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Consulting in the Clinical Skills Assessment

The aim of the Clinical Skills Assessment (CSA) is to test a doctor’s ability to gather information, apply learned understanding of disease processes, and offer appropriate person-centred care. Effective integration of these skills is a key element in the exam, and not commonly tested in other disciplines. The CSA is a type of Objective Structured Clinical Examination (OSCE). Most medical OSCEs have stations each relating to one skill set, such as ‘communication’ or ‘physical examination’. Although that may be more relevant in secondary care, where patients arrive already partly sifted, the primary care doctor is faced daily with undifferentiated, often multiple, problems experienced by patients who vary as much as their symptoms. The GP’s task is complex, and best considered as an integration of skill sets. The CSA is an exit exam, testing for evidence of competence of independent practice as a family doctor; hence, we use the entire consultation as our unit of testing. In this article I set out to demystify consulting in the CSA. Throughout, I offer practical tips; these are marked *. I end with a list of suggestions to better prepare candidates for what we all hope will be a good experience.