Review Article
The art and science of consultations in bovine medicine: Use of modified Calgary - Cambridge guides
Kiro R. Petrovski * ,
Michelle Mc Arthur

Mac Vet Rev 2015; 38 (2): 137 - 147

10.14432/j.macvetrev.2015.05.044

Received: 20 March 2015

Received in revised form: 08 May 2015

Accepted: 12 May 2015

Available Online First: 18 May 2015

Published on: 15 October 2015

Correspondence: Kiro R. Petrovski, kiro.petrovski@adelaide.edu.au
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Abstract

This article describes few steps of the application of the modified Calgary-Cambridge Guides (CCG) to consultations in bovine medicine. A review of pertinent clinical communication skills literature in human medicine was integrated with the burgeoning research within veterinary medicine. In particular, there are more recent studies examining companion animal veterinarian’s communication skills and outcomes which can be extrapolated to practitioners. This was integrated into a teaching example of a reproductive case consultation. The first article deals with the 1) Preparation, 2) Initiating the Session and 3) Gathering Information sections. The aim of the modified CCG is to provide a set of skills to facilitate a relationship-centred approach to consultations in bovine medicine, both at the individual animal and population level. They were initially developed for human medicine and expanded recently for use in veterinary medicine. The CCG enable the practitioner to facilitate interacting with that particular client at the time of the consultation. It is likely that the majority of practitioners do use many of the skills recommended by the modified CCG. These skills are often gained through experience. However, they may not use the skills intentionally and with purpose for a specific communication goal or outcome. Practitioners can improve their communication skills using the set of skills as recommended by the modified CCG. They allow the practitioner to gain insight into the client’s understanding of the problem, including underlying aetiology, epidemiology and pathophysiology. The guides also provide opportunity to understand client’s expectations regarding the outcome, motivation and willingness to change and adherence.

