Recorded Consultation Assessment (RCA)
UPDATE: RCA webinars now available online!!!
Here are TWO RCA Webinars that Dr Mehay recently did. The first (RCA Webinar 1) focuses on Data Gathering. The second (RCA Webinar 2) focuses on Clinical Management and InterPersonal Skills. However, there is a lot of other information in both webinars.
To make the two 2-hour webinars easier to watch, we have broken them down into 1 hour slots. So, there is now 4 lots of 1 hour webinars. This means that you can watch them bit by bit at your hearts content. The videos have been every so slightly speeded up to keep your retention going.
Their is a £25 charge for each video, which in the grand scheme of things is not much. But proceeds to help to fund the Bradford VTS website and continue the good work we do.
PASSWORDS NEEDED FOR THE FOLLOWING (click purple buttons above)
Data Gathering + InterPersonal Skills
Clinical Management + InterPersonal Skills
When is the next Bradford VTS RCA Webinar by Dr Mehay?
Ramesh Mehay runs webinars when there is a need. He doesn’t do them often but if there is a great need he will do them. He has done two highly successful webinars to date. Their success is because he covers things they don’t tell you – things not on websites. And the other reason is because he demonstrates how to do things in a variety of ways. He will show you ways that are acceptable and he will demonstrate things that trainees do which are not acceptable. The RCA webinar is run in two parts. Part 1 is 2 hours (covering Data Gathering – and lots of other things. Part 2 is on another day for 2 hours (covering Clinical Management and InterPersonal Skills and lots of other things).
Post a comment BELOW if you would like him to run another webinar. If there are lots of requests, then he will do another. Please also mention which month you would like the webinar and which week of that month. Don’t worry, your comments and requests will be removed within 3 months.
So, if you want Dr Mehay to run an RCA webinar, please place your request through the comments box below. Say which month. Say which week of that month you would like it. He will then try and pick a week that is good for the majority.
Look at the Downloadable Resources
Have a look at the Downloads box above.
- Ram’s RCA consultation model (use the pdf version) is a simple model to help you will the RCA videos. Keep it on your desk. Most of what is on here you will probably already be doing. But this little handy sheet will just remind you where you are at and what still needs doing if you get lost in the consultation.
- Another useful resource keeping on your desk is the RCA desk prep sheet. This handy tool helps you get into a ready state before you call the patient. It helps automate and remind you some things you can do to make sure you are skilled up ready for the patient.
Making notes before you call the patient
You may find it helpful to make notes before you call the patient after you have looked at their medical records and reviewed the clinical topic on something like CKS or GP Notebook. Things you may wish to make a note of are things like
- Clinical Systems or Differentials to Explore
- Clinical History bits not to forget
- Red flags not to miss
- The latest Clinical Management advice.
HOWEVER, PLEASE PLEASE PLEASE remember to keep these notes brief. If you make them detailed, you will be more concerned with your notes sheet than the patient and you will miss what they say and the consultation will lose its natural flow. So, in order to prevent this…
- Write one or two word things down.
- DO NOT write down everything you need to cover. It will confuse you and you mind will become distracted and lose focus in the “here and now”
- Just jot down things that you might forget or things to help organise your mind.
- Perhaps a maximum of about 5 items.
- Space them out over the whole of the blank A4 sheet.
- Use a brand new blank A4 sheet for the next patient. You don’t want to clutter the next patient with the previous patient’s notes do you!
A very important & special note on reviewing your recordings...
In no time at all, your 14 Fish account will be full of recordings. As you and your trainer and reviewing them, it is important to have a good MARKING system right from the start to signal which recordings are really good for submission, which are okay, which one if you are really desperate and which ones are bad.
If you don’t have a marking system right from the start, you and your trainer will get into an awful muddle and you will find yourself lost. Neither you nor your GP trainer will know which are good, which are bad, and which are somewhere in between. So, follow my system as detailed in the next two columns. Show this section to your GP trainer.
By the way, PLEASE DO NOT DELETE ANY OF YOUR RECORDINGS NO MATTER HOW BAD YOU THINK THEY ARE UNTIL YOUR TRAINER HAS SEEN THEM – because sometimes you will think it is bad but the trainer will think it is quite good in places. This is because your trainer understands the RCA marking system better than you. That is why they are a trainer after all. And sometimes, you might have done so well in (say) Data Gathering in a lot of the other cases, that it is okay to include one which isn’t so great but is strong in CM and/or IPS.
As a GP trainee…
So, I have come up with the following suggestion. Once you have done your recordings, have a look at each one yourself. Remember to look at it from three angles – Data Gathering, Clinical Management and InterPersonal Skills. What score would you give yourself out of 3 for each of the DG, CM & IPS areas. Now decide if the recording is one of two grades.
- (+) Is it a possibility for RCA submission? Then, under the TITLE of the Case, put a plus (+) before it. For example “(+) Lady with headaches”
- (-) Is it really bad? If so, put a minus (-) in the title. For example “(-) Man with knee pain”
And that’s it. Now, your trainer can see at a glance ones which you think are okay and those which aren’t. They can focus just on looking at the good ones and see if they are good enough.
If by the end, there are not enough good ones, they might want to look at some of your bad ones in case you have been too harsh on yourself.
As a GP trainer…
Start by looking at the ones the trainee has marked with a *. These are the ones the trainee thinks are okay. What score would you give out of 3 for each of the DG, CM & IPS areas? Now decide if the recording is one of 4 grades. (Add the following codes to the title so you can see at a glance which ones are which grades).
- (A) means the case is great.
- (B) means the case is okay. Use if, by the deadline date, the trainee is short of numbers.
- (D) means the case is borderline. Use if desperate for cases near the deadline date.
- (E) means the case is bad. Don’t bother using this one at all.
And that’s it. The absence of a C grade forces you to make a decision where the case is at – it moves you off from sitting on the fence. If you do this progressively as you review your trainee’s recordings, in the end, near the submission date, you will be able to see at a glance which ones to cherry-pick and send off.