The Gask Method
Watching yourself on tape can feel excruciating. Watching yourself with a kind group, a clear structure, and one very good rule is how you actually get better.
A practical, evidence-based method for using video and audio feedback in group teaching — developed by Professor Linda Gask to help GPs review their own consultations, spot exactly what worked, and change exactly what didn't. It is one of the most useful frameworks for building the skills the SCA examiners are watching for.
📥 Handouts, facilitator guides & video analysis slides
Everything you need to run a Gask-style session — handouts, facilitator notes, a video analysis slide pack, a handy comparison with ALOBA, and the original Gask paper on training teachers to teach communication skills.
path: THE GASK METHOD
🌐 Further Reading & Useful Links
A hand-picked mix of official guidance and real-world GP training resources. Because sometimes the best pearls are not hiding in the official documents.
🎥 Core video-feedback methods
📝 Feedback frameworks
🔬 The underpinning research
📖 RCGP & SCA official
🧰 Real-world GP training
📚 Linda Gask — books & writing
⚡ One-Minute Recall
If you only read one panel on this page, read this one.
🎯 Why this matters in general practice
Consultation skills do not improve because someone hands you a model in a tutorial. They improve when you watch yourself doing them, pause at the uncomfortable bits, and figure out — with structured help from people who have seen it all before — exactly what you would do differently next time.
The Gask Method is one of the most practical, psychologically safe, and enduring ways of doing that. Linda Gask designed it specifically for GP training groups in the late 1980s. Unlike many educational frameworks that sound good in theory and collapse in the room, Gask was tested in controlled trials, refined over years of real-world use, and shaped a generation of UK consultation teaching.
For trainees, it is the shortest route between "I think that consultation went okay" and "I know exactly which twenty seconds went wrong, why they went wrong, and what I will do differently next Tuesday."
For trainers and TPDs, it is a reliable scaffolding for Half Day Release, trainers' workshops, and practice-based teaching — one that avoids the awkward group-freeze that happens whenever nobody knows who should speak first.
And for trainees preparing for the SCA, Gask sessions are arguably the single most efficient way to build the observable, granular consultation behaviours the examiners are actually watching for. More on that below.
Most clinicians believe their consultations are better than a neutral observer would rate them. That perception gap — the space between what we remember and what actually happened — is where video feedback does its work.
👤 About Linda Gask
Linda Gask is Emeritus Professor of Primary Care Psychiatry at the University of Manchester, with a long collaborative history at the University of Leeds. She has spent her career building bridges between psychiatry and general practice — the territory where most people with mental health problems actually live, and where most GPs spend a very substantial part of their working lives.
She is best known in educational circles for two intertwined contributions:
- Reattribution — a structured consultation approach (Goldberg, Gask & O'Dowd, 1989) to help GPs work compassionately with patients presenting with medically unexplained symptoms by gently linking physical experiences to psychosocial context.
- Group video-feedback teaching — the method described on this page. Developed and tested through a series of controlled studies in the late 1980s and early 1990s, it demonstrated that group-based video feedback is as effective as one-to-one feedback for improving GPs' psychiatric interviewing skills, and that experienced GPs could be trained to teach it to their own trainees.
She has also written a quietly beautiful memoir — The Other Side of Silence — in which a psychiatric expert in depression discovers that expertise confers no immunity. Her own journey is woven together with the stories of her patients, drawing out themes of vulnerability, loss, loneliness, and grief. It is a reminder worth carrying into every teaching session: the clinicians teaching you consultation skills are, themselves, human.
💡 Why this matters for the method
Gask did not build this as an ivory-tower framework. She built and tested it in real GP training settings, specifically for clinicians who struggled with the softer parts of consulting — picking up cues, sitting with distress, exploring emotion. That heritage is why the method remains so practical, so kind, and so quietly effective.
🎬 The Gask Method — step by step
The eight ground rules that make the whole thing work. Read them once, print them out, stick them on the wall of the tutorial room, and do not negotiate them when the session gets uncomfortable.
Not the trainer's pick. Not the "best" consultation. The one the trainee genuinely wants to examine.
Specifics, not slogans. "I want to be better at breaking bad news" is too vague. "I want to work on my opening thirty seconds" is a usable agenda.
