Abstract This opinion article outlines the alignment between patient-clinician consultations in healthcare and student-investigator meetings focused on academic misconduct. We consider how healthcare consultations have evolved from a clinician-centred, authoritative approach to an increasingly shared decision-making model in which the patient is an equal partner. We explore how student–staff discussions on academic misconduct have also been transformed to a more student-centred approach, though this shift is evident only within certain educational organisations. The Calgary-Cambridge model, commonly used to structure clinical consultations, is adapted as a suggested model for framing conversations relating to academic misconduct with students. The five stages of the original Calgary-Cambridge (initiating the conversation; gathering information, physical examination, explanation and planning, closing the session) have been revised to four stages better suited to the non-clinical context of the academic misconduct meeting (initiating the conversation, gathering and examining information, providing information and planning, closing the conversation). The descriptions within the model have also been adapted to suit the academic integrity context. We propose that this adapted Calgary-Cambridge model supplements the Courageous Conversations approach, as described by House, Murdoch and Ellis. Courageous Conversations provide a broad framework for supportive conversations where the student is valued as a partner. The model we describe builds on this concept of student partnership as an anchor for academic misconduct meeting and provides a granular and practical structure for these conversations. We argue that the constructive and supportive approach to these challenging conversations is likely to have a more positive impact on future academic practice than an exclusively authoritative approach, mirroring the better patient outcomes observed with a partnership approach.