The consultation beyond the Clinical Skills Assessment

Abstract

Working for the Clinical Skills Assessment (CSA) can feel like trying to jump through the proverbial ‘hoop’; like being a circus dog training to jump higher and higher. I prepared for my CSA with two friends on a similar schedule. For months, my consulting style was scrutinised. They commented on my facial expressions, my body position and my tone of voice. I learned that graphs do not help patients understand preventative medicine, and that I sound patronising when trying to empathise. I learned how to break bad news, explain contraception, work with interpreters, and assess a young person’s Gillick competence. We progressed through cards, books and online resources. My acting skills became prodigious. I became more confident in conducting a certain kind of consultation. Eventually, we all jumped through the hoop. However, what of the consultation once you land on the other side? Do you forget how to read emotional temperature and to involve patients in decision making? Do you revert to a paternalistic approach in bashing through the volume of patients and paperwork? Do you accept everything patients say, and give them exactly what they want in order to get them out of the room? Hopefully, this is far from the case.