practice based assessment · j. checklist for pba candidates . k. guidelines for recording...

PRACTICE BASED ASSESSMENT

APPENDICES A. Candidate list of Peers

B. Practice profile

C. Recorded Consultations - Logbook for consultations on portable hard

drives

D. Recorded Consultations - Example of completed Logbook

E. Recorded Consultations - Patient consent form

F. Viva - Candidate consent form

G. Examiner Clinical Visit - Patient consent form

H. Viva - Sample questions and answers

I. Recorded Consultations and Examiner Clinical Visit rating form

J. Checklist for PBA Candidates

K. Guidelines for recording consultations

L. Viva and Examiner Clinical Visit schedule form

M. Assessment matrix

Appendix A - PEER RATING FORM – Candidate’s list of peers (25 required)

Please return to: Private and Confidential Fellowship Services Administrator – Practice Based Assessment The Royal Australian College of General Practitioners 100 Wellington Parade, EAST MELBOURNE VIC 3002

Candidate Name: ___________________________Candidate RACGP No. ________ No Name Qualifications Address Tel

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

RACGP PRACTICE BASED ASSESSMENT APPENDIX A

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Appendix A - PEER RATING FORM – Candidate’s list of peers (25 required)

No. Name Qualifications Address Tel

14.

15.

16.

17.

18.

19.

20.

21.

22.

23.

24.

25.

RACGP PRACTICE BASED ASSESSMENT APPENDIX A

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APPENDIX B – PRACTICE PROFILE

Candidate Name: __________________________________________________________ Candidate RACGP No.: __________ Practice address: __________________________________________________________ ________________________________________________________________________ State: _____Postcode:______ Telephone No: ________________

IMPORTANT NOTE: COMPLETED PROFILES MUST BE RECEIVED WITH THE ENROLMENT FORM AT TIME OF ENROLMENT APPLICATION. The Practice Profile will provide the Examiners with some understanding of the Candidate’s practice/organisation which will enable them to ask relevant questions of the Candidate during the Viva Examination. 1. Your position in the practice: (please tick)

Principal Assistant Locum Other

2. Length of experience in general practice

_________________________

3. Practice workload (average number of patients seen weekly): 4. Location of practice:

Capital City Regional City Country Town Remote/isolated - Please indicate the distance to your nearest colleague ____ kms.

5. Type of premises:

Hospital Health Centre Private Premises Other 6. Doctors in the practice:

Solo

Group/Partnership Please indicate the number of doctors in the Group

Other

RACGP PRACTICE BASED ASSESSMENT APPENDIX B

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7. Your obstetric commitment: Do you undertake confinements? Yes No

Do you perform antenatal and/or post-natal

care?

Yes No

8. Please list any special sessions:

9. Please list any areas of special interest or expertise:

10. Please provide a list of practice equipment that you utilise:

11. Please list the Clinical facilities to which, open or direct, access is not available:


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12. Please list any positions you hold outside the practice:

13. Patient profile: Out of 100 patients, how many would you see in an average week? ___ in the practice ___ at their home ___ in a nursing home ___ in hospital ___ at another location (please specify)

Out of 100 patients, how many would you see in an average week who are:

___ Caucasian ___ Aboriginal ___ Torres Strait Islander ___ Other ethnicity (please specify) __________________________________

Out of 100 patients how many would you see in an average week who are:

___ Female ___ Male ___ aged 0-4 years ___ aged 5-14 years ___ aged 15-24 years ___ aged 25-44 years ___ aged 45-64 years ___ aged 65-74 years ___ aged >75 years

Out of 100 patients, how many would you see in an average week who are:

___ itinerant ___ infrequent attenders ___ regular patients

List the five most common presentations you see in an average week:

1.

2.

3.

4.

5.


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List the five most common medical specialists that you refer to:

1.

2.

3.

4.

5.

Referral profile

Do you refer to any of the following community health services?