The tape — not memory — is the shared reference. Everyone watches the same thing. Nobody reconstructs the consultation from hearsay.
Not just the facilitator. Not just the learner. Any group member. This single permission is the democratising move that defines the method.
"Empathy" is not a teachable skill. "The two-second pause you took after she said 'frightened'" absolutely is.
The session is not about antibiotic choice or referral threshold. That is a case-based discussion, and it belongs somewhere else.
The tape can be paused to celebrate something done well — or to flag something that could have been done differently. Both are equally legitimate.
If you stop to offer a critique, you must have a specific alternative ready. Abstract criticism is not permitted.
The one rule that makes Gask actually work
No stopping the tape to say "that didn't feel right" and then trailing off into silence. If you stop, you own it — you must propose a concrete alternative. This single rule prevents the session becoming a public autopsy and turns every criticism into something the learner can actually use in clinic next week.
Most of the value lives in the loop between Stop → Discuss → Rehearse → Play. The best sessions are not tidy left-to-right; they double back several times on a single skill until the alternative starts to feel natural.
🧬 The anatomy of a Gask session
Before diving into the steps, here is how the pieces fit together. Gask sessions are built around three concentric rings — rules, roles, and focus — that together create a space safe enough for honest self-observation.
Remove any one ring and the session falls apart — rules without roles collapses into silence; roles without rules turns into a pile-on; either without focus becomes a rambling case discussion.
🧭 Rules (outer ring)
Ground rules agreed up front, non-negotiable once the tape is playing. They are what makes honesty possible without humiliation.
👥 Roles (middle ring)
Someone owns the tape. Someone facilitates. Someone can be asked to watch as the patient. The rest watch as peers. Diffused responsibility means nobody carries the whole session.
🎯 Focus (inner core)
The tape is the artefact. The skill is the unit of discussion. The alternative is what gives every observation a purpose.
📚 What sorts of issues can you teach on?
Gask carved the territory into two halves — detecting the problem and managing it. Everything you will ever work on in a video-feedback session sits somewhere in one of these two columns.
🔍 Problem detection skills
- Beginning the consultation the opening seconds often set everything that follows
- Picking up and responding to verbal cues open-ended questions, clarification, asking for examples
- Picking up and responding to non-verbal cues posture, gaze, pauses, tone of voice, shifts in body language
- Demonstrating empathy and visibly showing the patient that you have
- Asking about health beliefs and concerns ICE — ideas, concerns, expectations
- Ending the consultation safety-netting, closing, checking
🛠️ Problem management skills
- Ventilating feelings making space for the patient's emotion rather than rushing past it
- Information and education explaining clearly, checking understanding, avoiding jargon
- Making links between symptoms, life context, and the patient's experience
- Negotiating investigations, management plans, next steps
- Motivating change behavioural shifts, adherence, lifestyle
- Problem solving working with the patient, not at them
The pattern is striking. Trainees rarely fail because they don't know the clinical content — they fail to demonstrate it, usually at the joins between the tasks. That is exactly what Gask sessions target.
🎯 How to pick a focus in practice
Ask the learner directly: "Which of these twelve things do you want me and the group to watch for today?" Make them pick two or three — not all twelve. Focusing the group's attention is what turns feedback into behaviour change by next week.
🧭 Running the session — a facilitator's guide
The learner sets the agenda. The facilitator keeps the room safe, the feedback specific, and the session balanced. Here is how to do that without becoming the person who secretly runs the whole thing.
🪜 The Question Ladder — teaching the group to see
When you stop the tape at a cue the group has missed, resist the urge to announce what you saw. Lead them to it with a graded ladder of questions — general to specific. This is arguably the most educationally powerful move in the Gask method, because you are not just teaching what to look at — you are teaching how to look.
Start at the top. Drop down a rung only if the group does not arrive. By level 4 you are almost pointing at the answer — but along the way you have taught them the skill of looking, not merely given them the thing to see.
⚠️ Pitfalls that sink a Gask session
None of these are catastrophic on their own — but any of them will quietly drain the value out of the session and leave the learner going home with nothing they can actually change.
