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Communication and consultation skills are a crucial aspect of patient care, and they, like other clinical
skills, need to be learned. Students who will be moving into Year Four in the ALM course in 2010 began
2008 with communication skills teaching which more closely resembled the teaching of previous years,
but with the introduction of considering the patients perspective in gathering a history. The Calgary-
Cambridge model has been used to base the learning of consultation.
Thus, the consultation is broken down into five separate and sequential steps, each of which requires
particular skills to successfully move through them. Alongside these steps are the tasks of Building
the Relationship and Providing Structure. These are continuous threads which run throughout the
consultation.
(From: Kurtz S, Silverman J, Benson J, Draper J. Marrying Content and Process in Clinical Method Teaching: Enhancing the Calgary-
Cambridge Guides. Academic Med. 2003;78: p806)
Please note that the students opportunities to practise these skills have been limited almost entirely to
simulated situations, either with actors or with peers role-playing scenarios. They will benefit enormously
from being able to revisit and practise these skills with the patients they meet in the ALM programme.
Furthermore, such experiences will be highlighted when teaching staff are able to observe a proportion
of these interactions, and to provide feed-back to students as a consequence.
By the end of ELM 3, students should be competent to engage with a patient to determine the reasons
for their presentation, and having due regard for the patients perspective of their illness.
They will have attempted to gather information about key symptoms of cardiovascular, respiratory,
gastrointestinal, musculoskeletal and neurological diseases
They will have attempted to interview someone who is angry, or anxious or embarrassed
They will have been exposed to taking an obstetric history, a sexual history and a history from
someone who is depressed
Where there are differences from earlier Communication Skills learning, they will be (i) in the
structure of the consultation, and (ii) in some of the terminology used. In addition to this, the
framework encompasses the entire medical consultation. The model also makes it clear that patients
are to be encouraged to express their ideas, concerns and feelings.
Note: For the new cohort of students moving up through the Advanced Learning in Medicine programme, the
Year 5 OSCE stations relating to elements of the clinical consultation
will be based on the Calgary-Cambridge Model.