Are you preparing for SCA Exam? Consulting within 12 minutes is challenging for many GP trainees. Recently, I spoke with a GP registrar whose SCA preparation has hit a brick wall. He struggled to drive his consultation forward, often getting flustered and running out of time. After an in-depth analysis, we identified a major weakness in his consultations – a lack of structure.
The Importance of Structure
Without a structured approach, consultations can easily spiral out of control. So, how can you consult more effectively for SCA exam? This article explores three valuable consultation models that can transform your consultation skills.
Consultation Models
1. Pendleton’s Model
The Pendleton Model, one of the pioneering patient-centered models, emphasises involving the patient in the management plan. It outlines seven crucial tasks within a consultation:
1. Define the reason for the patient’s attendance: Understanding why the patient is seeking help is essential.
2. Consider other problems: Patients often have multiple issues, so screen for additional concerns.
3. Choose an appropriate action for each problem: Prioritise which problems to address during the consultation.
4. Achieve a shared understanding: Understand the patient’s perspective to make informed decisions together.
5. Involve the patient in the management: Encourage patient involvement and shared responsibility for their care.
6. Use time and resources appropriately: Distinguish between patient needs and wants to optimize resource utilization.
7. Establish or maintain a relationship: Building rapport is essential for positive outcomes.
2. Neighbour’s Model
In the Inner consultation, Neighbour proposed a five-stage framework that aligns with the natural flow of a consultation:
1. Connecting: Establish rapport and a connection with the patient.
2. Summarising: Summarise the patient’s concerns to ensure clarity and alignment.
3. Handing over: Transition smoothly to the next phase of the consultation.
4. Safety netting: Provide guidance on when and how the patient should seek medical attention.
5. Housekeeping: Manage your emotions and prepare for the next consultation.
3. Calgary-Cambridge Guide
The Calgary-Cambridge Model is another patient-centered approach, organised into five stages:
1. Initiating the session: Start the consultation effectively, setting the stage for collaboration.
2. Gathering information: Collect relevant data and listen actively to the patient’s narrative.
3. Physical examination: If necessary, conduct a physical examination.
4. Explanation and planning: Discuss findings and create a shared plan with the patient.
5. Closing the session: Conclude the consultation while ensuring the patient’s questions and concerns are addressed.
Building Relationships and Providing Structure
In addition to the stages, both the Neighbour and Calgary-Cambridge models emphasize building a strong doctor-patient relationship and maintaining structure throughout the consultation. They incorporate the psychosocial aspects of a patient’s life, ensuring a holistic approach to care.
Creating Your Consultation Style
Each consultation model has its merits, and none is perfect. Consider experimenting with different models and adapting components that work best for you. I suggest you develop your unique consultation style that combines the strengths of these models while aligning with your personality and patient needs.
Conclusion
Mastering consultation models is a vital step toward success in the MRCGP SCA exam. These frameworks provide structure, enhance patient-centered care, and improve your overall consultation skills. As you progress in your medical career, you’ll find that these models empower you to navigate challenging consultations with confidence.
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