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  • Dr T. Sami

Real-Life VS RCA VS CSA (From Chapter 2 Of How To Pass the RCA)

Updated: Feb 2

(The next set of articles are short excerpts from How To Pass The RCA. Buy the complete pair of the FIRST & ONLY RCA SPECIFIC texts here)


This is the introductory section on the RCA tutorial. I have spent a significant amount of time comparing the RCA, real life consultations and the CSA. This in itself could be a study or paper quite frankly. I address the fundamental differences in this assessment processes and the practical impact it has upon the one being tested. It is specifically relevant to passing in the RCA.

In order to illustrate the point see Q43 from the RCGP FAQs on RCA[1]:

.If I have always received competent or excellent gradings on my COTs from my Educational Supervisor. Does this mean that I'm going to pass the RCA?

Evidence from your WPBA is helpful in establishing your readiness for sitting an assessment but it is measuring different criteria from the RCA/CSA, so it is not a guarantee of performance nor an assessment within your submission for RCA.

1. Rabbit Holes (& Lots Of Them)

In real life when a patient is asked about sleep or mood there is a possibility they may focus on the negatives. This is to be expected within the current working environment particularly with the pandemic. Realistically we do not have time to always focus upon these secondary issues as much as we would like.

In the CSA the actor will shut these avenues down if they are not relevant. This makes for an efficient consultation.

In the RCA it must be seen that we act upon such cues and attempt to address them. This may lead to valuable time being lost when consulting about something else.

Another example may be if a patient comments that they have chest pain our minds will automatically jump to wanting to exclude acute coronary syndrome. After all this is only good clinical practice. However this involves a set of questions and a possible examination that may not be relevant to the main presentation.

[1] (Royal College Of General Practitioners, 2020)


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