Community Service Yes No Not available

Aboriginal & Torres Strait Islander Health

Aged Care & Disability Services

Aged Care Assessment Team

Breast Screening Services

Child Health Services

Community/Family Health

Dental Clinics – School & Community

Environmental Health

Family Planning

Health Promotion

Home & Community Care

Interpreter/Translator

Mental Health Services

Public Health Unit

Sexual Health Unit

Welfare Services

Women’s Health


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Do you refer patients to any of the following Allied Health Services?

Please indicate for what primary conditions or treatment.

Service Yes No Not Avail Primary condition

Aboriginal Health Worker

Audiologist

Chiropractor

Counselling Services

Dental Therapist/Dentist

Dietician/Nutritionist

Domiciliary Nursing

Occupational Therapist

Optometrist

Orthoptist

Orthotist/Prosthetist

Physiotherapist

Podiatrist

Psychologist

Rehabilitation Services

Social Worker

Speech Pathologist


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15. In no more than 250 words describe your practice and your role in the local

community as a health provider.

Signed: ___________________________

Date: _______________


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Appendix D - Sample of Logbook for Recorded Consultations

1 55 MHypertension check

upHyperlipidaemia Cardiovascular -

Current patient / new problem

- Chapter 1 13:03

2 40 F Tirednessneeds repeat

scriptBlood


Chapter 2 15.05

3 65 M Diarrhoea None Digestive New patient Chapter 3 11.15

4 17 M Right ear ache None Ear -Current patient / new

problem- Chapter 4 15:35

5 32 FReview of blood test

resultsReferral to specialist

Endocrine Current patient /

Follow up problemChapter 5 !3.08

6 7 F Conjunctivitis None Eye New patient - Chapter 6 7:12

7 40 F Vaginal discharge Depression Female GenitalCurrent patient /

new problemChapter 7 28.02

8 2 F # forearm None General New patient - - Chapter 8 9:26

9 32 M Request for Viagra None Male Genital New patient Chapter 9 14.04

10 28 FPain and numbness

Right handDysuria Musculoskeletal -


- Chapter 10 8:53

11 76 F Review post strokeneeds Aged

Care Assessment

NeurologicalCurrent patient /


12 35 M Depressionneeds repeat

scriptPsychological

Current patient / Follow up problem

Chapter 12 14.55

13 21 FRequest oral contraceptive

None Reproductive New patient - Chapter 13 18:58

14 34 M Bronchitis Mole check RespiratoryCurrent patient /


15 4 M Rash None Skin New patient - - Chapter 15 8:32

16 32 M Alcohol/depressionNeeds form for

CentrelinkSocial - -


Chapter 16 0:28

17 78 F UTI BP check UrologicalCurrent patient /


18 26 F Pap smear Back pain Female Genital -Current patient /

new problem- Chapter 18 10:51

Candidate signature:

ICPCs (please use

dropdown options)Con # Age M/F Primary Complaint

Other Complaints

New patient to practice

Current patient / New problem


Location # on portable hard

drives

Duration of consult (mins)

I hereby verify that the quality of sound and picture on the above recordings meets the requirements as outlined in Appendix J:

19 35 MFor flupentixol

injectionNone Psychological


Chapter 19 7

20 55 MFor Taxi Licence

medicalNone General


Chapter 20 28.3

I hereby verify that the quality of sound and picture on the above recordings meets the requirements as outlined in Appendix J: Candidate signature:

APPENDIX E – Recorded Consultations - Patient Consent Form

I, __________________________________________ agree to have my consultation with

Dr ___________ video recorded.

It has been fully explained to me the purpose of the video recording is for the assessment of

my doctor in the Practice Based Assessment of The Royal Australian College of General

Practitioners (RACGP).

My doctor will be video recording throughout the length of my consultation and may also record

during my physical examination. If my physical examination is of a sensitive nature, the

recording device will be re-directed away from the view of the examination and returned to the

viewing position after the physical examination is complete.

I understand the video recording will be copied for review by qualified general practitioners and

examiners involved in the RACGP’s assessment of my Doctor and the RACGP PBA Administrator

(as necessary). Every person who views the video recording is bound by the ethics and laws of

patient confidentiality and privacy. The RACGP will use the video recordings only as part of my

doctor’s assessment, until such time as the Practice Based Assessment is complete. The video

recording will be returned to my doctor to be deleted or may be retained by the doctor and

used for the purposes of their learning and development.

