Initiating the session
How the learner opens the conversation and establishes the patient's agenda.
Commora pilot information
Assessment approach
Commora provides formative communication feedback aligned with an adapted version of the Observation Scheme-12, which is based on the Calgary-Cambridge Guide.
Last updated
What the framework covers
The report looks at observable communication behaviours across six parts of a clinical conversation. It does not judge whether medical information, a diagnosis, or a treatment decision is correct.
Gathering information
How the learner encourages the patient's story, listens, clarifies, and explores understanding.
Building the relationship
How the learner uses understandable language, creates conversational space, and responds with empathy.
Providing structure
How the learner organizes the conversation, signals transitions, maintains focus, and manages available time.
Explanation and planning
How the learner tailors information, checks understanding, involves the patient, and clarifies next steps.
Closing the session
How the learner summarizes and confirms understanding and agreement at the close.
Published source
Observation Scheme-12 was developed as a 12-item tool for trained human raters assessing audio-recorded clinical consultations. The published codebook uses a 0 to 4 scale and reports validation and reliability findings for that human-rated use.
Source: Iversen ED, Wolderslund MO, Kofoed PE, et al. Codebook for rating clinical communication skills based on the Calgary-Cambridge Guide. BMC Medical Education. 2020;20:140.
Commora’s adaptation
Commora adapts the framework for automated, transcript-based formative feedback. Item wording has been paraphrased for the training platform, and scores are calculated only from items that can be assessed from the available transcript and conversation events.
Commora does not infer eye contact, facial expression, body language, posture, or emotion. If a behaviour cannot be judged reliably, the item is marked not directly assessable and removed from the available-score total.
How scores are presented
Each assessed item receives an integer score from 0 to 4. The report shows the raw assessed score, the available maximum, six normalized domain results, and a normalized overall score from 0 to 100. The normalized score is retained for consistency with saved Commora sessions. It is not a pass or certification result.
- 0 Not demonstrated
- 1 Limited
- 2 Developing
- 3 Effective
- 4 Highly effective
Validation and training limits
The published human-rated OS-12 framework has validation evidence. Commora’s automated adaptation has not been independently validated and requires clinical calibration. It must not be used for high-stakes assessment.
Feedback is for formative communication practice only. It does not assess medical knowledge, diagnosis, treatment decisions, clinical competence, licensure, or professional fitness. The source authors and institutions do not endorse Commora.