The CSA is a high-fidelity skills assessment based largely on the familiar and well-proven OSCE format providing an external, objective assessment of clinical skills at a standardised, pre-determined level of challenge. The validity of the CSA resides in its realistic simulation of real-life consultations. Patients are played by trained and calibrated role-players, and cases that are written and assessed by working GPs. The format of the assessment also allows for systematic sampling from the curriculum, using a selection blueprint.
Each candidate is allocated a consulting room and has 13 ten minute consultations.
The CSA focuses on testing the following areas of the GP curriculum:
- primary care management: recognition and management of common medical conditions in primary care
- problem solving skills: gathering and using data for clinical judgement, choice of examination, investigations and their interpretation and demonstration of a structured and flexible approach to decision making
- comprehensive approach: demonstration of proficiency in the management of co-morbidity and risk
- person-centred care: communication with patients and the use of recognised consultation techniques to promote a shared approach to managing problems
- attitudinal aspects: practising ethically with respect for equality and diversity, with accepted professional codes of conduct
- clinical practical skills: demonstrating proficiency in performing physical examinations and using diagnostic and therapeutic instruments
Use of children in the CSA:
A paediatric case has routinely been included in the daily case mix (palette) of the CSA since its inception. This has hitherto only been achieved through a third party, usually a parent presenting with concerns about their child.
Cases involving child role players, accompanied by their parents, have recently been piloted and these can now be included in the palette selection process with effect examinations in November 2013. Although there will be a paediatric case each day, this will not necessarily involve the use of a child role-player on every occasion.
Some new cases will test paediatric examination. There will be no need for candidates to prepare in a different way as the learning outcomes are unchanged.
Additionally, please note that the British National Formulary (BNF) for Children has now been added to the list of equipment that candidates are required to bring into the CSA examination.