How is the RCA graded?
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How is the RCA graded?
An important part of any exam is understanding how you will be marked and what to look out for in the exam. That's why I want to help the doctors taking the Recorded Consultation Assessment (RCA) by providing a breakdown of the RCA mark scheme and what each grade means.
In the RCA exam there are 4 grades you can achieve, which are clear pass, pass, fail and clear fail.
Clear Pass
The candidate demonstrates a high level of competence, with a justifiable clinical approach that is fluent, appropriately focused and technically proficient.
There is sufficient evidence provided to demonstrate capability in this domain.
The candidate shows sensitivity, actively shares ideas and may empower the patient.
Pass
The candidate demonstrates an adequate level of competence, with a clinical approach that may not be fluent, but is justifiable and technically proficient.
The lack of complexity in the case presented restricts the achievement of a Clear Pass grade.
The candidate shows sensitivity and tries to involve the patient.
Fail
The candidate fails to demonstrate adequate competence, with a clinical approach that is at times unsystematic or inconsistent with accepted practice. Technical proficiency may be of concern.
There is limited (new) evidence provided to demonstrate the capability of the doctor that is sufficient for safe independent UK General Practice.
The patient is treated with sensitivity and respect, but the doctor does not sufficiently facilitate or respond to the patient’s contribution.
Clear Fail
The candidate clearly fails to demonstrate adequate competence, with a clinical approach that is incompatible with accepted practice, arbitrary or technically incompetent.
There is no evidence or very limited evidence provided to demonstrate the capability of the doctor that is sufficient for safe independent UK General Practice in this domain.
The patient is not treated with adequate attention, sensitivity or respect for their contribution.
Mark scheme
The mark scheme is important, as this will tell you how you will gain marks and what to look out for in this exam. There are 3 main areas that you get marked on are Data Gathering, Technical and Assessment Skills, Decision Making and Clinical Management Skills and Interpersonal Skills.
Data Gathering, Technical and Assessment Skills
- Takes a focused history to allow for a safe assessment to take place
- Elicits and develops relevant new information
- Rules in or out serious or significant disease
- Considers and/or generates any appropriate diagnostic hypotheses
- Explores where appropriate the impact and psychosocial context of the presenting problem
- Plans, explains and where possible, performs appropriate physical/mental examinations and tests
- Appears to recognise the issues or priorities in the consultation
Decision Making and Clinical Management Skills
- Appears to make a safe and appropriate working diagnosis/es
- Offers appropriate and safe management options for the presenting problem
- Where possible, makes evidence-based decisions re: prescribing, referral and coordinating care with other health care professionals
- Makes appropriate use of time and resources whilst attending to risks
- Provides safety netting and follow up instructions appropriate to the nature of the consultation
Interpersonal Skills
- Encourages the patient's contribution, identifying and responding to cues appropriate to the consultation
- Explores where appropriate, patient’s agenda, health beliefs & preferences
- Offers the opportunity to be involved in significant management decisions reaching a shared understanding
- When undertaken, explains and conducts examinations with sensitivity and obtains valid consent
- Provides explanations that are relevant, necessary and understandable to the patient
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