Norfolk GP Speciality Training Programme: 2024

Week One

Find a venue

The ideal venue mimics the RCGP CSA examinaton floors. Your PGME (unless you are very lucky) isn't likely to have enough suitable rooms. Large (training) practices usually have enough consulting rooms and are often willing to host an event during an evening or weekend. An ideal venue will be centrally located, accessible, have sufficient consulting rooms, have a large enough reception or training room for briefings/feedback, and have tea and coffee making facilities.

Decide on Numbers

We run our events with 10 trainee candidates at a time, and you can scale things either way. For a first event, you are better to start with small numbers.

Find your Role–Players, Assessors and Helpers

If you're going to run an event for 10 trainees, you'll need about 10 assessor and role–player pairs (i.e. 20 people), plus one co–ordinator and a couple of ushers/ helpers. The ushers/ helpers are useful buffers in case you need stand–ins for the role–players/ assessors.

For role–players it is best if you can avoid using trainee peers, as this gives the event more realism. We have had trainers, GPST 1 and 2, sixth–formers, medical–students, nurses, paramedics, pharmacists, friends and relatives, STs from another training scheme, practice staff and more volunteer to give up their time. For assessors we have had Programme Directors, Trainers, ST3s who have passed CSA, Nurse Educators and GPs.

If you are planning a commercial course, or have access to funds, there are many established medical role play agencies that will supply actors for you. Helpers and ushers can be sourced from your pool of ST1 and ST2 trainees, practice F2, or, if your event is oversubscribed, from your candidate waiting list, on the understanding that they can stand–in for any candidate that doesn't show up.

Candidates

It's not usually a problem to find trainees wanting to take part as a candidate. We advertise the event years in advance, in our ST1 induction, at the start of ST3. We send out emails to potential candidates when we are sure we have enough Actors and Assessors to make it work on the day. It is essential that your the candidates commit to attending, especially if people are giving up their free time.

Week 2

Personnel

In week 2 you need to collate the responses and start establishing a list of role–player–assessor pairs and candidates and send out further emails to make up numbers as required. Once you have the pairings you can start allocating scenarios to the pairs.

Once we have the role–players, assessors, helpers & candidates all booked up, if you are a big scheme, it is helpful, if you have photos, to make up some picture boards for the event reception. We also use photos of the candidates on the mark sheets, which is a big help to our assessors.

Venue

Now is the time to send a friendly email to the venue confirming the basic details of the evening. If you are being hosted by a practice, it is good to send an outline of the event to the practice manager, as they may need to make arrangements with cleaners, reception etc so that you have access to the venue and ensure that your timings won't clash with evening surgery etc.

CSA Cases

You basically need a different case for each assessor pair. Each scenario needs some candidate notes, a role–player briefing and an assessor marksheet to help them in grading performance. It is perfectly possible to spend a whole day producing 10 cases from scratch but you may not have the time. It's a rule of thumb that x minutes of educational activity requires 4x of preparation the first time you do it, so you will need to think where that 10 x 4 x 10 minutes (about 8 hours) is going to come from.

Existing Sources for Cases

• CSA Books
• CSA Cases Workbook for the MRCGP– ISBN–10: 1907904123
• CSA Cases Workbook Mock Exam– ISBN–10: 1907904654
• MRCGP Clinical Skills Assessment: Practice Cases, Third Edition ISBN–10: 1905635893
• RCGP CSA Cases: Practice CSA Cases and Communication Skills for the MRCGP CSA Exam ISBN–10: 0992766109

• Internet Resources
• csaprep.co.uk
• bradfordvts.co.uk
• pennine–gp–training.weebly.com

Generating your own cases

• Keep a list of outlines of cases seen in a GP session and use this as the basis to generate material.
• Get the list of cases from a CSA exam feedback page in the ePortfolio, and use the headers to inspire you.
• Use a GPST sesssion to generate cases
• Devote a trainers' meetiing to producing cases for your event.

You'll need a spread of cases which will all need to be acheivable and reasonable for a ten minute consultation in a standard, average GP practice.

Home visit and/ or Telephone Consultation Cases

The CSA may contain stations which involve a home visit, or a telephone consultation. Before including/ writing such scenarios, you need some thought as to how you will arrange these at your even

For telephone consultation cases, each consulting room at the venue will have to have its own telephone extension and there will have to be a separate room with an extension with a speakerphone for the role–player and assessor. We have found that attempting to do this with mobile phones usually fails. You will need to have special instructions for each candidate and you will need an usher who travels around the circuit and announces the telphone scenario to the candidates. Without an usher or marker, there is a real risk that an assessor pair will become confused, skip a candidate and throw the circuit into chaos.

For home visit scenarios, you will need a dedicated home visit room, ideally centrally placed in the venue and with appropriate facilities (cough/ armchair, etc.) to mimic a home visit. You will need an usher who fetches candidates out of their room and shows them to the home visit room. You'll need to have special instructions in each candidate pack.

Week Three

Confirm & send out details to Candidates, Assessors, Role Players & Ushers

This is the time to confirm attendence, update the booking grid and send out information about the evening to those taking part.

The candidates need to be reminded of the date, time, and location of the venue, advised of the dress code, format of the event, and reminded to bring their doctors bag, BNF and cBNF. We advise candidates to bring video equipment, so that they may record their consultations, and use it for video review with their trainer. We give them an earlier start time so that they can get this set up on the evening. If your event venue is difficult to find you may need to provide a map.

Now is the time to send out to the Role–Players & Assessors a copy of the marksheet, case notes and actor brief for their station, so that they may familiarise themselves with it, add anything to the marksheet and discuss the case between them.