🎬 Drifting into clinical content
The group starts arguing about whether she needed an ECG. Pull it back: "That's a case discussion — let's park it. What about how he asked about her worries?"
🗯️ Vague feedback
"You seemed a bit rushed." Useless. Specific please: "You asked three questions in the first twenty seconds without pausing for an answer." That is something anyone can work on.
⛔ Criticism with no alternative
The Golden Rule gets broken first. Someone stops the tape to say "that didn't land well", the room goes quiet, and nobody offers what they would have said instead. Press them: "What would you have said?"
🎭 The public autopsy
Five group members pile on with alternatives after one observation. Limit to two alternatives per stop. More than that feels like being mugged.
🪞 Trainer hijack
The facilitator keeps stopping the tape with their own agenda. If the learner wanted to work on endings and you keep stopping at openings, you have taken over the session. Park your agenda for later.
🤐 Silence after a stop
Long awkward pauses happen. Use the question ladder. Or offer a low-stakes starter: "I'll kick off — I noticed his shoulders shifted just before she said 'scared'."
⏰ Not enough time
If you try to do a whole 10-minute consultation in detail, you will run out of time and do nothing well. Agree a chunk — the first two minutes, or the breaking-bad-news section — and go deep.
🎯 Forgetting the learner's agenda
At the end, check back: "You wanted to work on ICE. Did we cover it?" If the answer is no, the session has partially failed — even if everyone had a lovely time.
🔀 Gask vs the other video-feedback methods
Gask is one member of a small, closely-related family of methods. It is not the only one — and part of being a thoughtful trainer or trainee is knowing which method to reach for and when.
| Method | Origin | Best for | Distinguishing feature |
|---|---|---|---|
| Gask | Gask & Goldberg, 1980s–90s | Groups. Problem detection and management. Cue-spotting. | Anyone can stop the tape. If you stop to critique, you must offer a concrete alternative. |
| Pendleton's Rules | Pendleton et al, 1984 | One-to-one or small group. Early learners who need psychological safety. | Strictly separates "what went well" from "what could be better." Learner speaks first. |
| ALOBA | Silverman, Kurtz & Draper, 1996 | Groups using Calgary-Cambridge. More advanced learners. | Agenda-led, outcome-based. Learner defines what they want help with; the group rehearses alternatives. |
| SET-GO | Silverman, Draper & Kurtz, 1997 | Descriptive feedback used inside any of the above methods. | Five-step feedback micro-structure: Saw / Else saw / Thinks / Goals / Offers. |
| Calgary-Cambridge | Silverman, Kurtz, Draper, 1998 | Structured skills analysis referenced against a published guide. | Combines Pendleton's engagement rules with Gask's problem-based approach, referenced against observational guides. |
💡 The practical truth
Most experienced UK GP trainers blend methods in practice. They will use Gask's ground rules ("anyone can stop; specific alternatives only"), ALOBA's agenda-setting ("what do you want help with?"), and SET-GO's feedback phrasing ("what I saw was…"). Purity is for textbooks; in the room you use what helps the learner.
👨🏫 When to pick Gask over ALOBA
Gask has a lower barrier to entry. It works brilliantly with newer trainees and less-experienced facilitators because the rules are simple and the focus sits squarely on specific consultation skills. ALOBA is more sophisticated — it asks the learner to articulate not just their agenda but their intended outcomes, which is a bigger cognitive load. If your group is new or nervous, start with Gask.
💎 Real-world wisdom nobody puts in the handbook
💡 Warm the room before you play anything
Bringing a tape to a group is genuinely frightening — especially for IMGs, quieter trainees, or anyone who has been burned before. Spend the first five minutes on ground rules. "We focus on the skill, not the person. Nothing leaves this room. We stop to praise as much as to question." It doesn't just sound nice — it changes what happens next.
💡 Let the learner stop first
Before anyone else gets involved, let the learner stop their own tape once or twice. Self-observation first, group observation second. They will catch 60% of what you were going to flag anyway — and you get to reward insight rather than deliver criticism.
💡 Time-stamp the observation
"At three minutes forty-two, when she said 'fine' but looked away…" is infinitely more useful than "earlier on, when she seemed upset." Specificity is kindness — it gives the learner something they can actually return to.