Keywords: modified Calgary-Cambridge guides, practitioner, client, consultation


References

1. Kanji N, Coe J. B, Adams C. L, Shaw J. R, Effect of veterinarian-client-patient interactions on client adherence to dentistry and surgery recommendations in companion-animal practiceJ Am Vet Med Assoc 2012; 240: 4427-436. http://dx.doi.org/10.2460/javma.240.4.427. PMid:22309015
2. Coe J.B, Adams C.L, Bonnett B.N, A focus group study of veterinarians’ and pet owners’ perceptions of veterinarian-client communication in companion animal practiceJournal of the American Veterinary Medical Association 2008; 233: 71072-1080. http://dx.doi.org/10.2460/javma.233.7.1072. PMid:18828715
3. Shaw J.R, Adams C. L, Bonnett B.N, Larson S, Roter D.L, Veterinarian satisfaction with companion animal visitsJournal of the American Veterinary Medical Association 2012; 240: 7832-41. http://dx.doi.org/10.2460/javma.240.7.832. PMid:22443436
4. Sandler G, Costs of unnecessary testsBritish Medical Journal 1979; 7: 221-4. http://dx.doi.org/10.1136/bmj.2.6181.21.
5. Kurtz S, Silverman J, Benson J, Draper J, Marrying content and process in clinical method teaching:Enhancing the Calgary-Cambridge guidesAcademic Medicine 2003; 78: 8802-809. http://dx.doi.org/10.1097/00001888-200308000-00011. PMid:12915371
6. Gillard S, Benson J, Silverman J, Teaching and assessment of explanation and planning in medical schools in the United Kingdom:cross sectional questionnaire surveyMed Teach 2009; 31: 4328-331. http://dx.doi.org/10.1080/01421590801953018. PMid:19142799
7. Adams C.L, Kurtz S.M, Building on existing models from human medical education to develop a communication curriculum in veterinary medicineJ Vet Med Educ 2006; 33: 128-37. http://dx.doi.org/10.3138/jvme.33.1.28. PMid:16767635
8. Radford A, Stockley P, Silverman J, Taylor I, Turner R, Gray C, Development, teaching, and evaluation of a consultation structure model for use in veterinary educationJ Vet Med Educ 2006; 33: 138-44. http://dx.doi.org/10.3138/jvme.33.1.38. PMid:16767636
9. Moulton L, The naked consultation:A practical guide to primary consultation skills 2007; Abingdon, UK: Radcliffe;
10. Boudreau J.D, Cassell E, Fuks A, Preparing medical students to become attentive listenersMed Teach 2009; 31: 122-29. http://dx.doi.org/10.1080/01421590802350776. PMid:19140065
11. Rhoades D.R, McFarland K.F, Finch W.H, Johnson A.O, Speaking and interruptions during primary care office visitsFam Med 2001; 33: 7528-532.PMid:11456245
12. Dysart L.M, Coe J.B, Adams C.L, Analysis of solicitation of client concerns in companion animal practiceJournal of the American Veterinary Medical Association 2011; 238: 121609-1615. http://dx.doi.org/10.2460/javma.238.12.1609. PMid:21671816
13. Beckman H, Frankel R, The effect of physician behaviour on the collection of dataAnnals of Internal Medicine 1984; 9: 9517-521.
14. Heritage J, Robinson J. D, Elliott M. N, Beckett M, Wilkes M, Reducing patients’ unmet concerns in primary care:the difference one word can makeJournal of General Internal Medicine 2007; 22: 101429-33. http://dx.doi.org/10.1007/s11606-007-0279-0. PMid:17674111 PMCid:PMC2305862
15. Brock D.M, Mauksch L. B, Witteborn S, Hummel J, Nagasawa P, Robins L.S, Effectiveness of intensive physician training in upfront agenda settingJournal of General Internal Medicine 2011; 26: 111317-1323. http://dx.doi.org/10.1007/s11606-011-1773-y. PMid:21735348 PMCid:PMC3208461
16. Silverman J.D, Kurtz S, Draper J, Skills for communicating with patients 2005; 2nd ed. Oxford: Radcliffe Publishing;
17. Lipkin M, Putnam S.M, Lazare A, The Medical Interview:Clinical Care Education and Research 1995; New York: Springer-Verlag; http://dx.doi.org/10.1007/978-1-4612-2488-4.
18. Shaw J, Four core communication skills of highly effective practitionersVeterinary Clinics of North America - Small Animal Practice 2006; 36: 2385-396.
http://dx.doi.org/10.1016/j.cvsm.2005.10.009. PMid:16442449
19. McArthur M, Fitzgerald J, Companion animal veterinarians’ use of clinical communication skillsAust Vet J 2013; 91: 9374-380. http://dx.doi.org/10.1111/avj.12083. PMid:23980830
20. Abdel-Tawab N, Roter D, The relevance of client-centred communication to family planning settings in developing countries:lessons from the Egyptian experienceSocial Science and Medicine 2002; 54: 1357-1368. http://dx.doi.org/10.1016/S0277-9536(01)00101-0.
21. Gask L, Usherwood T, ABC of psychological medicine. The consultationBMJ 2002; 324: 73531567-1569. http://dx.doi.org/10.1136/bmj.324.7353.1567. PMid:12089097 PMCid:PMC1123505
22. Levinson W, Gorawara-Bhat R, Lamb J, A study of patient clues and physician responses in primary care and surgical settingsJournal of the American Medical Association 2000; 284: 1021-1027. http://dx.doi.org/10.1001/jama.284.8.1021. PMid:10944650
23. Quilligan S, Silverman J, The skill of summary in clinician-patient communication:a case studyPatient Educ Couns 2012; 86: 3354-359. http://dx.doi.org/10.1016/j.pec.2011.07.009. PMid:21821377
24. Safeer R.S, Keenan J, Health literacy:the gap between physicians and patientsAm Fam Physician 2005; 72: 3463-468.PMid:16100861
25. Bass P.F, Wilson J. F, Griffith C. H, Barnett D. R, Residents’ ability to identify patients with poor literacy skillsAcad Med 2002; 77: 101039-1041.
http://dx.doi.org/10.1097/00001888-200210000-00021. PMid:12377684
26. McMillan S.S, Kendall E, Sav A, King M. A, Whitty J. A, Kelly F, Wheeler A. J, Patient-centered approaches to health care:a systematic review of randomized controlled trialsMed Care Res Rev 2013; 70: 6567-596. http://dx.doi.org/10.1177/1077558713496318. PMid:23894060
27. Robinson J.H, Patient-centered care and adherence:definitions and applications to improve outcomesJ Am Acad Nurse Pract 2008; 20: 12600-607.
http://dx.doi.org/10.1111/j.1745-7599.2008.00360.x. PMid:19120591
28. Kleen J.L, Atkinson O, Noordhuizen J, Communication in production animal medicine:modelling a complex interaction with the example of dairy herd health medicineIrish Veterinary Journal 2011; 64: http://dx.doi.org/10.1186/2046-0481-64-8. PMid:21777495 PMCid:PMC3156738


Acknowledgment

KRP was responsible for the idea, preliminary write up and clinical aspects of the article. MMM was responsible for the theoretical basis and contributed to the writing and editing of the manuscript.

Copyright

© 2015 Petrovski K. This is an Open Access article distributed under the terms of the Creative Commons Attribution-Non Commercial License (http://creativecommons.org), which permits unrestricted non-commercial use, distribution, and reproduction in any medium provided the original work is properly cited.

Conflict of Interest Statement

The authors declared that they have no potential conflict of interest with respect to the authorship and/or publication of this article.

Citation Information

Macedonian Veterinary Review. Volume 38, Issue 2, Pages 137-147, p-ISSN 1409-7621, e-ISSN 1857-7415, DOI:  10.14432/j.macvetrev.2015.05.044, 2015