DECISION MADE:
You have chosen:
Bogged down in Data Gathering
"But I asked all the questions"
It is a common feature of struggling candidates to retreat to the comfort zone of asking direct questions, in the fallacy that this will save time. Open questions are the questions that give you the information you'll need to gather data to inform an evidence-based management plan.
The SCA examination tests Data Gathering and Diagnosis, Clinical Management & Medical Complexity, and Relating to Others. Most of the marks assigned for each case are in Clinical Management & Medical Complexity,
- Data Gathering and Diagnosis 36 marks
- Clinical Management & Medical Complexity 54 marks
- Relating to Others 36 marks
which means the emphasis in GP Consulting should be time spent on management and handling the complexity involved. Full marks on Data Gathering won't result in an overall pass, and devoting disproportionate time to questions and investigations doesn't make for effective consulting in independent practice
SCA Feedback Statements
Time management in the consultation was ineffective
Examiners felt that you showed poor time management during the cases, perhaps taking too long over certain tasks or failing to cover what was thought to be essential as time ran out.
The ability to consult within a short time is essential for current practice. We must manage time as a resource for the sake of ourselves, our other patients and the whole team.
A common reason for running out of time in cases is taking too long over data gathering, and then having to rush clinical management, explanations and follow-up arrangements. Pace yourself and consider roughly how long you should be taking for the different parts of the consultation. Remember the SCA cases are designed to be possible in the twelve-minute time frame.
A reminder: Data gathering requires us to be appropriately selective in the questions we ask, tailored to the circumstances of the patient, rather than being an ‘all inclusive’ review of systems.
Suggestions
Try to see patients within a limited time frame at work. Set up a clock within eyeshot of your desk. Role play strategies for managing time, especially in challenging situations. Observe clinicians who consult effectively but efficiently and incorporate their techniques into your practice.