Which model have we been using to structure our veterinary consultations?
The Calgary Cambridge model
What are the 5 main pillars of the Calgary Cambridge Model?
- Initiating the Consultation
- Gathering Information
- Physical Exam
- Explanation & Planning
- Closing the Consultation
What are the main goals of initiating the consulatation?
Greeting the client & pet
Introducing yourself
establishing initial rapport
identifying the reasons for the consulation
When identidfying the reasons for the consultation, what are some good techniques to use?
- Open ended questions
- listening attentitively
- screening for further problems
- summarize and confirm problem list
- Negotiate agenda/provide layout for the rest of the consulatation
What are some key ways to build a relationship with your client?
- use of nonverbal behavior - eye contat, facial expression etc
- acknowledge clients views and feelings
- being non judgemental
- using empathy
- invole the client in thinking process
- involed the animal(s)
- Appear confident!!
What are the goals of the gathering information stage?
- exploring the clients presenting complaint
- getting the client to tell a story
- move from open to close ended questions (funneling)
- listening attentively
- faciliating client response verbally and non verbally
- clairfy vauge statements
- summarize own understanding
- using easy to understand language/laymans terms
- establish clients ideas, expectations and how they will ahhect the clients life
What type of history are we interesting in gathering?
Long term - medical records, diet, previous illness/surgery etc
Short term - presenting complaint, recent changes, recent travel etc
What are some ways to provide structure to the consultation?
- summarizing and confirming understanding before moving on
- signposting
- struture consulatation in a logical sequence
- paying attendtion to timing and keeping consulation on task
After doing our physical exam, we reach the explanation and planning phase. What are our 4 main goals of this stage?
- Providing appropiate amount and type of information
- Aiding in accurate understanding & recall
- Achieving shared understanding, incorporating the clients perspective
- Sharing decision making while planning
How can we go about providing appropiate information and amount to our clients?
Asses the clients base knowledge
Chunk and check
give other information according to clients wishes
dont prematurely reassure client
prioritise information
What are good ways to aid in accurate recall and understanding?
organize the explanation logically
signposting
repetition and summarization to reinforce information
concise easily understood language
visual methods (diagrams, models, written etc)
check client understanding
How can we go about incorportaing the clients perspective?
relate explanation to clients initial concerns
provide opportunity for client to contribute/ask questions
recognize verbal/non verbal clues of distress/confusion/overload
elicit client’s beliefs, reactions and feeling “I can see this is upsetting you”
How do you share decision making with your client?
share own thoughts and ask for clients
OFFER choices
negotiate a plan
get informed consent
check with client that they accet plan and discuss their concerns
What are key pilars to closing the consulation
- summarize session
- clarify plan
- forward plan with safetynet (explain unexspected outcomes and what to do)
- contract next steps
- final check the client agrees and is comfortable with plan and informration
- Say goodbye
You have a chance to show empathy, should you take it?
YES! Take every chance to show empathy you can.
