Imagine being so anxious that you need medication to sit SCA exam. Meet Dr Temi, a hard-working GP trainee who faced overwhelming anxiety.
I was really optimistic I was going to pass and then I saw the result I’m like okay I think I don’t have it in me so my confidence level was really really really low.
Failing SCA by half a mark
Dr Temi was optimistic that she would pass SCA exam on her first attempt. Despite rigorous preparation with colleagues and long hours of practice, she missed a pass by just half a mark.
The failure shattered her confidence, leaving her questioning her abilities and future. Dr Temi was devastated, terrified of risking another attempt. Reflecting on her preparation, she realised she needed a new game plan.
A new approach
Determined not to repeat the past, she sought expert guidance to transform her preparation. She understood the value of constructive feedback and working smarter. She invested in her success and joined Consultation Blueprint Coaching.
Addressing Areas of Weakness
Dr Temi had a solid knowledge base but it wasn’t enough to pass SCA. She struggled to communicate assertively, often speaking in a hesitant tone. It is common for trainees to feel nervous after an unsuccessful attempt.
With expert help from Dr Erwin Kwun, she received a personalised plan to tackle her anxiety head-on. This plan included advanced communication skills, stress management strategies, and confidence-building exercises.
Dr Temi also struggled with time management. We diagnosed the causes of poor time management and fixed them. For instance, she learned to prioritise short-term and long-term issues which optimised her score in clinical management. She was equipped to manage uncertainty and complexity.
SCA Exam Results
Dr Temi’s transformation was remarkable. With newfound self-assurance and a clear strategy, she smashed SCA on her second attempt. The result? An impressive score of 87.5, a testament to her resilience and hard work.
It feels like a heavy burden has been taken off my shoulders
Are you ready to pass SCA Exam?
Dr Temi’s journey is a testament to the power of perseverance, strategic preparation, and the willingness to seek and implement guidance.
Are you looking for a breakthrough? Our intensive 1 to 1 coaching might be the solution for you.
Join over 200 trainees who sought help to achieve their goals.
Applications for 1 to 1 coaching are considered on an individual basis.
Imagine confronting an angry simulator for Simulated Consultation Assessment (SCA). Without preparation, this could be a daunting station. Mastering conflict resolution skills is crucial to scoring well in SCA exam. This article will provide actionable and insightful strategies to help you navigate difficult interactions effectively.
Understanding the Root Cause
The first step in managing an angry patient is understanding the underlying cause of their anger. Patients can become angry for various reasons. It could be due to frustration with their condition, dissatisfaction with previous treatments, or feeling misunderstood. By identifying the root cause, you can tailor your approach to address their specific concerns.
Maintain Professionalism and Calmness
When faced with an angry patient, it is essential to remain polite and calm. This sets the tone for the interaction and helps de-escalate the situation. Here are some strategies to maintain your composure:
Deep Breathing: Take deep breaths to stay calm and composed.
Non-Verbal Cues: Use open body language and maintain eye contact to show you are engaged and not threatened.
Voice Control: Speak in a calm, steady voice, avoiding any sign of agitation or defensiveness.
Show Empathy and Understanding
Empathy is a powerful tool in defusing anger. Showing that you understand and care about the patient’s feelings can significantly reduce their frustration. Here’s how you can demonstrate empathy:
Active Listening: Listen attentively without interrupting. Let the patient vent their anger. Nod and use phrases like “I understand how you feel” to show that you are listening.
Acknowledge Their Emotions: Validate their feelings by acknowledging their anger and frustration. For example, “I can see that you are very upset, and I want to help.”
Effective Communication
Clear and effective communication is key to managing an angry patient. Here are some techniques to enhance your communication:
Ask Open-Ended Questions: Encourage the patient to express their concerns in detail. Questions like “Can you tell me more about what’s bothering you?” can provide valuable insights.
Paraphrase and Clarify: Repeat what the patient has said in your own words to ensure you understand their concerns correctly. For instance, “So, you’re feeling frustrated because you haven’t seen any improvement with your current treatment, is that correct?”
Explain Clearly: Provide clear explanations about their condition and the proposed treatment plan. Avoid medical jargon that might confuse them.
Aligning Goals
Work with the patient to align their goals with the treatment plan. This collaborative approach can help them feel more involved and less adversarial. Here’s how you can do it:
Set Mutual Goals: Discuss and agree on realistic goals that both you and the patient can work towards.
