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Table 2 Codebook with criteria for points allocated to each item

From: Codebook for rating clinical communication skills based on the Calgary-Cambridge Guide

Domains

Item 1: Identifies problems the patient wishes to address

Initiating the session

Micro-skills

Demonstrated micro-skills /criteria

Points

1. Greets patients

2. Introduces oneself, one’s role and the nature of the interview

3. Demonstrates respect and interest; attends to patient’s physical comfort

4. Uses an appropriate opening question/listens attentively

5. Confirms issues to be discussed/screens for further questions and negotiates the agenda

Micro-skill 1 and micro-skill 2

One

Micro-skill 1 and micro-skill 2 together with one of the other micro-skills.

Two

Micro-skill 1 and micro-skill 2 together with two of the other micro-skills.

Three

All micro-skills are demonstrated

Four

 

Item 2: Clarifies the patient’s prior knowledge and desire for information

Gathering information

Micro-skills

Demonstrated micro-skills /criteria

Points

1. Listens attentively, allowing the patient to complete statements without interruption and leaving space for patient

2. Encourages the patient to tell the story of the problem(s) from when it/they first started to the present in his/her own words

3. Uses open and closed questioning techniques, appropriately moving from open to closed questions

4. Clarifies patient’s statements that are unclear or need amplification

5. Periodically summarizes, invites the patient to correct the interpretation or provide further information

One micro-skill

One

Two or three micro-skills

Two

Four micro-skills

Three

All micro-skills are demonstrated

Four

 

Item 3: Uses easily understood language, avoids jargon

Building a relationship

Micro-skills

Demonstrated micro-skills /criteria

Points

No micro-skills

Used ten or more medical words

One

Used between four and nine medical words

Two

Used two to three medical words

Three

Used one or none medical words

Four

Item 4: Uses appropriate non-verbal behaviour

Micro-skills

Demonstrated micro-skills /criteria

Points

1. Calm speaking paces

2. No interruptions

3. Leaves space for the patient to talk

4. Pausing

One micro-skill

One

Two micro-skills

Two

Three micro-skills

Three

All micro-skills are demonstrated

Four

Item 5: Provide support: expresses concern and willingness to help

Micro-skills

Demonstrated micro-skills /criteria

Points

1. Accepts the legitimacy of the patient’s views and feelings; is not judgmental

2. Uses empathy to communicate understanding and appreciation of the patient’s feelings

3. Provides support: expresses concern, understanding, and willingness to help.

Some support provided, but no micro-skill is demonstrated

One

One micro-skill

Two

Two micro-skills

Three

All micro-skills are demonstrated

Four

 

Item 6: Structures the interview in a logical sequence

Providing structure

Micro-skills

Demonstrated micro-skills /criteria

Points

Progresses from one section to another using

1. Signposting

2. Transitional statements

3. Rationale for the next section

Some structure is present, but no micro-skill is demonstrated

One

One micro-skill

Two

Two micro-skills

Three

All micro-skills are demonstrated

Four

Item 7: Attends to timekeeping, and keeps the interview on track

Micro-skills

Demonstrated micro-skills /criteria

Points

1. Structures the interview based on the C-CG

2. Attending to timing

3: Keeping the interview on track

Some structure is present, but no micro-skill is demonstrated

One

One micro-skill

Two

Two micro-skills

Three

All micro-skills are demonstrated

Four

 

Item 8: Shares thoughts and reflections with the patient

Explanation and planning

Micro-skills

Demonstrated micro-skills /criteria

Points

1. Assesses patient’s starting point (preferably using tailored explanations and illustrations)

2. Provides information in manageable chunks, assesses understanding uses patient’s responses as a guide for the best way to proceed

3. Providing the correct amount and type of information to individual patients

Some thoughts/reflections are provided, but no micro-skill is demonstrated

One

One micro-skill

Two

Two micro-skills

Three

All micro-skills are demonstrated

Four

Item 9: Checks the patient’s understanding

Micro-skills

Demonstrated micro-skills /criteria

Points

1. Organizes the explanation (uses summarizing)

2. Assesses the patient’s understanding (asks the patient to summarize the information he/she was provided)

3. Asks the patient what other information would be helpful, addresses patient’s needs for information

A question was asked, but no micro-skill is demonstrated

One

One micro-skill

Two

Two micro-skills

Three

All micro-skills are demonstrated

Four

Item 10: Negotiates a mutual plan of action

Micro-skills

Demonstrated micro-skills /criteria

Points

1. Explores options with the patient

2. Involves the patient in decision making

3. Negotiates a mutually acceptable plan

Some negotiation occurs, but no micro-skill is demonstrated

One

One micro-skill

Two

Two micro-skills

Three

All micro-skills are demonstrated

Four

 

Item 11: Contracts with the patient about next steps

Closing the session

Micro-skills

Demonstrated micro-skills /criteria

Points

1. Contracts with the patient about the next steps

2. Safety nets, e.g., phone number and other lifelines

One micro-skill is initiated but not completed

One

One micro-skill

Two

One micro-skill is completed and the other is initiated

Three

All micro-skills are demonstrated

Four

Item 12: Summarizes the session briefly and clarifies the plan of care

Micro-skills

Demonstrated micro-skills / criteria

Points

1. Final confirmation of patient understanding

2. Summarizes the session briefly and clarifies the plan of care

3. Finally confirms that the patient agrees and is comfortable with the plan

Some type of summary is provided, but no micro-skill is demonstrated

One

One micro-skill

Two

Two micro-skills

Three

All micro-skills are demonstrated

Four

  1. Be very precise about coding the demonstrated skills in the domains in which they occurred
  2. Zero points were recorded if an item was not apparent
  3. If the audio recording stops before all information is provided, items 8, 9 and 10 were coded as “not applicable”
  4. The structure was coded if the audio recording did not stop during “Initiating the session” and “Gathering information”