1. MRCGP Video Analysis Dr. Ramesh Mehay Course Organiser (Bradford VTS) Dr. Ramesh Mehay Course Organiser (Bradford VTS)

2. AIMS For participants to learn how to use the MRCGP marking schedule to improve their own consulting skills and those of others. This presentation has slide notes which you may wish to refer to For participants to learn how to use the MRCGP marking schedule to improve their own consulting skills and those of others. This presentation has slide notes which you may wish to refer to

3. OBJECTIVES MRCGP: To become familiar with the MRCGP marking schedule To learn how to use this to assess / review your own and others video consultations To learn what you need to do in order to produce a video that will pass MRCGP examination. MRCGP: To become familiar with the MRCGP marking schedule To learn how to use this to assess / review your own and others video consultations To learn what you need to do in order to produce a video that will pass MRCGP examination.

4. Key Point 1 You will soon come to see yourself in a better light.. A common first reaction to the sight of oneself on video is that you look professionally incompetent and personally unattractive – dont worry about this.

5. Sources of Information in the Consultation What the patient says (verbal cues) What the patient does (non-verbal cues) What the doctor perceives How the doctor feels Other parties (eg in 3 way consultations) What the patient says (verbal cues) What the patient does (non-verbal cues) What the doctor perceives How the doctor feels Other parties (eg in 3 way consultations)

6. The Video Tape PLEASE REMEMBER: The doctor on the tape is offering his/her tape as a gift for the group Respect that! Think of yourself in that situation before being critical PLEASE REMEMBER: The doctor on the tape is offering his/her tape as a gift for the group Respect that! Think of yourself in that situation before being critical

7. Giving Feedback Your aim is not to destroy the other person A Balancing Act between Being Too Critical Cosiness Zone The Most Important Part of Feedback is Offering an Alternative to the Skill or Task Being Analysed Your aim is not to destroy the other person A Balancing Act between Being Too Critical Cosiness Zone The Most Important Part of Feedback is Offering an Alternative to the Skill or Task Being Analysed

8. Giving Feedback So, feedback requires: Courage Skill Understanding Self Respect RESPECT FOR OTHERS So, feedback requires: Courage Skill Understanding Self Respect RESPECT FOR OTHERS

9. Feedback – general principles revisited Focus on Behaviour which can be changed Being accurate and clear The behaviour, not the person Observation, not inference Description, not judgement sharing ideas, not giving advice Exploring alternatives, not providing answers Focus on Behaviour which can be changed Being accurate and clear The behaviour, not the person Observation, not inference Description, not judgement sharing ideas, not giving advice Exploring alternatives, not providing answers

10. Feedback – general principles Also think about: How much to give When to give it Also think about: How much to give When to give it

11. Feedback – Pendletons Rules Clarify matters of fact Thing that went well How they went well Things that could have been done differently How they could have been done differently The pair or group agree areas for development Clarify matters of fact Thing that went well How they went well Things that could have been done differently How they could have been done differently The pair or group agree areas for development Doctor first, then the group

12. What to look for in the Video Look at (behaviour/skills) Performance Effects on Others Be Aware of (tasks) What (s)he does How (s)he does it Look at (behaviour/skills) Performance Effects on Others Be Aware of (tasks) What (s)he does How (s)he does it

13. The MRCGP Method

14. What are the Royal College Trying to Test? To test ability to consult effectively NOT a test of: medical knowledge clinical examination skills It is a criterion-referenced competency test To test ability to consult effectively NOT a test of: medical knowledge clinical examination skills It is a criterion-referenced competency test

15. The Five Units 1.Discover the reasons for a patients attendance 2.Define the clinical problem(s) 3.Explain the problem(s) to the patient 4.Address the patients problem(s) 5.Make effective use of the consultation 1.Discover the reasons for a patients attendance 2.Define the clinical problem(s) 3.Explain the problem(s) to the patient 4.Address the patients problem(s) 5.Make effective use of the consultation

16. How Its all Organised The five units Element AElement BElement C PC1 PC2 PC1 PC2 PC3 PC1 BEHAVIOUR OUTCOMES DOMAINS

17. Performance Criteria Refer to handout

18. Summary of Key Points 1.Dont worry about how you look (professionally or aesthetically) 2.Submit challenging consultations 3.Use the performance criteria to your advantage – use the ones with the most 4.Get someone to review your tapes 1.Dont worry about how you look (professionally or aesthetically) 2.Submit challenging consultations 3.Use the performance criteria to your advantage – use the ones with the most 4.Get someone to review your tapes

19. FACILITATOR NOTES

20. Facilitator Notes - MRCGP Ensure you have read the detailed explanations of what each performance criteria means Watch the whole tape Both registrars and trainers tick off the appropriate boxes (separately) on the marking grid At the end of the consultation, go through each box and ask if the group (a) what does that performance criterion mean (b) was it displayed or not :- i.If it was….in what way(s) – may be more than one example ii.If it wasnt ….was there an opportunity for it to have been shown (a missed opportunity?)….specify Ensure you have read the detailed explanations of what each performance criteria means Watch the whole tape Both registrars and trainers tick off the appropriate boxes (separately) on the marking grid At the end of the consultation, go through each box and ask if the group (a) what does that performance criterion mean (b) was it displayed or not :- i.If it was….in what way(s) – may be more than one example ii.If it wasnt ….was there an opportunity for it to have been shown (a missed opportunity?)….specify