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Strong candidates don't just hear words... they notice:
πŸ’­ Hesitation
😟 Worry
πŸ™ˆ Avoidance
🀏 Minimising
❀️ Emotion

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✨ Examiner feedback repeatedly praises:
βœ… Empathy
βœ… Rapport
βœ… Warmth
βœ… Emotional engagement
βœ… Active listening & responding to cues

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🚩 Missing cues is a common reason candidates lose marks.

Using silence 🀫 and summaries πŸ“ helps build rapport and keeps your consultation structured.

πŸ‘€ Common cues:
* "It's probably nothing..."
* "I've just been a bit off..."
* 😒 Sudden tears
* 🎭 A change in tone
* πŸ‘€ Avoiding eye contact
* πŸ”„ Changing the subject when something sensitive comes up

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πŸ’¬ Better responses:
πŸ—£οΈ "You say it's probably nothing, but it sounds like it's been playing on your mind."

πŸ—£οΈ "I noticed you hesitated thereβ€”tell me a bit more about that."

πŸ—£οΈ "The ... Β you mention sounds really difficult."

πŸ—£οΈ "I can hear that ... has been a lot to deal with."

🎯 Why this matters in the SCA

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A missed cue often means you've missed:
❌ ICE
❌ Risk
❌ Psychosocial context
❌ Empathy marks

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🚫 Don't rush to the next checklist question.

πŸ’‘ Sometimes the highest-yield move isn't another question...

It's a short reflective statement... 🀝

...and a pause. 🀫

Examiner feedback specifically highlights that silence often leads to deeper disclosure and more sensitive discussions.

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πŸ’ͺ This week's challenge

In your next consultation, deliberately respond to at least one emotional cue before moving on.

πŸŽ“ The consultation usually gets better when the patient feels heardβ€”not just questioned.

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Author

N. Boeckx

16 years teaching experience for the RCGP consulting exams

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