CSA Revision Notes for the MRCGP, second edition

By Jennifer Stannett

This book helps you to revise and prepare for the CSA part of the MRCGP exam. The new edition features an additional 11 clinical scenarios, all presented in the same standardised format to help you to improve your:

* data gathering – a broad range of appropriate questions to ask the patient are provided and red flags are highlighted where appropriate
* interpersonal skills – each clinical problem is described using terms that you can use in your explanations to patients
* clinical management – tells you which examinations to consider, which investigations to order, and how to manage each clinical problem based on the latest guidelines and current best practice
* consultations – to help you practise, every clinical case features a realistic role play scenario, all of which have been extended with additional information in the new edition.

Every clinical scenario in this new edition has been updated and new appendices have been added to cover driving and the latest DVLA guidelines, and when to suspect child maltreatment.

The book is designed to be used as a workbook, with wide margins to allow you to add in your own notes, questions and other aides-memoires. Used in this way, CSA Revision Notes for the MRCGP is the ideal book to help you successfully prepare for the exam.

From reviews of the first edition:

“Following the glowing reviews of this book I bought it for my CSA preparation. It is a very well written book and a good resource for the CSA. I like the lay out with different case scenarios presented in the CSA style of – data gathering, interpersonal skills and clinical management. I like the open questions and focused questions for each scenario and the role play idea at the end of each case scenario. Interestingly this is the recommended read from our VTS programme.”

• Language: English
• Publisher: Scion Publishing
• Release date: Mar 15, 2013
• ISBN: 9781907904721

Book preview

General practice consultation

Telephone consultation

• In a climate of increasing targets and demand for access, telephone consultations are playing an increasingly important role in the delivery of healthcare by GPs.

• The scope of telephone consultations is wide ranging, and includes triage, management of acute and chronic problems, follow-up care and delivery of information.

• It is important to be aware of the limitations of telephone consultations. Telephone advice is not always appropriate, and they do not provide the non-verbal cues that make up around 50% of face to face consultations (GPOnline, 2008, Consultation skills – telephone consultations).

• Key skills in telephone consultations include active listening, frequent clarification and picking up cues such as changes in the tone of voice.

Framework for telephone consultations

Preparation

• Look through the patient’s notes prior to the telephone call, familiarising yourself with their past medical history, medication history and recent consultations, etc.

• Have a notepad or paper available in case you need to take notes during the consultation.

Introduction

• Introduce yourself and ensure that you are speaking to the correct person to ensure confidentiality.

• Try to build a rapport through the tone of your voice.

Data gathering

• A detailed history is essential in the absence of physical examination and signs.

• Use open and focused/closed questions to include/exclude relevant conditions.

• Remember to exclude red flag symptoms.

Summarising

• Ensure that you have established the patient’s ideas, concerns and expectations.

• Allow time for the patient to ask questions.

Clinical management

• Agree on a plan of action and give clear information about when to seek further advice or help (safety net).

• Request that the patient repeats the advice given.

• Allow the patient to end the call first.

Documentation

• Accurate records should be kept for all telephone consultations, with details of the management plan and follow-up agreed with the patient.

Role play

Home visit

• Home visits still remain an integral part of primary care, although their use is diminishing.

• In 1995, 9% of all GP consultations in the UK were home visits, whereas in 2006 this had decreased to just 4% (ONS and DoH Survey).

• GPs tend to visit a patient at home when the patient is confined due to illness or disability, or when urgent treatment can be given more quickly by visiting.

• The disadvantage of a home visit is that it is very time consuming for the GP and there is not access to some medical equipment which might otherwise be available in the surgery.

Framework for home visit consultations

Preparation

• Ensure you read through the patient’s notes prior to visiting, familiarizing yourself with the patient’s past medical history, medication history, allergies and recent consultations. It is useful to take a print out of this information on a home visit.

• Ensure that you pack a doctors’ bag with all the relevant equipment.

• Ring the patient beforehand to determine the reason for the home visit request and confirm with them that you will be visiting.

• To ensure your safety, let a member of staff know that you are going on a home visit and give the details of which patient you are visiting.

Data gathering

• Ask open questions, followed by focused questions including those to check for red flags.

• Establish social history: Is the patient coping at home? Is additional help

Reviews for CSA Revision Notes for the MRCGP, second edition

[MohammadAbdurRahman · Rating: 5 out of 5 stars]

Very nice revision book for every GP