Here are some top tips to help you prepare and pass the RCA with ease.
The Recorded Consultation Assessment (RCA) is a new format replacing the previously undertaken CSA in response to the Covid-19 pandemic. The basis of the assessment is to stimulate patient consultations based on real-life scenarios, applying learnt disease processes in a primary care context. Here, the candidate chooses 13 consultations from their own working environment and submits the evidence utilising audio or video consultations.
Prior to the RCA Consultation
Obtain the right cases
Choosing cases:
This may sound obvious but choosing the appropriate level of challenge is sufficient to demonstrate independent and safe practice.
Ensure the cases chosen collectively demonstrate a breadth of knowledge across the curriculum.
There are three main domains that make up the assessment, it is paramount that sufficient evidence is demonstrated across all three for each case submitted.
Be aware of consultations involving the ‘swimsuit area’. Due to the nature of the RCA visually recorded consultations involving the demonstration of this area cannot be submitted.
Submit a range of different types of patients across various curriculum areas. It might help to have a table of the curriculum to hand and tick off different areas as you go through them, this will help you identify remaining cases.
Mandatory criterion requires the candidate to choose at least one consultation with a patient presenting a problem with an already pre-existing long-term condition. Ensure this is included within your overall submissions.
Obtaining the cases:
Staff need to be informed of the RCA assessment and what it entails. This includes not only clinicians but also receptionist staff, nurses, HCA’s and administrative staff.
Wherever possible only book consenting patients to maximise the opportunity for case retention.
Liaise with nursing staff in regard to any newly diagnosed patients such as diabetics or hypertensives- these can make great RCA consultations.
Practice makes perfect!
Get familiar with recording yourself and reviewing your recordings. Record cases even if you do not feel ready for submission, these will act as valuable tools for improvement and make you more confident in front of the camera. Go over cases with your trainer and ask them for feedback along, with familiarising yourself with the marking scheme and grade descriptions. Here at Hippocratix we believe it is paramount for the success of RCA candidates to get inside the examiner's mind, for this reason, we include detailed examiner feedback alongside our detailed consultation examples. Check out our five-star rated membership programme dedicated to helping candidates pass the RCA with ease.
The Consultation:
Focus on consultation skills, not the exam
It is easy to fall into the trap of focusing on mandatory criteria for the exam but initially, the most important thing to do is develop your own fluent consultation style. Focusing on phrases that feel natural and relaxed within a formal setting while minimising jargonistic consultation styles should be of primary importance. Once your consultation skills have been honed, then turn your focus onto embedding mandatory criteria into your consultation style.
Be patient-centred, not doctor-centred
The best consultations are naturally flowing, patient-led interactions. Ensure you are following a skeleton, structure to prevent distraction from really listening to the patient.
Safety netting for reassurance
Safety netting is an important element of the RCA however, should only be used when relevant to the consultation. Safety netting should be both empowering and reassuring for the patient and not come as a surprise.
Clear consent
Ensure that clear consent is obtained. If at any point during the consultation, consent is removed under no circumstances should the consultation be submitted. If used as evidence sanctions will be considered and zero marks awarded, along with a potential referral to the Responsible Officer.
Examination
As of September 2021 physical examinations are no longer a mandatory for the RCA. Examinations can still be submitted, however, only when in the best interests of the patient.
Make sure ICE is covered
‘Idea, concerns, and expectations’ (ICE) are key elements of effective patient-clinician consultations and something that the RCA assesses. Often within a consultation, the ‘ideas’ part of the question comes up early as this goes hand in hand with discussing their illness. Concerns naturally take place later after the symptoms have been described. Expectations can be clinician lead and easily dotted throughout the consultation for example, ‘how can I help you today?’.
Things to remember while recording consultation:
Place a ‘do not disturb’ sign on the door, it is imperative that everyone in the practice is aware of what is going on and is respectful of the privacy you require.
Try to work with your supervisor and practice. Ask for dedicated clinics to make sure appropriate patients are booked into your clinic and allocated time to ensure you're able to capture the best consultations.
Ensure you verbalise any relevant patient history that aids your decision process, especially information that is not discussed within the recorded consultation. Remember, the examiner cannot see medical records and are unaware of the patient's medical history, medications etc.
Invest in a timer. This will help you keep track of the duration of the consultations and ease ambiguity.
Avoid typing or scrolling as this can distract from the flow of the consultation.
Formulate a crib sheet. Keeping a post-it note or two near your computer helps you to cover key points and maintain a good consultation structure- especially when you are nervous!
Perform a trail run with a colleague before recording the patient consultation. This ensures that the camera is in the right direction and the audio is working correctly.
Ensure that the video or audio is continuously recorded with clear sound throughout. A break in the recording will likely incur a penalty or zero marks awarded.
Use the patient's full name as a mark of respect if you don’t know them well- especially with elderly patients.
If you would like further top tips on passing the RCA with ease check out our dedicated video below:
Includes further information on what case types to submit, examples of complex cases, how to record and cyber security
Includes top tips from a recently qualified GP on their own experience passing the RCA