Leicester Assessment Package for video consultation

I use this as a formative assessment tool when watching video or sitting-in watching the GP registrar consult: he/she watches me too, and I encourage the GP registrar to assess my consultations as well.

Microsoft Word documentLeicester assessment package


Leicester Assessment Package
for video consultationName: Date:Brief clinical details Consultation duration (mins)

  1. Interviewing/history taking (Relative weighting 20%)
    • Introduces self to patients
    • Puts patients at ease
    • Allows patients to elaborate presenting problem fully
    • Listens attentively
    • Seeks clarification of words used by patients as appropriate
    • Phrases questions simply and clearly
    • Uses silence appropriately
    • Recognises patients’ verbal and non-verbal cues
    • Identifies patients reasons for consultation
    • Elicits relevant and specific information from patient and/or their records to help distinguish between working diagnoses
    • Considers physical, social and psychological factors as appropriate
    • Exhibits well organised approach to information-gathering
  2. Physical examination (Relative weighting 10%)
    • Performs examination and elicits physical signs correctly and sensitively
    • Uses the instruments commonly used in family practice in a selective, competent and sensitive manner
  3. Patient management (Relative weighting 20%)
    • Formulates management plans appropriate to findings and circumstances in collaboration with patients
    • Makes discriminating use of investigations, referral and drug therapy
    • Is prepared to use time appropriately
    • Demonstrates understanding of importance of reassurance and explanation and uses clear and understandable language
    • Checks patients’ level of understanding
    • Arranges appropriate follow-up
    • Attempts to modify help-seeking behaviour of patients as appropriate
  4. Problem solving (Relative weighting 20%)
    • Generates appropriate working diagnoses or identifies problem(s) depending on circumstances
    • Seeks relevant and discriminating physical signs to help confirm or refute working diagnoses
    • Correctly interprets and applies information obtained from patient records, history, physical examination and investigations
    • Is capable of applying knowledge of basic, behavioural and clinical sciences to the identification, management and solution of patients’ problems
    • Is capable of recognising the limits of personal competence and acting accordingly
  5. Behaviour/relationship with patients (Relative weighting 10%)
    • Maintains friendly but professional relationship, with due regard to the ethics of medical practice
    • Conveys sensitivity to the needs of patients
    • Demonstrates an awareness that the patient’s attitude to the doctor (and vice-versa) affects management and achievement of levels of cooperation and compliance
  6. Anticipatory care (Relative weighting 10%)
    • Acts on appropriate opportunities for health promotion and disease prevention
    • Provides sufficient explanation for preventive initiatives taken
    • Sensitively attempt to enlist patients’ cooperation to promote change to healthier lifestyles
  7. Record keeping (Relative weighting 10%)
    • Makes accurate legible and appropriate record of every doctor-patient contact and referral – minimum information including
      • date
      • relevant history/examination
      • any measurement (BP, PEFR, weight)
      • the diagnosis/problem
      • outline of management plan
      • investigations and follow-up
      • prescription dose/quantity/special precautions intimated to patient

Overall clinical competence: Grade Specific strategies for improvement:


Questions to be asked of candidates

  1. At the end of history-taking:
    • What are your diagnostic hypotheses at this stage?
    • Why have you erected these hypotheses?
    • What physical examination do you intend to carry out, and why?
  2. After physical examination:
    • What did you find on examining the patient?
    • How have these findings affected your thoughts?
  3. After patient has left:
    • Why did you choose your management plan?

Criteria for allocation of grades

  • A: Demonstrates mastery of all (or almost all) components consistently and to the highest standard. The criterion performance.
  • B: Demonstrates mastery of all (or almost all) components consistently and to a high standard, and some to the highest standard.
  • C+: Consistently demonstrates capability in all (or almost all) components to a satisfactory standard – some to a high standard. No serious defects.
  • C: Demonstrates capability in all (or almost all) components to a satisfactory standard but tends to lack discrimination, organisation and good time management.
  • D: Demonstrates inadequacies in at least one component. Lacks discrimination and/or organisation. Tends to perform inconsistently. Raises doubts concerning capability for independent practice.
  • E: Demonstrates major omissions and/or serious defects. Grossly unacceptable standard overall. Not safe to practice independently.

Leicester Assessment Package for video consultation
Summary

Name: Date:

  1. Interviewing/history taking (Relative weighting 20%)

    Grade (A-E):

    Strengths: Specific recommendations for improvement:

  2. Physical examination (Relative weighting 10%)

    Grade (A-E):

    Strengths: Specific recommendations for improvement:

  3. Patient management (Relative weighting 20%)

    Grade (A-E):

    Strengths: Specific recommendations for improvement:

  4. Problem solving (Relative weighting 20%)

    Grade (A-E):

    Strengths: Specific recommendations for improvement:

  5. Behaviour/relationship with patients (Rel wt 10%)

    Grade (A-E):

    Strengths: Specific recommendations for improvement:

  6. Anticipatory care (Relative weighting 10%)

    Grade (A-E):

    Strengths: Specific recommendations for improvement:

  7. Record keeping (Relative weighting 10%)

    Grade (A-E):

    Strengths: Specific recommendations for improvement:

  • Overall clinical competence:

    Grade (A-E):

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