell the story of their problem(s): "Would you like to tell me more about that?".
- Use open and closed questioning techniques.
- An open question is: "Can you tell me about your cough?"
- A closed question is: "Does your cough get worse when you exercise?"
- Listen attentively, both verbally and nonverbally.
Gathering Information: Exploration of the Problems
- Pick up on cues, expressions, and body language.
- Use appropriate language and avoid jargon.
- Establish dates and the sequence of events.
- Clarify if something is unclear: "Patient: I took a turn, doctor". "Doctor: Could you explain that in more detail please?"
- Summarize to ensure you have interpreted the patient's statement correctly, and to show you have been listening.
Calgary Cambridge Consultation Model
- Widely used model to structure consultations with patients
- Developed by Suzanne Kurtz and Jonathan Silverman in 1996, later revised
- Emphasizes building rapport, gathering information, providing structure, and involving the patient
- Focuses on effective communication skills for healthcare professionals
Initiating the Session
- Greet the patient and introduce yourself, stating your role
- Make sure the patient is comfortable
- Show interest and respect for the patient
- Gain consent to proceed with the consultation
Identifying the Reason for Consulting
- Ask an open-ended question to identify the patient's presenting complaint
- Listen attentively to the patient's response without interrupting
- Confirm understanding of the problem(s)
- Negotiate an agenda with the patient, considering both needs
Gathering Information: Exploration of the Problems
- Encourage the patient to tell their story about the problem(s)
- Use open and closed questioning techniques
- Listen actively to facilitate the patient's responses verbally and non-verbally
- Pick up on cues, expressions, and body language
- Use appropriate language, avoiding jargon
- Establish dates and sequences of events
- Clarify any unclear information
- Summarize information to ensure accurate interpretation and demonstrate attentiveness
Ideas, Concerns, and Expectations
- Be aware of the patient's:
- Ideas: beliefs about the cause of the problem
- Concerns: worries about their symptoms, potential implications
- Expectations: what help they hope for
- Consider how the problem affects their life and daily living
Providing Structure to the Consultation
- Ensure a logical flow and sequence in the consultation
- Organize information by summarizing regularly before moving to the next section
- Use signposts to transition between topics
Building Relationships with Patients
- Utilize non-verbal communication effectively: eye contact, facial expression, tone, posture, etc.
- Develop rapport through empathy, acknowledging patient views, and providing support
- Involve the patient in the consultation by asking for their perspectives and opinions
History Taking Sequence
- Follows a structured format:
- Introduction and Consent
- Presenting Complaint
- History of Presenting Complaint
- Past History: Medical History, Surgical History
- Medications
- Allergies
- Social History
- Family History
- Systems Review
- Summary
- Differential Diagnosis
- Management Plan
Presenting Complaint
- Uses the acronym SOCRATES to gather information about the patient's presenting complaint
- This approach helps collect details about:
- Site: which joint or body part is affected
- Onset: When did it begin, sudden or gradual?
- Character: Describe the pain, e.g., dull, sharp, throbbing
- Radiation: Does it spread to other areas?
- Associated symptoms: Are there other related symptoms?
- Timing: When does it occur, how often?
- Exacerbating factors: What makes it worse?
- Relieving factors: What makes it better?
- Severity: How severe is the pain on a scale of 1 to 10?
- Activities of daily living: How does it impact your daily life?
Past History
- Gather information about the patient's past medical and surgical history
- Use a combination of open and closed questions
Medications
- Inquire about all medications, including prescribed, over-the-counter, and herbal remedies
- Record medication details, including purpose, prescription date, compliance, and side effects.
Allergies
- Note any known allergies to medications or latex
- Document the severity of the allergic reaction and what happened during exposure.
Social History
- Collect information about the patient's lifestyle, including occupation, smoking habits, alcohol consumption, and recreational drug use.
Family History
- Record any significant medical conditions present in the patient's family.
Introduction to Communication Skills
- The course focuses on improving communication skills for future doctors.
- Students will learn about the Calgary Cambridge Consultation Model and its practical application.
- The lecture will include information on gathering information, understanding patient concerns, and developing a management plan.
