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The companion website contains a number of resources, including 18 clips – 12 cases + 6 ethical dilemmas, general suggestions on making the best use of the clips and the video- and case-specific educational support material.
www.wiley.com\go\Roberts\CSAExam
Rachel is a GP, trainer, CSA examiner, and is a Patch Associate Director for General Practice, London. She is also the Associate Director for trainees in difficulty for North East and Central London. Her main interests are in helping learners to achieve their full potential and to enjoy working in a typical, busy general practice.
As a retired teacher, David has a strong educational and examining background. Appointed Lay Adviser to the RCGP, he worked on the Simulated Surgery Exams and, subsequently, on the development of the CSA exam. He has been the CSA Role-Player Lead, responsible for the training and quality assurance of the simulated patients, and has published several papers about his work with the simulated ‘patients’ in the CSA.
Simon is a GP with a special interest in General Practice. He has been a trainer since 1996, and a member of the MRCGP examiners panel since 2010. He is currently Honorary Secretary of the North East London Faculty RCGP.
Anjum qualified from the Royal Free Hospital and worked as a GP for 5 years in Stepney, East London. In 1996, he moved GP practice to Enfield, North London. He remains committed to Education and Training as a Trainer and Programme Director in Enfield. He has also been a CSA examiner since 2008. It remains a privilege for him to serve patients and enjoy consulting.
The authors would like to acknowledge the North East London faculty of the RCGP, and Anwar Khan, who brought the team together in organizing the RCGP course. Working together on this course, being GP educators and being examiners for the RCGP were the breeding ground for the ideas in this book.
We would also like to thank those who contributed to early versions of course material from all London faculties and the RCGP. They are Anwar Khan, Mei-Ling Denney and Marilyn Graham. We would like to thank Dr Anwar Khan for the ideas that developed into the six ethical case clips.
The Clinical Skills Assessment (CSA) is less than a decade old. But during that time, it has continued to evolve to keep abreast of the latest in best practice in assessment. It has also been at the centre of a storm of controversy relating to differential pass rates for those who trained abroad and UK graduates from BME backgrounds. While the recent judicial review found no evidence of discrimination, it remains the case that the CSA is a challenge for many aspiring to be General Practitioners in the United Kingdom.
For those looking for a magic formula through the CSA, take note, you will be disappointed. Equally, this book does not offer a recipe for passing the examination. However, if you want to understand the essence of being a sophisticated consulter in a modern-day general practice, this book opens a world of opportunities. This book offers you three opportunities – the first is for you to learn about yourselves (what are your needs, how might you learn, where can you look to learn about the CSA and who can support you in your learning journey); the second is to make the most of the learning opportunities that general practice training has to offer; and the final is to demystify the CSA itself.
The chapters are written in an easy-to-read manner with a strong emphasis on simplifying the language around the CSA, a focus on bringing out the practical tips to maximize your learning and opportunities for improving your consulting. It reconnects the CSA with the best in educational practice, and in doing so, re-frames the CSA – not as an examination to be feared but to be seen as the culmination of a year-long (and career-long) expression of mingling the science of modern medical practice with compassionate consulting.
Three of the authors of this book are practising GPs – they apply the art of compassionate consulting and modern medicine in their day-to-day practice. They are all educators – they understand the challenges of preparing doctors for a life of general practice (not just preparing for the examination but for a career of consulting). The doctors are all CSA examiners – they know how examiners think and what they expect. In addition, Dave Russell has been the role-player lead for the CSA, who has a wealth of understanding around the simulated patient.
This book is the accumulation of their collective experience, their desire to show you that there is an alternative to learning focused on ‘getting through the exam’, and by doing so they are trying to achieve something greater – make effective consulting part of your daily practice and, by doing so, reduce the tension and anxiety associated with the CSA.
But don't just believe what I say! Dip into the book, read a couple of chapters and even try out some of the suggestions the authors make. It has the potential to transform how you do things in the consulting room!
Dr Sanjiv Ahluwalia MBBS FRCGP MSc
Head of Primary Care Education and Development
Health Education North Central and East London
In planning this book, we aim to help you understand more about the three main components of the CSA exam, and to give insights into how you can maximize your potential for success.
Firstly, we will consider your own personal needs, as the Candidate, in order to pass the exam. Secondly, we will discuss getting the most from your Simulated patients (the role-players). Then we will give you an overview of the Assessment itself – what to expect and what is expected of you.
Each of these first three chapters contains boxes of essential ‘Learning Points’, and after each one we have listed as bullet points relevant ‘Tips and Hints’ under the headings of ‘Getting Started’, ‘The Consultation’ and ‘On the Day’. We hope you will find all these useful in your studies as a guide and aide-memoire.
Example:
We go on to give advice about dealing with dilemmas and applying an ethical approach in your consultations. We suggest an exercise to put all this into practice, and then go on to supplement this with a focus on CSA examiner feedback. Chapter 7 reviews possible areas of concern and how to avoid and/or deal with them. Part 1 concludes with a collation of the essential Learning Points from the earlier chapters.
In Part 2, we have collaborated to produce 16 cases to help you practise your exam technique, and perhaps to use as a template to apply to the exercise suggested in Chapter 5 creating your own cases, focusing on identified hot topics. In addition we have 6 ethical cases with supporting material in chapter 4.
Finally, in addition to the written materials in this book, we have filmed 18 clips – 12 cases + 6 ethical dilemmas to offer an additional learning resource. This gives a different perspective on the six cases illustrating ethical dilemmas in Chapter 4 of Part 1 and on 12 of the cases in Part 2. Purchasers of the book will have the opportunity to access these video clips on our website, and details of how we recommend they could be used are outlined in the Introduction to Part 2.
We hope you find this approach useful, and that our advice helps you to maximize your potential in the CSA. The RCGP demographic is changing since the MRCGP has become mandatory and the functions of the College are changing too. At its core remains the function of ensuring high-quality, professional GP care for all patients, and the MRCGP exam is essential to this. Patients need value-driven, patient-centred, quality- and safety-focused, energetic, knowledgeable, vocational doctors LIKE YOU!
Good luck!
Rachel Roberts
David Russell
Simon Ormerod
Anjum Iqbal