Organisation

You need to have a think about managing the flow of the event — in the exam, the trainees stay in the rooms and the actors and assessors move from room to room. In the practice event you will have to make sure that the role–player—assessor pairs go in the direction that you want them to, which can be a cat–herding type experience. It works best if you make the pairs start at the same candidate & room number as their assessor pair and then move along, e.g. Assessor pair 3 starts at room 3 and then moves to room 4, then, 5,6,7,8,9,10 and then round to 1.

What will your timings be? For an evening event, after a busy workday, most trainers and trainees will start to flag after about 90 minutes, which is about 7 cases, or roughly half the real CSA exam. We suggest that the event finishes with time for coffee and short global feedback from the assessors to candidates, which will take 3/4 of an hour.

If you are running a weekend event you could run 13 cases if you can find enough assessors and role–players. You will need to organise two rounds of coffee and split the event into 2 halves of 7 and 6 cases with an additional 15 minute break in the middle for refreshments.

How will you time the event– are you going to keep it simple and rely on a stopwatch and a handbell? So we can run the event with a single organiser, if needs be, we have quite a complex timing set up. We have a MacBook running an applescript timer that does all the counting, announcing and ringing the bell for us. In some of our bigger venues we use second and third sets of speakers driven wirelessly. If you're using a complex set up, it is wise to test it out first.

Sorting out the CSA paperwork

If you are doing this for the first time you will have quite a potential shopping list. You will have to decide what resources you think are essential, and which are optional, e.g. coloured paper is convenient, but not essential. Laminating is useful if you are going to run an event more than once, but optional. Setting up all the paperwork will take at least 3 or 4 hours for an event for 10 candidates

To help we have provided a Shopping List (link) for all the materials required if you are starting from scratch.

The Box

We suggest two large boxes (we use 35l Really Useful Boxes) and 5 foolscap box files

Candidate Paperwork Packs

In each candidate pack you will need a front–sheet, the candidate instructions, the candidates scenario sheets, a feedback sheet etc. To get the cases in the right order you need to start with the candidate number and then go backwards in order. e.g. if you are doing candidate pack 3, start with scenario 3, then scenario 2, then scenario 1, then 10, 9, 8, 7 etc. Tie them together in order with a treasury tag. Each candidate gets an A4 whiteboard, marker and eraser. Due to the cost of A4 whiteboards, we have made up laminated whiteboard sheets which are clipped on a clipboard for each candidate.

• Linked with a treasury tag
  • Candidate Pack Front Sheet x10
  • Candidate Instructions x10
  • Scenario Sheets (10 cases) x10
  • Candidate Feedback Sheet
  • Pathology Request Form x30
• Clipboard x10
• Wipeboard sheet x10
• Whiteboard Eraser x10
• Whiteboard Marker Black x10
• Whiteboard Eraser Spray x1

Candidate Pack Front Sheets: Pages | Word [White]

Candidate Instructions: Pages | Word [Pink]

scenario sheets as above

Candidate Feedback Form: Pages | Word [blue]

Candidate Case Paperwork Pack

Each candidate in the CSA gets an A5 case paperwork pack containing forms including MED3, FP10 etc. You will need to make up a pack per candidate.

• A5 clear plastic folder x10
  • Plastic Folder Frontsheet x10
  • FP10 x30
  • MED3 x30
  • Pathology Request Form x30

Assessor Packs

In each assessor pack you will need; a front sheet, the assessor instructions, an assessor marking guide, the role–players information, the candidate information, the candidate marking sheets and assessor and role–player feedback sheets. To get the candidates in the right order you need to start with the candidate mark sheet number that is the same as the assessor pain, and ten go upwards in order. e.g. if you are doing assessor pack 3, start with candidate marking sheet 3, then the marksheet for candidate 4, then 5,6,7,8,9,10,1,2.

• Linked with a treasury tag
  • Assessor Pack Front Sheet x10
  • Assessor Instructions x10
  • Case sheets Sheets (2 per pack x 10 cases)
  • Candidate Marksheets (10 per pack) x 10
  • Assessor Feedback Sheet
  • Role–Player Feedback Form x30
  • Case Examination Findings Sheet (as required)
• (all clipped to) assessor clipboard x10

Assessor Team Pack Front Sheets: Pages | Word [White Paper]

Assessor Instructions: Pages | Word [Lilac Paper]

Assessor Scenario Information: as above

Role–Player Scenario Information: as above

Candidate Scenario Information (copy): as above

Any required examination findings (as above)

Candidate Marksheets: Pages | Word [White Paper]

Assessor Feedback Form: Pages | Word [Pink Paper]

Role Player Feedback Form: Pages | Word [Green Paper]

We have a big box of biros, and enough clipboards for each assessor pair.

Signage

To help everyone arrive in the right place, and follow round the circuit, I suggest copious signage, to get people in through the right entrance, make their way to reception, identify the candidate rooms, and follow their way around the circuit. Because we run this event in different venues, we have various packs of laminated signs.

Rest Station/ Tea and Coffee Station signs: Pages | Word [White Paper]

Circuit direction signs: Pages | Word [White Paper]

Candidate Room signs: Pages | Word [White Paper]

Candidate Room signs: Pages | Word [White Paper]

External, Entrance & Reception Direction signs: Pages | Word [White Paper]

Organisers Box

The organisers box will need; sign–in register sheets, your numbered list of candidates, your list of assessor pairs. As we are a big scheme, we have a photoboard for the programme directors and the candidates

Please Register signs: Pages | Word [Blue Paper]

Register sheet: Pages | Word [Blue Paper]