GP · core-skills
Consultation models and patient-centred communication
Also known as Calgary-Cambridge guide · Patient-centred consulting · Communication skills in general practice
GP-fellowship guide to consultation models and patient-centred communication: Pendleton, Neighbour and Calgary-Cambridge structures, the outcome evidence for patient-centredness, core process skills examiners mark, agenda setting and ICE, explanation-planning, difficult contexts, and demonstrating patient-centredness under CCE time pressure.
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Red flags
- A consultation that ends without knowing what the patient actually wants has failed, however sound the diagnosis
- The doorknob presentation - the real reason surfacing at the door - signals an unexplored agenda at minute one
- Jargon-heavy explanations with no comprehension checks are a safety hazard, not just poor style
Overview
The consultation is the unit of general practice work. Models give it a teachable structure; communication skills make it work in real time. The evidence base is stronger than commonly assumed: of 21 studies meeting quality criteria linking physician-patient communication to health outcomes, 16 reported positive results.[6]
References7ShowHide
- [1]Kinnersley P et al. The patient-centredness of consultations and outcome in primary care. Br J Gen Pract, 1999.PMID 10756612
- [2]Stewart M et al. The impact of patient-centered care on outcomes. J Fam Pract, 2000.PMID 11032203
- [3]Makoul G Essential elements of communication in medical encounters: the Kalamazoo consensus statement. Acad Med, 2001.PMID 11299158
- [4]Kurtz S et al. Marrying content and process in clinical method teaching: enhancing the Calgary-Cambridge guides. Acad Med, 2003.PMID 12915371
- [5]Henbest RJ et al. Patient-centredness in the consultation. 1: A method for measurement. Fam Pract, 1989.PMID 2632300
- [6]Stewart MA Effective physician-patient communication and health outcomes: a review. CMAJ, 1995.PMID 7728691
- [7]Pill R et al. A randomized controlled trial of an intervention designed to improve the care given in general practice to Type II diabetic patients: patient outcomes and professional ability to change behaviour. Fam Pract, 1998.PMID 9694180