Preparing with your colleagues for the MRCGP SCA, is it worth your time? A hard discussion no one is willing to have!

Have you ever asked yourself the following… What’s the best way to prepare for the MRCGP SCA? If you spend any time on Telegram, Whatsapp, or Facebook groups, you will see that GP trainees are looking for colleagues to team up with for SCA practice. In this blog, I’d like to ask the difficult question of whether it’s a big waste of your time?! To answer this question, I can only rely on the experiences that I’ve had with our MRCGP SCA coaching trainees.

Have you ever asked yourself the following… What’s the best way to prepare for the MRCGP SCA?

 

If you spend any time on Telegram, Whatsapp, or Facebook groups, you will see that GP trainees are looking for colleagues to team up with for SCA practice. In this blog, I’d like to ask the difficult question of whether it’s a big waste of your time?!

 

To answer this question, I can only rely on the experiences that I’ve had with our MRCGP SCA coaching trainees.

 

The MRCGP SCA aims to assess a GP trainee’s ability to integrate and apply skills appropriate for real-life general practice whilst objectively measuring the skills required for GP competence.

 

Since the purpose is aimed at real-life general practice, how easy is it to replicate real-life consultations? 

 

No two patients are the same…

 

Patient variation is difficult to replicate. The variation comes in all shapes and sizes, but the variation here isn’t about how the ICE or psychosocial domain differs. It’s about the variation in how patients share their stories, how they perceive your questions and when and where they choose to share their deepest concerns.

 

Let’s say you’re practising a case on reflux, and the brief is that you are a patient with new reflux, weight loss and dysphagia.

 

Patient A may give you everything in the first two minutes.

 

Patient B may give you the reflux and hold on to the weight loss and dysphagia, hoping that you don’t pick up on a possible cancer diagnosis.

 

Patient C may start with a trivial ankle sprain while exercising the courage to speak about the red-flag symptoms.

 

How do you objectively assess a consultation without being an expert in communication?

 

The theory of consultation is multifaceted and nuanced. When working in groups or with peers, you often rely on your peers to determine the quality of your communication skills.

 

I’ve recently found in our one-to-one coaching sessions that trainees will challenge our outcomes and feedback regarding simple communication tools like ascertaining the ICE or contextualising the consultation.

 

Recently, I challenged a trainee on their use of ICE. The trainee asked the ICE and responded to the ICE by acknowledging each element.

 

For example…

 

The doctor says, “Is there anything worrying you?”

 

The patient says, “I am worried this could be my heart.”

 

The doctor says, “I understand you are worried this could be your heart.”

 

My argument was that you should demonstrate natural curiosity when ascertaining the ICE. Let’s say a similar curiosity that you would offer to your friends or family…

 

Let’s say your friend says to you…

 

“You know that pain I’ve been having? I think it could be my heart.”

 

Your response is likely natural, and you’d be interested in why your friend worries about heart pain.

 

“What made you think about your heart?”

“Tell me, what’s making you worry about your heart?”

 

The point I’m making isn’t necessarily about the ICE; what’s important is knowing how you and your colleagues understand communication skills and how you subsequently share that information.

 

Empathy is important

 

Having worked with many GP trainees preparing for the SCA, I understand the challenge of being empathetic when providing constructive criticism. It very much underpins the iterative process we follow at WellMedic.

 

When it comes to practising with your peers, it’s difficult not to be empathetic. Having witnessed trainees preparing in groups, I find that trainees are mostly empathetic in two ways;

 

  1. We are empathetic in sharing information from the SCA case.

 

When working in groups, you are more likely to share essential information from the case to help your colleague. In contrast, when consulting with the actors, they are trained to withhold and share at specific points in the consultation.

 

  1. We are empathetic with our feedback.

 

It’s challenging to be honest when it may upset your colleagues. So, you’re more likely to focus on the softer truths.

 

Does this mean I shouldn’t practice in a group?

 

My reason for writing this blog isn’t to say that group work is a no-go. It has its benefits. Practising with a colleague is an excellent way to tackle a high volume of cases, a good way to practice handing over management plans, and a fantastic way to practice describing findings in lay terms. 

 

That said, it can’t be your only way of preparing for the SCA.

 

You have to practice with actual patients, record your patient interactions, and put in the effort of listening back to actual cases.

 

By doing so, you will recognise the skills you have used and the areas that you can improve!

 

How can I improve group SCA work?

 

Consultation theory is essential. By upskilling your understanding of consultation theory, you can improve and implement new skills and provide reliable feedback to your colleagues.

 

If working in groups, vary the patient type to reflect actual general practice.

 

And finally, don’t mistake empathy and constructive criticism. Share your honest opinion in a professional and empathetic way. By lying to a colleague, you are not helping them pass the exam!

 

Consider investing in independent feedback. One of the strengths of our SCA coaching programme is that we offer one-to-one feedback over an iterative four-session process. We build rapport and learn about how you communicate.

If you’d like to know more about how we helped Dr Tilney, you can listen to this podcast. 

If you’d like to sign up for SCA coaching – click here!

 

https://www.wellmedic.co.uk/wp-content/uploads/2021/06/site_logo_white2.png

Welcome to the WellMedic. Where we talk you through a more-complex scenario where you will have to look at the application of your knowledge, but also some of the finer details covered within the guidelines.

Newsletter

    Copyright © 2024 WellMedic. Made with  by Creative Marketing Ltd.