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 |