Provide Choices: Offer different treatment options and involve the patient in decision-making. This can give them a sense of control over their situation.
Safety First
While angry patients in the SCA will not pose a physical threat, it is crucial to be aware of your own safety in real life. If a patient becomes physically aggressive, follow these steps:
Stay Calm and Professional: Do not respond with anger or aggression.
Seek Help: If the situation escalates, call for assistance from a colleague or security personnel.
Know Your Environment: Be aware of the nearest exits and keep a clear path to them.
Reflect and Learn
After a challenging interaction, take time to reflect on what went well and what could have been done differently. Discussing with a supervisor or mentor can provide valuable feedback and support.
Conclusion
Managing angry patients effectively is a vital skill for any GP. By staying calm, showing empathy, communicating clearly, and ensuring your safety, you can turn a challenging situation into a positive outcome. Every difficult interaction is an opportunity to learn and grow.
How Dr Yoginee passed SCA Exam?
Dr Yoginee was consumed by self-doubts and fears. Check out how she conquered her fears and passed SCA on her first attempt.
Are you gearing up for your Simulated Consultation Assessment (SCA)? A study group can transform your SCA practice and increase your chance of success.
The Benefits of Study Groups
Being part of a study group brings accountability. After a long day in clinic, you might feel too exhausted to revise. However, if you’ve scheduled a session with peers, you’re more likely to stick to it. This commitment from group members can keep you on track.
Moreover, you’ll find motivation from peers who are also preparing for the exam. Most importantly, practicing with colleagues offers new perspectives. A common mistake among those who fail the exam is relying solely on self-study, missing out on the practical experience that comes from group practice.
1. Choose Your Study Group Wisely
The first step is to be selective about your study group members. The quality of a study group is determined by the quality of its participants. Look for study partners with a growth mindset—those eager to learn, open to feedback, and positive. Avoid those who constantly complain or lack commitment. Ensure that all members are preparing for the exam around the same time to maintain a high level of dedication. Also, consider everyone’s availability to schedule suitable practice sessions. A well-coordinated group is crucial for productive study sessions.
Example:
Sarah and John are both sitting SCA in two months, while Michael is sitting for it in four months. Sarah and John form a study group, ensuring a high level of commitment and focus since their timelines align.
2. Plan Your SCA Practice Early
Once your group is formed, planning is essential. Early on, set expectations and decide how to approach your exam preparation together. Initially, you might meet once a week, but as the exam approaches, increase the frequency to twice a week or more. Discuss how to conduct role plays and select a variety of cases, including random ones, to cover a wide range of scenarios. By exposing yourself to a variety of scenarios, you will prepare yourself for any case that might come up in the exam.
Example:
Initially, your group gathers every Wednesday evening to establish a strong foundation. As the SCA exam date approaches, you strategically increase your meetings to Mondays, Wednesdays, and Fridays. This intensified schedule not only boosts consistency but also allows for thorough coverage of the curriculum. By incorporating a variety of random case scenarios, you ensure comprehensive preparation, equipping yourselves to tackle unknown and uncertainty with confidence.
3. Constructive Feedback
Constructive feedback is vital for improvement. Encourage honest and specific feedback within your group. Generic comments like “you’re doing okay” are not helpful. Instead, provide detailed feedback, pointing out exactly what can be improved and how. For example, if someone struggles with the introduction, suggest ways to make a better first impression. This kind of targeted feedback will help you and your group members identify and address your blind spots, enhancing your overall performance.
Example:
Instead of saying, “You need to be more confident,” say, “During your introduction, try to maintain eye contact and smile to appear more approachable. This will make a better first impression on the patient”
4. Set Specific Goals
Setting clear and specific goals for each study session is crucial. Instead of practicing cases here and there, focus on particular areas such as time management or specific clinical scenarios. Document your goals and the feedback you receive. Reviewing these notes closer to the exam will reinforce your learning and ensure that you remember key points.
Using SCA Companion, a structured system to track your progress can be incredibly beneficial.
Example:
If your group struggles with time management, set a goal to complete each case within the allotted 10-minute window. Use a timer during practice sessions and note any instances where the timing was exceeded, discussing ways to improve efficiency.
5. Form Your SCA Practice Group
If existing study groups don’t meet your needs, take the initiative to form your own. This allows you to be selective about members and control how the group operates. Leading a study group not only enhances your own learning but also develops your leadership skills. By investing more effort into organising and running the group, you’ll gain more benefits from the practice sessions.