💡 Role-play the alternative out loud
Do not merely describe what you would have said — say it, as if you were the doctor. Then let the learner try it too. Practising the alternative phrasing three or four times in the room is what actually shifts behaviour in next week's clinic. Talking about the phrase does not.
💡 Watch the second time with fresh eyes
If a key moment was contested — "did that look dismissive or just efficient?" — rewind and watch it a second time with one specific question in mind. Second viewings are revelatory. People see things they missed entirely the first time round.
💡 End with one thing
Close the session by asking everyone — including observers — for one thing they are taking away. Just one. Not three. One concrete change they will try this week. That single-item discipline is what turns a session into learning rather than entertainment.
💡 The 30-second rule
Most consultations are won or lost in the first thirty seconds and the last thirty seconds. If you only have time to review two minutes of tape, make them these two. Openings set the frame; closings create safety. Everything in the middle is easier if these two are strong.
👨🏫 Teaching Pearls — running Gask with your group
🎓 Running your first Gask session
If you have never facilitated one before, start with an experienced trainee and a short tape segment of two or three minutes. Aim for four stops maximum. Model the question ladder yourself at least once. Do not try to cover every skill domain — focus the group on one or two.
🎓 Common learner blind spots
Trainees consistently underestimate how much they interrupt, how often they miss cues in the opening sixty seconds, and how rarely they check whether their explanation has actually been understood. These are the territories where Gask sessions produce the biggest shifts — and, conveniently, they are also the territories the SCA examiners watch most closely.
🎓 What to do when the tape is… bad
Sometimes a trainee brings a tape and it is rough going — missed cues, closed questions, patient visibly withdrawing. Resist the urge to catalogue every problem. Pick two skills. Work on those. A tape with fifteen flagged faults and no alternatives rehearsed is a trainee who goes home demoralised and changes nothing.
🎓 Reflective questions for tutorials
- "Which consultation this week would you least like the group to watch? Why?"
- "What's a moment in a recent consultation that you keep replaying in your head?"
- "If you could re-do thirty seconds of any consultation this week, which thirty seconds — and how?"
- "What cue do you think you missed in that tape? What was the first sign?"
🎓 Integrating with WPBA and SCA prep
A well-run Gask session can feed straight into a trainee's reflective log, a COT debrief, or an audioCOT discussion. It also pairs beautifully with the RCGP's SCA Consultation Toolkit — use the RAG self-assessment tool after each Gask review so the trainee is rehearsing the very judgment examiners will apply. Park the learning on the 14Fish ePortfolio so it can be reviewed at the next meeting.
🎓 Building a SCA-focused Gask cycle across ST3
Six Gask sessions, spaced fortnightly from six months before the SCA, will cover the core domains more than once. Session 1: openings and ICE. Session 2: cue-spotting and empathy. Session 3: structuring explanations. Session 4: shared decision-making. Session 5: safety-netting. Session 6: challenging consultations — angry, tearful, unreasonable requests. Six tapes, six specific shifts, one genuinely SCA-ready trainee.
🗣️ Community Wisdom — what trainees and UK GP educators actually say
This section synthesises the recurring, high-value insights shared by UK GP trainees who have recently passed the SCA, UK GP trainers and examiners who teach on it, and UK-focused GP training video educators. It has been cross-checked against official RCGP guidance and the SCA Consultation Toolkit — nothing here conflicts with either.
These are the patterns that come up again and again across different voices, different courses, and different post-exam reflections. They are exactly the kind of insights the Gask Method — which drills specific, observable consultation behaviours — was built to target.
The same six themes surface in nearly every UK GP trainee's post-exam reflection, every experienced trainer's tutorial debrief, and every UK GP SCA educator's video content. Together they form a rough map of where Gask sessions give the biggest return on investment.
