Calgary Cambridge Model

Question 1

What is the cycle of learning throughout the communication skills course?

Answer 1

Prepare, Communicate, Reflect, Receive Feedback, Reflect on feedback, repeat.

Question 2

What is the aim of the communication skills course?

Answer 2

Drawing on effective ways of communication you already possess.
Learning about the range of communication methods that others have.
To expand your repertoire of styles to enable you to meet the needs of a more diverse range of clients.

Question 3

1. 2 components of communication.
2. What other skill type is essential to being a good communicator?

Answer 3

1. Verbal and non-verbal.
2. Listening.

Question 4

1. Verbal communication skills in consultation.
2. Aspects of the listening skills in consultation.

Answer 4

1. Questioning techniques – open and closed Qs, reflective / probing / leading Qs.
   Giving info – ‘chunk and check’, summarising.
2. Eye contact.
   Non verbal cues.
   Encouragement / paraphrasing.
   Fluency of conversation.
   Summarising back.

Question 5

1. What is non verbal communication described as?
2. What are the functions of non verbal communication?

Answer 5

1. Communication that involves all forms of communication other than the spoken word.
2. Convey attitude and emotion.
   Support (or contradict) verbal messages.
   Add meaning to verbal communication.
   Regulate interaction – Taking turns and show interest through ‘active listening’.

Question 6

Components of non verbal communication.

Answer 6

Facial expression and movement.
Eye contact.
Body movements and posture.
Proximity and orientation.
Personal appearance and environment.
Paralinguistic features – volume, pace, pitch, tone, fluency, non meaningful utterances (um ah uh).

Question 7

SOLER.

Answer 7

Sit – ideally at a slight angle to owner.
Open position maintained – legs/arms uncrossed.
Lean slightly forward.
Eye contact maintained without staring.
Relax and avoid fidgeting.

Question 8

Effect of communication on case outcome.

Answer 8

Accuracy of data collection.
Health.
Owner compliance/adherence.
Patient/client satisfaction.

Question 9

Outline the top layer of the modified Calgary Cambridge model.

Answer 9

Preparation for consultation.
Initiating the consultation.
Gathering information.
Physical examination.
Explanation and Planning.
Closing the Consultation.

In doing this, we provide structure to the consultation and build a relationship with the client.

Question 10

Purpose of using the Calgary Cambridge model.

Answer 10

Adaptation of a model in human medicine, validated for application to a veterinary context.
As a way of looking at a vet consultation from a communication viewpoint.
Allows exploration and discussion of communication skills within vet consultation.
Facilitates learning – encourages individuals to reflect on and develop their personal communication skills.
NOT prescriptive in any sense – e.g. may not be applied as a linear model.

Question 11

Outline second layer of the Calgary Cambridge model.

Answer 11

In preparation – establish context and create a professional, safe, effective environment.

Initiation – Establish initial rapport w/ client and animal and identify reasons for consult.

Gathering info – Exploring client’s presenting complaint – Clinical perspective (disease – short term history), client perspective (including animal’s purpose), essential background info (long term history).

PE

Explaining and Planning – Providing appropriate amount of and type of info, aiding accurate understanding and recall, achieving shared understanding: incorporate the client’s perspective, planning appropriately to suit all needs.

Closing the consultation – summarise, forward planning.

Make organisation overt and attend to flow.

Build relationship with client by non verbal bhvr, rapport, client involvement, animal(s) involvement.

Question 12

The basic stages.

Answer 12

Prep
Initiate
Gather info
Give info
Shared decision making
Provide structure to consult
Develop positive relationship w/ client.
Close consult

Question 13

Skills for consult prep.

Answer 13

Familiarise with past history.
Anticipate potential conflicts or difficulties.

Ensuring facilities / environment professional and appropriate to anticipated needs.

Question 14

Skills for initiation – establish initial rapport w/ client and animal.

Answer 14

Greet client (and animal if appropriate); obtains / confirms client’s name and the name or identity of the animal(s).
Introduce self, role and nature of consult; obtains consent.
Demonstrate interest, concern and respect for client and animal.
Attend to client and animal physical comfort.

Question 15

Skills for initiation – identifying reason(s) for consult.

Answer 15

Identifies problems/issues client wishes to address w/ appropriate opening Q.
Listen attentively to client opening statement w/o interrupting or directing client’s response.
Check and screen for further problems.
Negotiate agenda, taking client’s and VS’s needs into account.

Question 16

Skills for gathering info – exploration of client’s problems.

Answer 16

Encourage client to tell the story.
Use open and closed Qs.
Listen attentively.
Facilitate client’s responses verbally and non verbally.
Pick up verbal and non verbal cues from the client.
Clarify statements that are vague or need amplification.
Periodically summarises
Use concise, easily understood language, avoiding or adequately explaining jargon.

Question 17

Types of questioning.

Answer 17

Open Qs.
Closed Qs.
Probing Qs.
Leading Qs.
Rhetorical Qs.
Clarifying Qs.

Question 18

Cone of history taking.

Answer 18

Open Qs – who, what, where, how, when…
Can you tell me more about…
And then the specifics.

Question 19

Additional skills for understanding the client’s perspective while gathering info.

Answer 19

Determines and acknowledges:
- Client’s ideas.
- Client’s expectations.
- How each problem affects client’s life.

Question 20

Skills for giving explanations.

Answer 20

Assess client’s starting point.
Gives explanation at appropriate times: avoids giving advice, info or reassurance prematurely.
Prioritises info given.
Organises explanation into discrete sections, develops logical sequence.
Explicit categorisation/signposting.
Repetition and summarising to reinforce info.
Uses concise easily understood language, avoids or explains jargon.
Visual methods of conveying info.
Checks client’s understanding of info given or plans made.

Question 21

Skills for shared decision making and planning.

Answer 21

Relate explanations to client’s initial concerns.
Provide opportunities and encourage client contribution.
Elicits client’s beliefs, reactions and feelings regarding info given, terms used, financial implications; acknowledges, empathises and addresses where necessary.

Appropriate shared decision making:
Share your own thought: ideas, thought processes and dilemma.
Offers choices rather than giving directives.
Encourage contributions of client’s thoughts, ideas, suggestions and preferences.
Negotiates mutually acceptable plan.
Encourages client to make decisions to the level that they wish.
Checks w/ client if they accept plans, if concerns have been addressed.

Question 22

Skills in making organisation overt.

Answer 22

Summarise at end of a specific line of inquiry to confirm understanding before moving to the next section.
Progressing from one section to another using signposting.
Attend to flow by structuring consultation in a logical sequence and attending to timing and keeping consultation on task.

Question 23

Skills in building relationship with the owner.

Answer 23

Demonstrate appropriate non verbal behaviour.
Acknowledge clients views and feelings, accept legitimacy, don’t judge.
Demonstrate understanding of animal’s importance and purpose.
Use empathy to communicate understanding and appreciation of client’s and animal’s feelings.
Provide support to client: expresses concern, understanding, willingness to help, acknowledges coping efforts and appropriate animal care; offers partnership.
Sensitively deal with the embarrassing and disturbing topics and physical pain.
Share thinking with client to encourage their involvement.
Explain rationale for questions.
Acknowledges animal and / or alerts animal to their presence.
Relates to animal, taking into account the relationship between client and animal.

Question 24

Skills in closing the consultation.

Answer 24

Summarise and present plan for client agreement.
Safety nets – what to do if concerned or clinical situation changes.
Next steps.
Final check.
Goodbyes.