Example:
Create a post on SCA Support Facebook group looking for study partners. Clearly state your goals, availability, and the exam date to attract like-minded individuals. Take the lead in organising the first meeting and setting a schedule.
Final Thoughts
Joining a study group can make a significant difference in your SCA exam preparation. It provides structure, support, and diverse perspectives that self-study often lacks. If you’re ready to take your preparation to the next level, consider forming or joining a study group today.
Imagine consulting Mr. Smith, who complains of chest pain. You’re concerned about a possible heart attack and recommend he visit the Emergency Department. However, Mr. Smith hesitates because he has guests coming over this evening.
This scenario highlights a common challenge in clinical practice: convincing patients to follow urgent medical advice. Without prompt treatment, Mr. Smith could face a life-threatening situation. This is where negotiation skills become crucial.
Learning to negotiate is invaluable not just in medicine, but in all areas of life, from buying a house to asking for a raise. Negotiation helps us reach agreements when we encounter differing perspectives or interests.
Key Elements of Effective Negotiation
Understand the Other Party’s Needs: Entering a negotiation solely focused on your own needs is a common pitfall. Successful negotiators know the importance of active listening. Understanding what the other party wants is the first step towards a mutually beneficial agreement.
Active Listening: Great negotiators pay close attention to what the other party is saying. This involves asking questions and genuinely understanding their needs and concerns. It’s about finding common ground and building trust.
Collaboration Over Competition: Many people view negotiation as a zero-sum game, where one person’s gain is another’s loss. This mindset often leads to combative interactions. Instead, aim for a collaborative approach where both parties can find a solution that meets their needs.
Empathy and Open-mindedness: Approaching negotiations with empathy and an open mind helps build trust and fosters better relationships. This positive attitude often leads to more successful outcomes.
Case Study: Negotiating a Better Salary
Tom is a newly qualified GP. He is offered a £60K salary for a six-session per week post, which breaks down to £10K per session. Initially, this seems fair, but considering the on-call commitments and actual hours, it’s not as appealing. Tom accepts the offer without negotiating, missing out on potentially higher earnings.
Had Tom negotiated, he might have secured an extra £1,000 per session, raising his annual salary to £66K. To avoid selling yourself short, follow these steps:
Research and Preparation: Know the salary range in your area. Speak with colleagues to gather information. Being informed boosts your confidence during negotiations.
Define Your BATNA (Best Alternative to a Negotiated Agreement): Understand the minimum terms you’re willing to accept. If an offer doesn’t meet your BATNA, be prepared to walk away.
Articulate Your Value: Justify your request for a higher salary with valid reasons, such as the demands and responsibilities of the role and local salary standards. For example, if local salaries range from £11K to £13K per session, use this data to support your case.
Example Dialogue for Salary Negotiation
“Thank you for the offer. I’m excited about the possibility of joining your practice and can be available for on-call duties. However, I have some concerns about the remuneration. Based on my research, local salaried posts are in the range of £11K to £13K per session. Could we discuss adjusting the offer to align with these figures?”
If the practice can’t meet the top range, suggest a compromise, such as a salary review after six months. If the offer doesn’t meet your BATNA, it’s okay to decline politely and continue your job search.
The Art of Win-Win Negotiations
The best negotiations result in win-win outcomes. Great negotiators seek creative solutions that address the interests of all parties involved. They look for opportunities to collaborate, combine resources, and unlock mutual benefits, paving the way for future partnerships and long-term success.
Meet Dr Gordon, a GP trainee, who faced a major hurdle on his path to attaining MRCGP.
I struggled with the exam format itself. Going into it, I wasn’t sure what would be coming up or how to prepare for it.
Gordon’s journey to becoming a fully qualified GP was hard. He failed the RCA twice and the SCA once, each time missing the pass mark by a few points. In his third attempt, he missed a pass by half a mark.
I was short by half a mark, which was devastating. So close, yet so far away!
His close calls were frustrating and demoralising. These repeated failures left Gordon questioning his preparation methods and his ability to succeed.
A New Approach
After his third attempt, Gordon realised he needed a new approach. He sought the guidance of Dr Erwin Kwun, an experienced medical educator who had helped many trainees pass their exams. With a new perspective, Dr Gordon gained the clarity and direction he desperately needed.
