RCA - Hints and Tips

Recording

Start recording as early in training as possible, preferably in ST1/2 GP.
Get used to the microphone/camera/technology so you can focus on the patient.
Ensure the sound (and picture quality) is good.
Make sure that you are consenting the patients correctly.

RCA Rules

Read the most up to date rules on the RCGP website carefully.
Avoid exposing ‘swim suit’ areas to maintain patient dignity.
‘Staged’ recordings are easily spotted so avoid.
A submission for long term condition cannot be the initial presentation.

Consultation Skills

‘Consult like a GP’ rather than a hospital doctor.
Listen and respond to the patients answers.
Make it more like a flowing conversation rather than a list of disjointed questions.
Establish ICE (all three) and use them within your management plan.
Verbalise your thinking and involve the patient.
Deal with second problems, should they arise, by prioritising and arranging a separate appointment.
Use Safety netting and follow up appropriately.

Marking (imagine yourself as the assessor):

Could the case be managed by a non GP? (low challenge).
Have all three domains been covered? (Data Gathering, Clinical Management and Interpersonal Skills have 1/3 of marks each).
Is the case a follow up? (Inadequate new information).
Ensure all important information has been completed by 12 minutes (time management).
Explain how and why arranging an appointment for examination will affect management.
Make a working diagnosis and a clear management plan.

Drs Simon Huins and Claire Fox
South West HEE