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Introducing the SCA

The Simulated Consultation Assessment (SCA) is a permanent replacement for the Remote Consultation Assessment (RCA). The RCA was a temporary examination brought in during to the COVID-19 pandemic to replace the Clinical Skills Assessment (CSA). The SCA needed to be fit for purpose, reflective of real-life general practice, and be able to objectively measure the skills required for competent consulting. Part of the development process included reviewing the different types of consultations that now take place in primary care, understanding the prevalence of conditions we now see and representing the populations we now serve. Stakeholders were asked to provide feedback that would inform the development process. The following key drivers for change have subsequently been implemented into the SCA.

Drivers for change

The purpose of the SCA is to assess a GP trainee’s ability to integrate and apply skills appropriate for general practice. These skills include clinical, professional and communication. They must also demonstrate and achieve the underlying principles of good medical practice, in that:

  • Patients are kept safe
  • GPs can be adaptable in treating different types of patients and illnesses
  • GPs can manage risk, complexity and uncertainty
  • GPs exhibit appropriate behaviours, attitudes and concerns for their patients

Key drivers:

  • To provide a standardised examination which didn't require trainees to collect cases from within your surgeries. 
  • To reduce the time taken in preparing for your examinations.  
  • To have cases which reflected the prevalence of conditions seen in the UK. 
  • To have cases which reflected the type of work done in UK general practice. 
  • To champion accessibility, convenience, time saving, cost saving, and sustainability.  
  • To have more opportunities to sit within the year. 

Format of the SCA

There will be twelve consultations with simulated patients, each lasting twelve minutes.

The cases are performed by professional role-players who are trained, calibrated and standardised so that although the case appears the same for every trainee, it responds to the approach of each individual doctor, as in real life. The case material has been reviewed by linguist and ED&I experts to identify and remove potential bias for those candidates who do not have English as their first language. 

The cases may be patients (most commonly), or their carer/parent or other health or social care workers. In the majority of these you will be able to see the simulated patient. Others will be audio only. There will be a 3-minute gap in between cases.

It is recognised that GP consultations in the UK do not follow a single model: they are complex, with many factors interacting in unpredictable ways. The new examination recognises this variability. There is not a preferred model, nor a script to follow. 

The cases are testing the transferable capabilities from your workplace consulting which can be assessed objectively in a simulated environmentTo ensure the assessment criteria are transparent, the capabilitiesmarking domains and feedback statements can all be found in the marking and results section. 

Physical examinations will not be assessed within the SCA, and instead will be covered within WPBA.

Location and IT

Trainees will sit the SCA in a local GP surgery via an online IT platform. In most cases this will be your own surgery, and we are working with deaneries and practices to ensure as many accredited training practices can meet the necessary IT requirements.

The entire examination will be recorded remotely and will be viewed and marked at a later date by examiners. Each of the twelve cases will be independently marked by a different examiner.

The Trainee Surgery Guide explains how to set up your surgery for the SCA.