Communication Skills - 2 min read
SCA Consultation Models Explained: Which One to Use?
Compare consultation models and choose a flexible structure for patient-centred conversations.
Why consultation models are worth knowing about
Consultation models offer a way of describing what tends to happen in a good consultation: opening, gathering information, examining, explaining, sharing a plan, and closing. They are background reading rather than scripts, and most candidates eventually develop a hybrid style that suits them.
Calgary-Cambridge as one common framework
Calgary-Cambridge is one of the most widely taught models in UK general practice. It breaks the consultation into broad stages and lists behaviours that often improve patient-centred care, such as picking up cues, structuring information, and checking understanding.
Other models trainees often encounter
Other frameworks you may encounter include Pendleton, Neighbour, Stott and Davis, and BARD. These are distinct approaches, with different emphases on consultation tasks, the patient’s agenda and reflection. Use a model as a prompt during practice review, then check your performance against the actual SCA marking domains.
Mapping models to the SCA marking domains
The RCGP describes SCA marking around data gathering and diagnosis, clinical management and medical complexity, and relating to others. Trainees may want to use a consultation model to reflect on which behaviours sit under each domain, rather than treating the model as the assessment itself.
Choosing a structure that works for you
No single model is required by the RCGP. A flexible structure that keeps the consultation safe, patient-centred, and complete is usually more useful than rigid adherence to a single framework. Many trainees find that picking one model as a 'home base' and borrowing prompts from others works well.
Useful sources
The RCGP SCA toolkit and global skills pages describe consultation skills in the examiner's own language. Background reading on Calgary-Cambridge (the original Silverman, Kurtz and Draper guides) and Neighbour's 'The Inner Consultation' are commonly recommended.
Suggested practice prompt
Trainees often find it helpful to record (or replay in their head) a recent consultation, then map what happened against a chosen model. The gaps it surfaces are usually more useful than the section the model labels as 'completed'.
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