The Calgary-Cambridge Guide

Written by Gabia Neverauskaitė, Psychologist & Remote Assessment Coordinator,

The Calgary-Cambridge Guide (CCG) is a patient-centred method used to structure medical interviews. It includes physical, psychological, and social aspects of consultations and is practical by providing a list of tasks.1 uses the CCG short-form to mark a candidate’s performance. This short-form includes a 12-item score sheet which focuses on specific communication skills which should be portrayed during an OSCE (Objective Structured Clinical Examination) case scenario.2 

The CCG was developed in order to create targets for teaching communication skills as part of medical curricula.3 It covers the entire medical interview and is widely used as an assessment tool using its short version. The CCG demonstrates good test-retest reliability and construct validity deems it as an appropriate instrument for measuring communication skills among medical students.3

The CCG breaks down a consultation into seven separate stages: initiating the session, gathering information, building the relationship, providing structure, explanation and planning, and closing the session.2 Each stage of the CCG awards points based on how well “micro-skills” are demonstrated. These micro-skills vary in each stage and examine different elements of communication skills. When initiating the station, questioning is an important micro-skill to ensure you are addressing the correct patient and concern. An open-ended question such as, “how can I help you today?”, is an example of a complete micro-skill. A close-ended question depicts a lack of skill and receives a score of zero. 

A global rating scale is an addition to the CCG, which uses a 5-point scale ranging from clear fail to excellent. The goal of this scale is to examine the overall performance including; the appropriate interaction with the patient and portrayal of a good impression while also ensuring the information provided is accurate and correct.2

The CCG may not suit all consultations as some assessors may find it difficult to follow the structure or some patients may even prefer a more doctor-centred approach.1 Even though there is no “perfect” model to assess communication skills, the CCG is more structured and task-focused which makes it more helpful for assessors compared to other models.1

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