One of the first changes Dr Gordon made was to structure his consultations more effectively. He learned to use the three minutes of the reading time to prime the case, gathering crucial information and setting the stage for a more focused and effective interaction. This initial step was crucial in helping him manage his time and ensure that all necessary aspects of the consultation were covered.
Addressing Weaknesses
Breaking bad news was another area where Dr Gordon struggled. He found it challenging to navigate emotionally charged situations and deliver negative news sensitively and effectively. Through the 1:1 coaching, he learned to give patients space to process the news and to tailor his approach based on their reactions. Instead of rushing, he gave the patient time and space to absorb the bad news. This subtle yet powerful shift in approach made a significant difference in Dr Gordon’s performance.
Implementing Proven Strategies
Dr Gordon also refined his strategy for shared management plans. Initially, he felt that he knew what was best for the patient, but he learned the importance of involving the patient in the decision-making process. This approach not only improved his scores in the “relating to others” domain but also led to more effective and personalised patient care.
In his day-to-day practice, Dr Gordon began to allocate specific times for data gathering, addressing patients’ ideas, concerns, and expectations, and developing shared management plans. This structured approach mirrored the exam conditions and helped him become more efficient and effective in real-life consultations.
SCA Exam Day
When it came time for his fourth attempt, Dr Gordon was ready. He went into the exam with a clear structure in mind. He spent the first six minutes on data gathering, ensuring he covered all necessary aspects, including medical, psychosocial, and patient-specific concerns.
Gordon then used the remaining six minutes to develop and discuss a shared management plan, incorporating the patient’s input and addressing their concerns.
Writing key reminders on his whiteboard also helped: “Do not miss red flags, shared management, and follow-up.” This allowed him to stay focused and ensured that he didn’t overlook any critical components of the consultation.
SCA Exam Result
After missing SCA exam by half a mark, Dr Gordon gave everything he could on his fourth attempt. His hard work and strategic plan paid off. He passed the exam with a score of 87, over 10 points above the pass mark. His success marked the culmination of a challenging journey and the beginning of an exciting new chapter in his career.
5 Tips from Dr Gordon
Are you preparing for MRCGP SCA? Here’s five lessons from Dr Gordon’s case-study:
Seek Guidance: Don’t hesitate to seek help from experienced coaches or mentors who can provide new perspectives and strategies.
Structure Your Consultations: Use a clear and consistent structure to ensure you cover all necessary aspects within the time limit.
Practice Breaking Bad News: Learn to tailor your approach based on the patient’s reactions and give them space to process the news.
Develop Shared Management Plans: Involve patients in decision-making to create personalized and effective care plans.
Stay Focused: Use reminders and a clear structure to keep on track during the exam.
Are you ready to pass SCA Exam?
Dr Gordon’s journey is a testament to the power of perseverance, strategic preparation, and the willingness to seek and implement guidance.
Are you looking for a breakthrough? Our intensive 1 to 1 coaching might be the solution for you.
Join over 200 trainees who sought help to achieve their goals.
Applications for 1 to 1 coaching are considered on an individual basis.
Imagine pouring your heart and soul into preparing for the Simulated Consultation Assessment (SCA), only to encounter a devastating failure. Meet Dr Musttafa, a determined GP trainee who faced a major setback in the early stage of ST3. But with unwavering resilience and sheer determination, he transformed his failure into an inspiring success story.
Sitting SCA Exam for the first time
Dr Musttafa was confident when he took the SCA exam for the first time in January. But when the results came in, he was shocked.
It’s a result that I didn’t expect. Then, there was no confidence left.
This failure was a heavy blow, both professionally and personally. He began to regret taking the SCA so early and realised that his clinical management skills, particularly formulating patient-centered plans, were where he stumbled the most.
The Transformation
Despite the disappointment, Dr Musttafa never gave up. He took a step back to figure out what went wrong. He was aware that more SCA practice would not help if he didn’t identify and fix his blindspots.
Determined to pass SCA, Musttafa sought out resources and support. He watched YouTube videos, reviewed official Royal College of General Practitioners (RCGP) materials, and, most importantly, enrolled in a 1:1 coaching programme that provided the structured feedback he needed.
Working Smarter
For his second attempt at the SCA, Musttafa left no stone unturned. He developed a structured approach to his consultations, focusing on effective time management and creating shared management plans with his patients.
