Structure powers marks 🧱

A fluent consultation is usually a structured consultation.
Examiner feedback repeatedly highlights systematic and structured data gathering as a major pass theme, appearing in around 70% of successful feedback. By contrast, poor structure / disorganised consultation is a major fail pattern, showing up in around 60% of weaker consultatio‌n‌s ‌

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Clinitalk’s simple structure is a very practical one:
Patient story → Targeted questions → Shared management ‌ ‌

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1. Patient’s story 📖
- Let the patient tell the story first.
- In the SCA you will probably have to ask several focused open questions to get the full story – don’t give up and slip into closed questions.
- Keep with  open questions until you have a clear story.
- Pick up on any cues.
Examples of focused open questions
• “Tell me what’s been happening from when it first started till now.”
• “How has this been affecting you?”

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2. Targeted questions 🎯
Now clarify the key missing pieces.
What questions will help confirm or refute the diagnosis?
⚠️Don’t ask questions about topics the patient has already answered

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This is where you cover any missing:
• red flags
• focused symptom questions
• ICE
• psychosocial context

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⚠️*ICE and social context are not optional extras* — they are recurrent themes in examiner feedback, with ICE appearing in about 50% of pass feedback and ICE/psychosocial/context issues showing up frequently in failed consultations t‌o‌o
Examples
• “I have some ideas about what might be going on, but what were you worried this might be?”
• “There are various treatment options, was there one you were to try?”

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3. Shared management 🤝
Now discuss options together. You normally need at least 5 minutes to do this so build the time you need into your structure!
Examples
• “I’d like to go through the options together to see which ones you are interested in?”

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🚨 Common mistake:
'Jumping back and forth between history, diagnosis, and management.'
This feels disorganised and increases the risk of missing red flags or running out of ti m e

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This week’s challenge:🤔
Look at one of your consultation traces.
1. Can you clearly see: Patient’s story → Targeted questions → Shared management?
2. Do you spend at least 5 minutes on management?

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