Crammer’s Corner

Abstract

The Recorded Consultation Assessment (RCA) is an interim assessment developed by the RCGP. General Practice Speciality Trainees have been preparing and submitting recording for this assessment while the COVID-19 pandemic has disrupted the known Clinical Skills Assessment (CSA) examination. Dr Hana Patel will discuss how trainees can prepare for this new assessment in this two-part series.

What is the Recorded Consultation Assessment?

The new Recorded Consultation Assessment (RCA) has been developed by the RCGP in response to the government guidance following the COVID-19 pandemic. At the time of writing, the new exam development group at the RCGP is working to present a paper to the RCGP Trustees and Council. While a minimum 6-month notice period will be given to GP trainees of any change to the exam format, it is expected that the timings will follow the same schedule as this year, with sitting likely in January, March and May 2022. Box 1 demonstrates changes in RCA case selection from later this year.

Box 1.

Changes to RCA from September 2021.

To help candidates avoid potential ‘breach’ of a mandatory criterion and therefore a potential penalty, breast lumps will be explicitly excluded from maternal and reproductive health.

The RCA is a summative assessment (like the Clinical Skills Assessment or CSA), that GP trainees in ST3 use to demonstrate clinical, practical, professional and communication skills by submitting pre-recorded audio, video or face-to-face consultations. GP trainees should submit a range of consultations to demonstrate relevance to the curriculum. These are mapped to the same areas that the CSA exam tests, that is: knowing yourself and relating to others, applying clinical knowledge and skill, managing complex and long-term care and caring for the whole person and the wider community.

General advice regarding the RCA

Once an RCA booking is confirmed by the RCGP, GP trainees will have access to the FourteenFish RCA Platform, on to which recordings can be either submitted or recorded directly.

The FourteenFish RCA Platform can be used to directly contact the patient and link to the chosen consultation mode. GP trainees can then start uploading a variety of recorded formats and a final total of 13 consultations in their current working environment (the same number required for the CSA examination).

The cases chosen for submission should demonstrate safe and independent practice associated with an appropriate challenge for an ST3 trainee and demonstrate safe and independent practice. The cases are then examined by trained experienced GP examiners who make a global judgement of each individual consultation, independent from any other consultation.

Submitted recordings will be deleted from the FourteenFish RCA Platform after the Examination Board has ratified and published results.

General tips for the RCA

Each of the individual consultations must be recorded continuously, with no editing in anyway. The camera should not be turned off during consultations. GP trainees should not share their recordings for submission or potential submission for the RCA with anyone outside of their own speciality training programme. GP trainees must also not share their recordings in any preparation course for the RCA or use any case screening services before submission to the RCA. GP trainees risk being referred to the General Medical Council (GMC) if this guidance is not adhered to. It is usual to record many cases during the ST3 year that are then used for other Workplace-based Assessments (WPBAs), such as Consultation Observation Tools (COTs). Unfortunately for the purposes of the RCA, cases that have been used for WBPAs cannot then be submitted for the exam.

How to get the best out of recording consultations for the RCA

While it seems obvious, one of the main barriers trainees face when preparing for the RCA is a failure to appreciate how long it can take to find 13 suitable cases for submission in time for the deadline.

Another common issue is finding out that the cases for submission are not of sufficient technical quality (in terms of sound and picture).

If video or face-to-face consultations are submitted, GP trainees should ensure that the face of both the patient and doctor are visible, pending the latest personal protective equipment guidance (PPE). The GMC and the RCGP stress the importance of maintaining the dignity of patients during consultations and good medical practice. However, the GMC states that an examination may be continued out of line of the camera with appropriate consent and a chaperone.

Cases that involve clothing being removed to the ‘swimsuit area’ in adults or ‘nappy area’ for children up to the age of 2 years old, should not be submitted if visible in the recorded consultation. GP trainees will be asked to verify this in their online workbook. If a case is submitted and this guidance has been breached, then no marks will be awarded for that consultation. Finally, it is the GP trainee’s responsibility to choose recordings for submission, taking into account advice from their Educational Supervisor.

ORCID iD

Dr Hana Patel https://orcid.org/0000-0002-1056-9271

References

General Medical Council (2020) Coronavirus: Your frequently asked questions. Available at: www.gmc-uk.org/ethical-guidance/ethical-hub/covid-19-questions-and-answers (accessed 16 March 2021).

RCGP (2021) Examinations update. Available at: www.rcgp.org.uk/about-us/rcgp-blog/rcgp-examinations-update-10-may-2021.aspx (accessed 6 July 2021).

World Health Organization (2019) Coronavirus Disease (COVID 19) pandemic. Available at: www.who.int/emergencies/diseases/novel-coronavirus-2019 (accessed 16 March 2021).