1. Time management is usually a symptom, not the disease
UK GP SCA educators consistently point out that running over time is rarely about speaking too slowly. It is usually caused by:
- Lack of a clear mental structure for the consultation
- Reluctance to commit to a working diagnosis out loud
- Excessive summarising that earns no marks
- Dwelling in data gathering past seven or eight minutes because of a fear of missing something
- Not using the three minutes of reading time to "prime" the case in advance
2. ICE must be woven in, never ticked off
Trainees who pass describe ICE not as three questions at the end but as a running thread:
- Ideas surface naturally when the patient mentions reading about symptoms online or has a family history they are thinking about
- Concerns emerge when the patient hesitates, looks worried, or goes quiet
- Expectations come through in phrases like "I was hoping you could…"
- Delivered as a mechanical checklist at 6 minutes in, ICE loses most of its value — and its marks
3. Explanations should be plain English, not medical school
A recurring theme from UK GP examiners and trainers is that the explanation phase is where a lot of marks are won or lost:
- "Your LDL is 4.2" means nothing to most patients
- "Your cholesterol is a bit higher than we'd like — enough to increase the risk of a heart attack or stroke over the next ten years" is what scores
- Chunk the information, then check understanding — don't deliver a monologue
- Link the explanation back to what the patient told you earlier about their worries
4. Specific safety-netting beats vague reassurance every time
"Come back if it gets worse" is one of the most commonly flagged weaknesses by UK GP examiners. Candidates who consistently do well produce safety nets that name:
- The specific symptom(s) to watch for
- The timeframe for reviewing
- The action to take — call us, 111, A&E
- A natural transition: "before you go, can I just check what you'd do if…"
5. Shared decision-making is a habit, not a moment
A strong community consensus from UK GP trainers: UK general practice expects partnership, not direction. Several consultation habits from other healthcare cultures — perfectly appropriate where they were trained — can quietly cost marks here:
- "You should…" or "You must…" — where is the patient in that decision?
- Offering one option only, not "a couple of options to think about"
- Explaining without asking: "what are your thoughts on that?"
- Launching into a plan before linking it to the patient's own ideas and worries
6. The biggest obstacle is usually anxiety, not knowledge
A strikingly consistent message from UK GP trainees who have failed once and then passed: the second-attempt win was almost never about learning more medicine. It was about:
- Managing exam-day anxiety so it didn't take over
- Building confidence through repeated rehearsal in a safe setting
- Treating the simulated patient like a real patient, not a moving target
- Watching oneself on video often enough that the shock wears off
- Getting honest feedback from someone willing to tell you what went wrong — not just reassurance
🔟 The ten most-repeated practical tips from the UK GP training community
These tips crop up so often — across UK GP training YouTube channels, trainee-authored blogs, RCGP blogs, educator podcasts, and deanery resources — that they are effectively community consensus. All checked against RCGP SCA Toolkit guidance before inclusion.
💬 What recently-passed UK GP trainees say, in their own themes
These are paraphrased synthesised voices — reflecting recurring patterns from UK GP trainee reflections shared publicly through RCGP blogs, GP training community blogs, and educator Q&As. Nothing here is a direct quote; each one captures a theme that comes up repeatedly.
"After I failed, I was devastated and lost confidence in how I consulted. What changed wasn't my knowledge — it was watching myself honestly and fixing the specific habits that were costing me marks. Small changes, practised until they were automatic."
"The first time I watched a tape of myself I cringed. After the tenth, I just watched. That desensitisation is the point — you stop reacting emotionally and start seeing the micro-skills. Nothing else gets you there."
"I joined two different study groups and it was the single best decision. One group was supportive; the other was brutally honest. I needed both. The supportive group kept me practising. The honest one kept me improving."
"I spent weeks reading about consultation models and none of them felt right until I stopped trying to remember them. In the end I had a simple mental shape — opening, data gathering with ICE woven in, committing to a diagnosis, management with shared decision, safety net, close. That was enough."
"As an IMG I had to unlearn the consulting style I trained in. Not because it was wrong — it was right for where I trained — but because UK general practice expects something different. Partnership instead of direction. Asking about feelings instead of only symptoms. It felt strange at first. Video feedback was the fastest way to see the gap."
"My knowledge was fine. My anxiety wasn't. Once I accepted that the exam was designed to look like real general practice, I stopped performing and started consulting. That's when it clicked."
