RCGP Insider's Guide to the CSA for MRCGP

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Author: Alexandra Rolfe, Sarah Atkins, Kamila Hawthorne and Celia Roberts
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This book gives a true ‘insider’s’ guide on the CSA from a number of useful perspectives. The authors range from a GP who sat the CSA herself, a CSA examiner and case writer and researchers who have looked closely at the exam, to provide a uniquely important guide to the CSA. It gives practical tips on what your CSA day will be like, how you can prepare and unpacks some of the myths and truths of the exam.

Practical guidance

Practical guidance is given on conducting the CSA cases. You’ll be taken through how the 10-minute consultations are typically structured by candidates, as well as the occasions that you’ll need to show a little flexibility.

Evidence-based communication guidance

Communication skills are a central component of your assessment and, for the first time, this book presents guidance and ideas on communication based on evidence from the exam itself, rather than an idealised view of what we think should happen.

Researchers from the University of Nottingham, King's College London and Cardiff University have looked at many hours of video from the CSA to conduct a study of linguistic patterns. This makes it the first CSA book where recommendations are based directly on findings about real candidates’ performances, particularly the skills and strategies successful GPs make use of in their own exams. Transcripts of real candidates talk are given to help you look closely at what they do and give a feel for what the exam cases sound like.

Practice circuits, case notes and marking criteria

Two entire practice circuits have been written for you to try out some of these ideas. The cases have been carefully selected to represent a typical CSA exam and have been checked by the CSA case-writing group, to ensure they provide you with an accurate feel for the exam. The paperwork provided for these not only demonstrates the type of case notes you will receive as a candidate in the exam, but also details the marking criteria an examiner will assess you against and the kinds of directions role-players receive before performing as patients. This means you can also try on the role of a CSA examiner – a real insider’s perspective of what your examiners will be looking for!

Unique features include:

  • Evidence-based communication skills - the first CSA book where recommendations are based directly on findings about real candidates’ performances.
  • Transcripts of candidates’ talk and their communication skills and strategies are carefully explored using linguistic analysis – the only text on the market that does this.
  • The heart of the exam – the consultation – is looked at in-depth with a focus on communication techniques employed by successful candidates.
  • Shows how entire cases are structured into a series of tasks by candidates to best effect.
  • Provides context for the CSA, both in its format and how it fits in with the other assessments.
  • Dispels unhelpful ‘popular myths’ about the CSA and examines some of its ‘truths’.
  • Examines the CSA structure and advises on best preparation.
  • Features practical tips, key concepts and short exercises throughout.
  • Provides two entire practice circuits as well as 100 short ideas for additional cases, with case notes and marking criteria so you can even try the role of examiner!

"The authors provide insight into the development and structure of the CSA…their aim is to build confidence with practical preparation exercises and tips so that candidates approach the exam with the right mindset and succeed. I recommend this book to all GP trainees and trainers." From Dr Pauline Foreman’s Foreword, Chief Examiner, MRCGP
Read the full foreword here


ISBN Number: 9780850843897

Number of pages: 224

Publisher: RCGP

Published: July 2015

View table of contents

  • Rationale for and principles of the CSA.
  • Recent changes to the regulation of postgraduate exams.
  • The structure of the exam.
  • Tips on preparation.
  • Practice consultations.
  • Getting to the exam and what to do on the day.
  • Myths and truths about the CSA.
  • Linguistic information on transcripts from CSA exams.
  • A discussion of the key concepts of alignment, signposting and metacommunication.
  • Analysing the stages of a consultation.
  • How to give an explanation of a particular medical condition, concept or treatment option.
  • How to relate information back to the patient.
  • Two practice circuits, to be used individually or to practise the entire exam.
  • One hundred brief suggestions for cases.

Author Bio

Alexandra Rolfe is a GP and a clinical education fellow at the University of Edinburgh. Her work includes medical education assessments and inter-professional education. She is deputy editor of InnovAiT.

Sarah Atkins is a post-doctoral research fellow at the University of Nottingham, within the Centre for Research in Applied Linguistics. Her research investigates language and professional communication in healthcare settings.

Kamila Hawthorne is Associate Dean and Director for Community Learning at the School of Medicine, Cardiff University. Her research interests are in diabetes, health inequalities and medical education assessments. She has been an MRCGP examiner since 1997, and was involved in the design and delivery of the CSA from its inception in 2007. She is Chair of the Curriculum and Assessment Development Committee of the RCGP.

Celia Roberts is Professor Emerita in Sociolinguistics at King’s College London. Her research is in the areas of language and communication in institutions. She was the Principal Investigator on the research project ‘Performance features in clinical skills assessment’ on which Chapters 4 and 5 are based.

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