This shift was crucial. “It all comes down to time because if we don’t have the time then we can’t actually see what the patient thinks or what they are expecting,” he explained.
I didn’t have a structure. I think I recognised that early on because of several things. I overran my time a lot, so that told me I wasn’t targeting things, I wasn’t focused.
His commitment to improvement didn’t stop at technical skills. Musttafa also worked on his body language and communication style, recording many consultations to refine his approach. The transformation was clear—not just in his consultation structure but also in his newfound confidence and positive attitude.
SCA Results
When the results of his second attempt were published, Musttafa was understandably nervous. But this time, his hard work paid off. Refreshing the results page, he saw the green bubble indicating a pass. His score went from 70 to 82.5, a testament to his dedication and strategic approach.
I honestly couldn’t believe it. I took a few seconds and looked, and it was a pass. I was ecstatic.
He celebrated his achievement with colleagues, family, and friends, marking the end of a journey filled with hard work and determination.
Post-CCT plan
After achieving a pass in the SCA, Dr Musttafa is now set to join his training practice in the Northwest. He is excited about continuing his career as a GP. His journey highlights the importance of resilience, structured preparation, and seeking help and feedback when needed.
Dr Musttafa’s story is a powerful reminder that setbacks are part of the journey. With determination, support, and a strategic approach, success is always within reach. As Musttafa wisely advises, “It’s important to take some time off, re-evaluate, and then just come back stronger. Don’t let it beat you down.”
Are you ready to pass SCA?
Are you preparing for the SCA or facing similar challenges? I hope Dr Musttafa’s journey offers hope and practical insights into overcoming obstacles on your journey to becoming a fully qualified GP.
Like Dr Musttafa, you may feel devastated after failing SCA. If you are looking for a breakthrough, our intensive 1 to 1 coaching might be the solution for you.
Join over 200 trainees who sought help to achieve their goals.
Applications for 1 to 1 coaching are considered on an individual basis.
Success in the MRCGP Simulated Consultation Assessment (SCA) requires effective communication and a partnership with your patients. The SCA tests your ability to diagnose and manage clinical conditions while engaging in patient-centered care and shared decision-making. In this article, you will learn SCA tips to excel in shared decision-making.
What is Patient-Centered Care?
Patient-centered care places the patient at the heart of the consultation process. It involves understanding and incorporating their unique needs, preferences, and values into the management plan. Here are some core principles:
Active Listening: Pay close attention to the patient’s concerns, fears, and expectations. This builds trust and rapport.
Empathy and Reassurance: Address the patient’s emotional needs. For example, a coughing patient with a neighbor diagnosed with lung cancer might need extra reassurance or a thorough investigation to alleviate their fears.
Informed Decision: Ensure patients are well informed about the benefits and risks to facilitate informed decision-making.
Shared Decision-Making in Practice
Shared decision-making (SDM) empowers patients to take an active role in their health. It requires flexibility and considering the patient’s preferences, even if they differ from your initial recommendations. Here’s how to implement SDM effectively:
Explore the Patient’s Agenda: Start by asking open-ended questions to understand what the patient wants to address. Example: “What concerns you the most about your current symptoms?” or “Is there anything specific you hope to achieve from today’s consultation?”
Provide Tailored Information: Once you understand the patient’s agenda, offer relevant information in an easy-to-understand manner. Example: For a vaccine-hesitant parent, you might say, “I understand there are strong beliefs in your community about vaccines. Would you like some resources from community leaders that might provide more insights?”
Involve the Patient in Decision-Making: Encourage the patient to propose solutions and discuss their preferences. Example: “Considering your concerns about the medication, what lifestyle changes do you think could help manage your weight?”
Be Flexible and Adaptable: Modify your recommendations based on the patient’s feedback. Example: “I see that you prefer to avoid medication for now. Let’s explore some lifestyle modifications that might help.”
SCA Tips
Practice Role-Playing: Engage in role-playing scenarios, focusing on patient-centered care and SDM. This helps you get comfortable with these techniques and receive constructive feedback.
Use Educational Resources: Utilise trusted resources to enhance your consulting skills. Gain deeper insights into effective communication and SDM.
Reflect on Feedback: After each practice session or mock exam, reflect on the feedback provided. Identify areas for improvement and work on them consistently.