🎯 Turning community wisdom into Gask session focuses
Every one of these themes maps onto a concrete Gask session structure. If you want to use this community wisdom practically, here is how each theme becomes a next-week's tape.
Six community themes. Six targeted Gask agendas. Six concrete clinic behaviours to try next week. Each row is a closed loop — insight becomes practice becomes habit.
🎯 The meta-lesson from the community
If you distil every trainee reflection, every examiner tip, and every UK GP training video into one message, it is this: the SCA is not won by adding more — it is won by doing the right things in the right way. The Gask Method, used well, is simply the most reliable way of finding out what your right things are. Everything on this page is designed to help you do that.
🎓 Using the Gask Method to improve your SCA performance
The SCA is not a knowledge test with a video camera strapped to it. It is an assessment of the observable, granular consultation behaviours that a newly-qualified GP should demonstrate. That makes the Gask Method — which does precisely this, behaviour by behaviour — one of the most efficient preparation tools available.
🔗 Why Gask maps so cleanly onto the SCA
The SCA is marked against three domains: Data Gathering & Diagnosis, Clinical Management & Medical Complexity, and Relating to Others. Examiners use Clear Pass / Pass / Fail / Clear Fail for each domain, with performance across all twelve cases feeding into a Borderline Regression calculation. Two of the three domains are essentially pure consultation behaviours — and the third is mostly about how you talk about management, not just what you know.
The Gask Method drills exactly these behaviours. It does not teach you guideline content; it sharpens the observable micro-skills the examiner is watching for in every case.
Almost every skill Gask makes you drill feeds into at least one SCA domain — and many feed into two or three simultaneously. That is why Gask-trained candidates tend to score consistently rather than in patches.
📊 The SCA at a glance
Data Gathering & Diagnosis
Systematically gathering relevant, targeted information. Generating a sensible differential. Ruling red flags in or out. Discovering psychosocial context.
Gask drills:- Open-to-closed question flow
- Cue recognition (verbal & non-verbal)
- Structured ICE exploration
- Transition between history tasks
Clinical Management & Medical Complexity
Safe, patient-centred management. Handling multi-morbidity and polypharmacy. SMART safety-netting. Appropriate follow-up.
Gask drills:- Clear, chunked explanation
- Checking understanding
- Shared decision-making phrasing
- Concrete safety-net wording
Relating to Others
Empathy, active listening, fluid adaptation to each patient, professionalism, and shared decision-making that runs throughout the consultation — not just at one neat moment.
Gask drills:- Demonstrated empathy (not just felt)
- Reading and responding to cues
- Adapting tone to the patient
- Authentic, human language
🔁 A SCA-targeted Gask study loop
Individual Gask work — with a peer, your trainer, or a study group — gives you a repeatable cycle that progressively closes the gap between how you think you consult and how an examiner will actually score you.
🎯 SCA-specific tape-stopping triggers
When you Gask-review a tape with the SCA in mind, these are the moments worth pausing on. Each one tends to correspond to an examiner mental tick-box.
🔍 Data gathering triggers
- You used a closed question in the first 60 seconds when an open one would have opened the story
- The patient dropped a cue and you moved on stop the tape, replay, name the cue
- You asked "any ideas what it could be?" as a checklist item did you actually explore the answer?
- You never asked about psychosocial impact the single most-missed data-gathering task in the SCA
- You double-backed to re-ask something that's a sign of poor sequencing earlier on
- Red-flag screening felt mechanical did it sound like questions from a list, or a genuine clinical conversation?
🛠️ Management & relating triggers
- You launched into a plan without naming the problem clearly first patients need the label before the plan
- Your explanation was a monologue no chunk-and-check, no pauses for questions
- You said "you should" or "you must" where is the shared decision?
- Safety-netting was "come back if it gets worse" vague = no marks; specific symptom-timescale-action = full marks
- You closed without checking understanding "does that make sense?" is not enough on its own
- You never acknowledged what the patient was feeling Relating to Others is assessed throughout the 12 minutes, not just at the empathic moment
🚦 The RAG self-review after a Gask session
After you finish a Gask-style self-review, score each of the three SCA domains as Red / Amber / Green for that specific tape. Write one sentence per amber and red explaining what you would do differently. Over six tapes, look for the pattern. The RCGP's own SCA Toolkit uses an identical RAG self-assessment — so you are effectively pre-rehearsing the very judgment examiners will apply.