Calgary Cambridge Consultation Model
- The model outlines key stages within a consultation, including initiation, gathering information, generating ideas and concerns, and developing a management plan.
- It emphasizes building rapport with the patient, actively listening, and understanding their perspective.
Initiating the Session
- Establish Rapport: Greet the patient, introduce yourself, and ensure they are comfortably seated.
- Gain Consent: Obtain consent from the patient to proceed with the consultation.
- Identify the Reason for Consultation: Ask the patient "Why are you here today?" and listen attentively to their response.
- Agenda-Setting: Negotiate an agenda with the patient, considering both their and your needs.
Gathering Information
- Encourage Storytelling: Ask open-ended questions like "Can you tell me more about that?" to encourage the patient to share their story.
- Utilize Open and Closed Questions: Employ open-ended questions (e.g., "Can you tell me about your cough?") to encourage detailed information; use closed questions (e.g. "Does your cough get worse when you exercise?") to clarify specific details.
- Active Listening: Pay attention to verbal and non-verbal cues, including expressions and body language.
- Clarify Unclear Information: Ask for further information to clarify any unclear statements.
- Summarize: Summarize what the patient has shared to ensure understanding and demonstrate attentiveness.
Gathering Information: Exploring Pain
-
SOCRATES: Use the SOCRATES mnemonic to gather details about pain.
- S: Site: Where is the pain located?
- O: Onset: When did the pain start? How did it begin?
- C: Character: Describe the pain (e.g. dull, sharp, throbbing, burning).
- R: Radiation: Does the pain spread to other areas?
- A: Associated symptoms: Are there any other symptoms accompanying the pain?
- T: Timing: How long does the pain last? Is it constant or intermittent?
- E: Exacerbating factors: What makes the pain worse?
- S: Severity: How severe is the pain on a scale of 1-10? How does it impact daily activities?
Gathering Information: Past History
- Past Medical History (PMH): Ask about any known medical conditions, treatments, or regular medical care.
- Past Surgical History (PSH): Inquire about any past surgeries or hospital investigations.
- Medications: Document current medications, including prescribed, over-the-counter, and herbal remedies.
- Allergies: Record any known allergies (medication, latex, etc.) and the extent of the allergic reaction.
Social History
- Home Environment: Ask about living arrangements, family support, and dependents.
- Occupation: Inquire about the nature of their work and work/life balance.
- Hobbies: Ask about any hobbies, particularly those involving exercise.
Alcohol and Smoking History
- Smoking History: Ask about smoking status, including duration and quantity (pack years).
- Alcohol History: Probe into alcohol consumption patterns and frequency, using units of alcohol as a measure.
Family History
- Living and Deceased Relatives: Ask about the health status of family members (parents, siblings), including any known conditions.
- Inherited Conditions: Inquire about any known conditions that run in the family, such as cystic fibrosis, haemochromatosis, diabetes, heart disease, or high blood pressure.
Beyond Year 1
- Systems Review: A thorough review of all body systems to uncover any additional concerns.
- Summary of Findings: A concise summary of the information gathered during the consultation.
- Differential Diagnosis: A list of potential diagnoses based on the patient's symptoms.
- Management Plan: A detailed plan outlining actions to address the patient's concerns.
Communication Skills
- Be Aware of Patient's Ideas, Concerns, and Expectations (ICE): Throughout the consultation, be mindful of the patient's thoughts and feelings.
- Use Appropriate Language: Avoid medical jargon and use clear and concise language.
- Active Listening: Pay attention to verbal and non-verbal cues.
- Be Empathetic: Show understanding for the patient's situation.
References
-
Kurtz SM, Silverman JD, Draper J (1998) Teaching and Learning Communication Skills in Medicine.Radcliffe Medical Press (Oxford)
-
Silverman JD, Kurtz SM, Draper J (1998) Skills for Communicating with Patients.
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Description
This quiz focuses on the essential techniques used during patient consultations, including establishing rapport and exploring patient problems. It involves understanding the steps in initiating a session and gathering information to better address patient needs. Test your knowledge of effective communication strategies in a clinical setting.
