LESSON 2.2: The Three Core Models You Must Know

Calgary-Cambridge Model (Silverman, Kurtz & Draper, 1996)

The most comprehensive and evidence-based model. Five stages with two threads (building the relationship + providing structure) running throughout:

1. Initiating the session - establish rapport, identify reasons for attendance
2. Gathering information - explore problems using open-to-closed questioning, listen actively, elicit the patient's narrative
3. Physical examination - (not applicable in SCA)
4. Explanation and planning - provide correct information, achieve shared understanding, plan together
5. Closing the session - summarise, agree on plan, safety net

Neighbour's Inner Consultation (1987)

Five checkpoints that map naturally to the flow of a GP consultation:

1. Connecting - establish rapport and connection with the patient
2. Summarising - get to the point; elicit ICE; summarise back to the patient
3. Handing over - transition to management; share responsibility with the patient
4. Safety netting - "What if I'm wrong?" - provide guidance on when to return
5. Housekeeping - manage your own emotions; prepare for the next patient

Pendleton's Model (1984)

Introduced the concept of ICE (Ideas, Concerns, Expectations) and seven patient-centred tasks:

• Define the reason for attendance, including the patient's perspective (ICE)
• Consider other problems (don't tunnel-vision)
• Choose an appropriate action for each problem with the patient
• Achieve a shared understanding of the problems
• Involve the patient in the management plan
• Use time and resources appropriately
• Establish and maintain a relationship with the patient