Clinical knowledge and being nice is not enough to pass SCA. It demands a compassionate and collaborative approach to patient care. By mastering patient-centered care and shared decision-making, you ensure your consultations are effective and respectful of each patient’s unique needs and preferences. Practice these skills diligently, and you’ll be well-prepared to succeed in the SCA exam.
How Dr Lawrence passed SCA?
After a failed SCA attempt with a score of 69, Dr Lawrence’s confidence was crushed. Check out how Dr Lawrence conquered SCA after this major setback.
Are you struggling to clear SCA (Simulated Clinical Assessment)? You’re not alone.
Many GP trainees work hard for SCA. Yesterday, I spoke with a trainee who dedicated almost a year of his life to preparing for SCA.
Dr Akin practised diligently with his colleagues, sacrificing countless evenings and weekends. Imagine the disappointment of investing so much time and effort, only to fall short of your goal. Unfortunately, this GP trainee failed with a score of 63.
This trainee’s story is not unique. Many trainees report experiencing nightmares and even PTSD from the stress of the SCA. This particular IMG had to take a hard look at what went wrong.
The blind leading the blind
Despite his consistent practice, Dr Akin made little progress in his study group and SCA practice. It was a classic case of the blind leading the blind. Many trainees fall into this trap—relying solely on peer study without seeking expert guidance. Here’s why this approach often fails:
Lack of Expertise: Without the insights of those who have successfully passed the SCA, trainees may not know which areas to focus on or how to effectively approach different scenarios.
Reinforcement of Mistakes: Studying exclusively with peers can lead to the reinforcement of incorrect methods, which only perpetuates the cycle of failure.
Missed Opportunities for Improvement: Constructive feedback from experienced mentors is crucial. They can pinpoint weaknesses and provide strategies for improvement, which peers might overlook.
Emotional and Mental Toll: Repeated failure without understanding the root causes can take a significant emotional and mental toll, reducing motivation and confidence.
The missing piece in this GP trainee’s preparation was constructive feedback. Identifying blind spots and working on areas of weakness is essential for success. Without this critical component, he had no clear path to improvement and eventual success in the SCA.
How did Dr Akin break the cycle and succeed
To avoid falling into the same trap, this trainee sought 1:1 coaching from a mentor with a proven track record of helping trainees pass the SCA. With constructive feedback, Dr Akin gained clarity and refined his consultation. His score went from 63 to 84.
4 Actionable steps
Here are some steps you can take:
Get Constructive Feedback: Seek out mentors or coaches who have successfully guided others through the SCA. Their experience can provide you with valuable insights and personalised advice.
Use Structured Tools: Utilise resources like the SCA Blueprint to systematically identify and address your weaknesses.
Practise with Purpose: Instead of just going through the motions, focus on targeted practice that addresses your specific areas of improvement.
Stay Positive and Motivated: Understand that failure is part of the learning process. Use each setback as an opportunity to learn and grow.
Remember, you don’t have to navigate this journey alone. With the right guidance and support, you can turn your weaknesses into strengths and achieve your goal of passing the SCA.
Are ready to pass SCA?
You may feel devastated after failing SCA. If you are looking for a breakthrough, our intensive 1 to 1 coaching might be the solution for you.
Join over 200 trainees who sought help to achieve their goals.
Applications for 1 to 1 coaching are considered on an individual basis.
As a GP trainee preparing to sit the MRCGP SCA, you might view Shared Decision Making (SDM) as just another checkbox. However, SDM is far more than a procedural requirement—it’s a transformative approach that enhances patient care and outcomes significantly.
The Evolution from Paternalistic to Collaborative Care
Gone are the days when doctors acted as all-knowing oracles, dictating treatment plans without patient input. Nowadays, patients are active partners in their health journeys. Understanding the spectrum of decision-making models—from paternalistic to informed to shared—is crucial. SDM stands out as it combines the expertise of the doctor with the personal insights of the patient, making it a balanced and effective approach.
The Advantages of Shared Decision Making
SDM brings numerous benefits, such as enhanced patient satisfaction, improved health outcomes, and cost-effectiveness by aligning treatments with patients’ desires, leading to better adherence and overall outcomes. Such collaborative practices are not only rewarding but are shaping the future of personalised healthcare.
Addressing the Challenges
While SDM is the ideal model in many scenarios, it’s not universally applicable. Certain situations, such as emergencies or when dealing with particular medical conditions, might require more directive decision-making from the doctor. Trainees must learn to assess when to apply SDM and when to take a more decisive stance, ensuring they manage patient expectations and anxiety effectively.