🗣️ High-scoring SCA phrases to rehearse during Gask sessions
One of the most effective things a Gask session can do is turn a theoretical "I should explore ICE" into an actual phrase sitting ready on the tip of your tongue in the exam. Rehearse these out loud until they sound like you, not a script. Adaptable templates are shown in square brackets — change the wording to fit the patient.
Opening & ICE
- "Tell me what's been going on."
- "What's worrying you most about this?"
- "Were you wondering if it might be something specific?"
- "How is this affecting your [work / sleep / day-to-day]?"
- "What were you hoping we might do today?"
Empathy & emotion
- "That sounds really difficult."
- "I can understand why that would worry you."
- "Take your time — there's no rush."
- "It makes complete sense that you're concerned about this."
Explanation & shared decisions
- "From what you've told me and what I've found, this fits with…"
- "Let me explain what I think is going on — and then I'd like to hear what you think."
- "We've got a couple of options — shall we talk through what might suit you?"
- "What matters most to you in how we manage this?"
Safety-netting & closing
- "If [specific symptom] happens, I'd like you to [specific action] within [specific time]."
- "If things haven't settled by [timeframe], please come back — that's what we're here for."
- "Before you go — can I just check what you'll do if things change overnight?"
- "Does the plan we've agreed feel workable for you?"
💡 Why saying them out loud matters
Reading a phrase silently leaves it trapped in the "theory" part of your brain. Saying it out loud — even alone at your desk — begins to wire it into speech. By the time you reach the SCA, the useful phrases should feel like things you say, not things you've memorised. That is the shift Gask rehearsal produces.
A Gask session can focus on any phase of this timeline — which is why it is so well suited to structured SCA practice. If your data gathering consistently over-runs, drill that phase. If your safety-netting is vague, drill the closing minutes. You are not practising the whole thing each time; you are targeting the weak link.
🎯 The single biggest SCA-preparation win
Most SCA fails are not about missing clinical knowledge. They are about running out of time in data gathering, producing a generic safety net, or failing to demonstrate empathy visibly enough for an examiner to score it. Every one of these is a consultation behaviour — exactly what Gask sessions exist to refine. If you have six tapes between now and your sitting, three focused Gask sessions will do more for your score than ten hours of reading.
❓ Quick Questions
How long should a Gask session last?
What if the trainee refuses to bring a tape?
Do I need specialist equipment?
What about patient consent?
Can Gask be used one-to-one, not just in groups?
What do IMGs find most challenging with Gask?
Is Gask still relevant for SCA preparation?
What's the evidence base?
🏁 Last Look Before You Go
Ten things to take away before you run — or participate in — your next video-feedback session.
- The learner picks the tape. The learner sets the agenda. Always.
- Anyone in the room can stop the tape — that is what makes it a group method.
- If you stop to criticise, you must have a specific alternative ready.
- Focus on consultation skills, not clinical content — park the antibiotics debate.
- Be specific. Time-stamp your observations. "You glanced at the screen at 2:14" beats "you looked distracted."
- Use the question ladder when the group misses a cue — lead them to it, don't hand it to them.
- Balance positives and alternatives. An unbalanced session leaves the learner either complacent or crushed.
- Role-play the alternative phrasing out loud. Talking about it does not change behaviour — saying it does.
- For SCA prep, target one domain per tape. Six tapes, six specific shifts — that is genuinely exam-ready.
- Always send the learner home with genuine praise. Bringing a tape takes real professional courage.
📖 Key References
- Gask L, McGrath G, Goldberg D, Millar T. Improving the psychiatric skills of established general practitioners: evaluation of group teaching. Medical Education 1987;21:362–8.
- Gask L, Goldberg D, Lesser AL, Millar T. Improving the psychiatric skills of the general practice trainee: an evaluation of a group training course. Medical Education 1988;22:132–8.
- Goldberg D, Gask L, O'Dowd T. The treatment of somatisation: teaching techniques of reattribution. Journal of Psychosomatic Research 1989;33:689–95.
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