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1
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- New Performance criteria from 2004
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2
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- is based on good consulting skills
- is under the candidate’s control
- relies on good preparation
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3
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- Standard VHS format, normal speed
- 7 full consultations (but up to 2 hrs if for Summative Assessment)
- Valid consent for each
- 1 paediatric case
- 1 psych/social case
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4
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- Show both doctor’s & patient’s face on screen
- Be audible & visible
- Show whole consultations
- Consent off-screen
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5
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- Should show length of time of consultation (<15 mins)
- Should indicate the paediatric and psychological/social case in the
summary
- Comments should show insight into the consultation process
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6
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- Embarrassing examinations on-screen
- Multiple consultations in 1 slot
- Mainly low-challenge consultations
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7
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- Elicit the patient’s account of the symptoms which made him/her turn to
the doctor:
- PC 1. the doctor is seen to encourage the patient’s contribution at
appropriate points in the consultation
- PC 2. the doctor is seen to respond to signals (cues) that lead to a
greater understanding of the problem (M)
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8
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- Obtain relevant items of social and occupational circumstances:
- PC 3. The doctor uses appropriate social and psychological information
to place the complaint(s) in context
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9
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- Explore the patient’s health understanding:
- PC 4. The doctor explores the patient’s health understanding
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10
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- Obtain additional information about symptoms and details of medical
history:
- PC 5. the doctor obtains sufficient information to include or exclude likely
relevant significant conditions
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11
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- Assess the condition of the patient by appropriate physical or mental
inspection:
- PC 6. the doctor chooses a physical/mental examination which is likely
to confirm or disprove hypotheses…or is designed to address a patient’s
concern
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12
|
- Make a working diagnosis:
- PC 7. the doctor appears to make a clinically appropriate working
diagnosis
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13
|
- a. Share findings with the patient
- PC 8. the doctor explains the problem or diagnosis in appropriate
language
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14
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- tailor the explanation to the patient:
- PC 9. the doctor’s explanation takes account of some or all of the
patient’s health beliefs (merit)
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15
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- Ensure that the explanation is understood and accepted by the patient:
- PC 10. the doctor specifically seeks to confirm the patient’s
understanding of the diagnosis (merit)
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16
|
- a. Choose an appropriate form of management
- b. Involve the patient in the management plan to the appropriate extent
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17
|
- Choose an appropriate form of management:
- PC 11. the management plan (including any prescription) is appropriate
for the working diagnosis, reflecting a good understanding of modern
accepted medical practice
|
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18
|
- Involve the patient in the management plan to the appropriate extent:
- PC 12. the patient is given the opportunity to be involved in
significant management decisions
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19
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- Are relevant options available?
- Is this patient capable of making choices?
- Does this patient want to make a choice?
- Is this an appropriate strategy here? (if not, don’t try to contrive
it!)
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20
|
- “so given that choice, what would you like me to do?”
- “I could refer you to our counsellor, or you could contact Relate
yourself: which would you prefer?”
- “some people prefer to adjust their inhaler dose themselves: would you?”
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21
|
- Make effective use of resources:
- PC 13. in prescribing the doctor takes steps to enhance concordance, by
exploring and responding to the patient’s understanding of the
treatment (merit)
- PC 14. the doctor specifies the conditions and interval for follow-up
or review
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22
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- Make sure these are solid!
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Notes
