LESSON 2.2: The Three Core Models You Should 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
3. Physical examination — (not applicable in SCA)
4. Explanation and planning — provide correct information, achieve shared understanding
5. Closing the session — summarise, agree on plan, safety net

Neighbour’s Inner Consultation (1987)

1. Connecting — establish rapport and connection
2. Summarising — get to the point; elicit ICE; summarise back
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:

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