The CSA with Confidence

CONSULTATION MICROSKILLS

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An introduction to the CSA

CSA Frameworks

CSA Practise Tools

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Miscellaneous

 

Scripts & Phrases for the Consultation

These scripts and phrases may help you with your communication skills.  Generally , I don’t recommend memorising scripts and phrases because a conversation between two people should flow naturally – in other words, a conversation where each person responds to what each other has just said – and most of the time you cannot second guess what the other person will say.  So – beware of scripts and phrases – they can make the consultation look artificial or contrived and the CSA examiners are very good at picking up things that sound artificial.   For example, don’t explore Ideas, Concerns and Expectations (ICE) just because others have told you it is a good thing to do in everyone.  Do it because you are genuinely interested and because you think it will be helpful.  The same goes for the psycho-social-occupational (PSO) exploration of the impact of an illness. 

On the other hand, scripts and phrases can provide you with a starting point by giving you some idea of what to say.    They sound better if you can modify them so that they fit with your personality and style.   

 
 
 
 

Examiners’ Feedback Statements

There’s a lot you can learn from Examiners’ feedback statements on previous exams.  They highlight common difficulties and failures – which you can learn from!

 

 

 

 

 

What are Micro-Skills?

First of all, if you don’t properly understand how the CSA works or what it is testing, then it is unlikely you will succeed.    Think about it for a moment – if you truly understand the marking schedule, then actually you have the ‘answer’ sheet which should guide you how to pass.    So step one to passing is going back to basics and truly understanding what the CSA is about and what it is testing. 

These are the 3 areas you will be tested on:

  1. In Data Gathering, they are testing communication skills AS WELL AS clinical skills like clinical examination; around 3 stations will involve clinical examination.
  2. Clinical management includes synthesis, diagnosis, appreciation of co-morbidity, flexibility and sharing management options with the patient.
  3. Interpersonal skills include, communication, respect for others, professionalism and other behavioural indicators.

And finally, always safety net (ask your trainer if you don’t know what this means).

More information is available on the RCGP CSA pages.

Picking up and responding to cues

Reading a consultation book or two will definately help you get some of the cores communication skills to consult effectively with patients.   Although some people are naturally good at patient-centred consultting and others less so, the good news is that these skills can be learnt.   Yes!  Even if you are not good at consulting in a person-centred way, with practise you can learn to be as good as those who are naturally good.   Of course, the key word here is practise!

Some good consultation books are…

  1. The Inner Consultation by Roger Neighbour (a great starter esp for ST1s).
  2. Skills for Communicating with Patients by Silverman et al (one of the best foundation books around – a definite worthwhile read).  
  3. The Doctor’s Communication Handbook by Peter Tate (another foundation book).
  4. The Naked Consultation by Liz Moulton (covers a variety of tricky scenarios – another definite worthwhile read).

Projecting Interpersonal Skills

Reading a consultation book or two will definately help you get some of the cores communication skills to consult effectively with patients.   Although some people are naturally good at patient-centred consultting and others less so, the good news is that these skills can be learnt.   Yes!  Even if you are not good at consulting in a person-centred way, with practise you can learn to be as good as those who are naturally good.   Of course, the key word here is practise!

Some good consultation books are…

  1. The Inner Consultation by Roger Neighbour (a great starter esp for ST1s).
  2. Skills for Communicating with Patients by Silverman et al (one of the best foundation books around – a definite worthwhile read).  
  3. The Doctor’s Communication Handbook by Peter Tate (another foundation book).
  4. The Naked Consultation by Liz Moulton (covers a variety of tricky scenarios – another definite worthwhile read).

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