The aim of the book is to leave exam candidates with more time to concentrate on passing the CSA exam itself. Here are the five key steps needed to do this. The five key steps 2. Ideas, concerns, expectations ICE and effect on day-to-day life 4. Explain diagnosis and shared management plan 5. The red flags and safety net ensure the consultation is safe.
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The aim of the book is to leave exam candidates with more time to concentrate on passing the CSA exam itself. Here are the five key steps needed to do this. The five key steps 2. Ideas, concerns, expectations ICE and effect on day-to-day life 4. Explain diagnosis and shared management plan 5.
The red flags and safety net ensure the consultation is safe. Many candidates swap steps 2 and 3 around, so ICE is asked earlier on, and this can often be a good way of eliciting a patient-centred history. All five steps pose a challenge to the CSA candidate, but most find steps 2 and 4 especially difficult. Therefore while this book covers all five steps, it goes into more detail on steps 2 and 4. During the exam Writing down the five key steps on the notepaper provided in the exam will prompt you to cover all three domains regardless of your nerves Interpersonal skills will be demonstrated throughout the 10 minutes.
Each step, together with interpersonal skills will be expanded in the next sections. It is important to verbalise what you are thinking in the exam. Similarly, if you offer to give written information, you will only gain marks if you have explained the contents of written materials. Basic consultation structure This section expands on the five key steps outlined in the previous section. The actor will volunteer a set amount of information. In some cases, this will purposely not be very much.
Often most of the information will already be covered in the patient summary sheet. However, it is possible that not all relevant information will be given, reflecting real life.
During the exam — red flags Red flags are specific to the condition, but a simple rule is to ask about: 1. It is important to ask these questions using a warm and caring tone of voice. It can be especially useful to ask the questions slowly, even hesitantly, thus demonstrating your concern and sensitivity to the patient.
When to ask which question will vary depending upon the presenting complaint. You may find that you prefer to ask about ICE much earlier on, e. This is especially true for psychiatric and social-type cases, but also true for many physical health symptoms. At this point it can also be useful to summarise the history to the patient. This not only shows that you have been actively listening, but ensures you have not missed anything out and gives the patient a chance to correct any wrong information.
Explain diagnosis and shared management plan This step is one of the most difficult parts of the CSA. The approach will vary depending on the type of case, but here are some suggested guidelines. Use jargon-free language Try to use the same words as the patient if possible. Practising with a non-medic is also useful here. Tell the patient your diagnosis Or tell them of the possible diagnoses or simply your understanding of their situation.
Check their understanding of this i. Give management options Often there will be more than one option, but sometimes it will be necessary to recommend urgent management e. Give rationale for investigations and treatments where appropriate, especially if urgent management is needed. Ask the patient what they think of the diagnosis and management plan. The appropriateness of which investigation to use or whether to investigate at all are all specific to the individual case.
Safety net and arrange follow up Tell patient when to seek help, e. Arrange follow up either with yourself or another health care professional e. Explain how to seek further assistance if required, e. Refer if appropriate. Consultation structure — summary.
CSA Scenarios for the MRCGP, fourth edition
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CSA SCENARIOS FOR THE NEW MRCGP PDF
CSA Scenarios for the MRCGP 4th Edition PDF