Implementing SDM in Your Practice
To effectively implement SDM, consider the three-talk model:
Information Exchange: Engage in a thorough discussion where both patient and doctor share relevant information about treatment options, with the doctor explaining the potential benefits and risks.
Deliberation: Together, deliberate over the options, taking into account the patient’s values, preferences, and lifestyle.
Decision: Make a joint decision that aligns with the patient’s best interests and health goals.
Overcoming barriers in these stages might include strategies like using decision aids to help explain complex information, or role-playing exercises to practise engaging reluctant patients.
Case Example
Consider Dr Sarah, a GP discussing treatment options with a patient newly diagnosed with type 2 diabetes. Instead of deciding to start medication for the patient, Dr Sarah outlines lifestyle changes and medication options. By incorporating the patient’s personal goals and concerns into the decision-making process, they collaboratively decide on a treatment plan that suits the patient’s daily life and long-term health objectives.
The Ultimate Guide to Shared Management
The ability to effectively collaborate with patients in treatment decisions is vital. Take every opportunity during your training to practise SDM, whether through simulations or real clinical interactions. This hands-on experience will build your confidence and proficiency, truly equipping you to foster deeper patient relationships and deliver care that respects patient autonomy and preference.
How did this IMG pass MRCGP SCA?
After a failed SCA attempt with a score of 69, Dr Lawrence’s confidence was crushed. Check out how Dr Lawrence conquered SCA after this major setback.
Are your consultations running late? Time management is a major challenge in the MRCGP SCA.
Tom is a GP Registrar, preparing to take the MRCGP SCA in three months. He is currently on a 20-minute appointment slot. He has started revising for SCA. Tom often finds himself running late. He struggles to fit everything within 12 minutes.
He is okay with straightforward cases but things don’t go so well for challenging cases. Poor time management is usually a symptom. It is vital to diagnose the underlying causes.
Some candidates take more time due to a lack of structure, not committing to a diagnosis or excessive use of summary. GP trainees often dwell on data gathering past 7-8 minutes due to a fear of missing important information. The first step is to audit your time in the consultation. This is where recording your consultation is helpful.
1. Use a timer
Do you keep track of time? Many trainees don’t keep an eye on time and only start clinical management eight minutes into the consultation. As a result, they don’t have sufficient time to conclude the consultation. You can’t manage your time efficiently without gauging yourself.
Use a timer and keep track of the length of time you spend in data gathering and clinical management. Aim to move to clinical management after six minutes.
2. Strategic priming
How do you prepare before starting a consultation? It’s vital to use the information provided in the patient’s record to plan the consultation. Priming a case beforehand will help you prepare and anticipate what to do in the consultation.
In the three minutes of reading time, read the case carefully and write down key questions you shouldn’t miss to enable a safe assessment. Consider management you might like to discuss.
3. Structure your consultation
Do you find yourself going back to history-taking and asking disjointed questions? Without a structure, trainees may appear to take a history haphazardly. Trainees can miss important clinical issues because the consultation is chaotic.
Organising a consultation is vital to take a history systematically. It is helpful to revisit consultation models to learn how to structure your consultation. By using a structure, trainees can take a targeted history.
4. Avoid over summary
Do you find yourself summarising excessively? It’s a common mistake. Many trainees tend to recount everything which is an inefficient use of time. Remember, summarising the consultation extensively doesn’t earn you any points. It is more effective to focus your efforts elsewhere to make better use of your consultation time.
If you find this tips useful so far and want more in-depth resources, get 7-day SCA Blueprint for free
5. Pace your speech
Have you ever found yourself searching for words? Some trainees might speak more slowly since English is not their native language. This may affect the pacing of the conversation.
Preparation helps you maintain a steady flow without unnecessary pauses or deviations. Organise your thoughts and main points before the explanation. Practice delivering your content several times to get comfortable with the flow and timing.
Time management is key in the SCA. After implementing these changes, you will notice an improvement in your consultation without rushing clinical management. Moreover, you will have time to provide safety netting advice, an important component of the consultation first introduced by Neighbour.
How Dr Lawrence passed SCA?
After a failed SCA attempt with a score of 69, Dr Lawrence’s confidence was crushed. Check out how Dr Lawrence conquered SCA after this major setback.