I understand that at the end of my consultation, I have the right to view the recording of my

consultation before it is used and I reserve the right to withdraw consent and use of my

recording at that time.

Signed: _______________________________ Date: _________________________________ Witness Name: (please print): ______________ Witness Signature: ______________________ Date: _________________________________

Appendix F – Viva – Candidate consent form

I, Dr ________________________________________ (RACGP No. _________) do hereby give

my consent to be video recorded by Dr ___________ during my Viva Examination for my

assessment in the Practice Based Assessment (PBA) of The Royal Australian College of General


It has been fully explained to me that the purpose of the video recording of my Viva

Examination is to enable other RACGP Examiners to view the recording so they may assess my

performance in the Viva Examination as part of PBA and rate it accordingly.

I understand that the Education Department of the RACGP will retain the videorecorded Viva

Examination as part of their record of assessment, and will remain the property of the RACGP

until such time as my PBA is complete, after which time it will then be deleted.

The videorecorded Viva Examination will not be released to, or be obtained by, Candidates or

any other external parties.

Signature: _____________________________ Date: _________________________________ Examiner’s Name: _______________________ Examiner’s Signature: ____________________ Date: _________________________________

Appendix G - Examiner Clinical Visit (ECV) - Patient Consent Form

I, __________________________________________ agree to have my consultation with Dr

_____________observed by an Examiner of The Royal Australian College of General


It has been fully explained to me that the purpose of the observation is for the assessment of

my doctor in the Practice Based Assessment of the RACGP.

I understand that the observer will be a qualified general practitioner and Examiner for the

RACGP and is bound by the ethics and laws of privacy and patient confidentiality.

I understand that the Examiner will retain a record of the number of patients seen during their

visit, however, there will be no information recorded that would allow for my personal

identification. This information will be kept by the RACGP until the process of Practice Based

Assessment is complete and for future development of Practice Based Assessment.

Signed: _______________________________

Date: _________________________________

Witness Name: (please print): ______________ Witness Signature: ______________________ Date: _________________________________

Appendix H – Viva sample questions and answers

These sample questions are a guide to the type of questions the Candidate will be asked in their Viva Examination. The questions have a lead-in scenario with 2 questions following on from this scenario. The majority of the questions which a Candidate will be asked during this exam will contain a similar format. Provided with the sample questions below are the corresponding answers. It is not expected that these questions will be answered correctly, or even a minimum number, as these answers are a guide only. It is expected the answers the Candidate provides will meet a minimum standard to be considered competent in unsupervised general practice in Australia. Question 1 A 60 year old female patient collapsed in church yesterday. She comes to see you and describes feeling hot, dizzy and having blurred vision, before “blacking out”. Her daughter says she was stiff and unresponsive, but recovered spontaneously in about a minute.

a. What differential diagnoses might you think of in a patient such as this?

b. What is your patient management strategy? Question 2 Despite being told by the receptionist that you have no free appointments, a mother insisted that her baby be seen. You find the problem appears to be only a nappy rash.

a. What possible explanations are there for this mother’s behaviour?

b. What are the principles of management of simple nappy rash? Question 3 You will receive from the examiner an abnormal urine result, such as the one below, for an unwell child. MSU: Heavy growth E. coli, RBC nil, WBC nil, sensitive to all Here is an MSU result from a three-year-old boy who was seen two days ago with a febrile illness. He was given no medication and his mother phones today for the result. She says he is now better with no fever.

a. What further action, if any, would you take and why?

b. If the result had shown microscopic haematuria and pyuria how would your management differ?

RACGP PRACTICE BASED ASSESSMENT APPENDIX H

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VIVA - sample answers Question 1 a. Postural hypotension secondary to medication

Vertebro-basilar insufficiency TIA/RIND (reversible ischaemic neurological disease) Drop attack Carotid stenosis Cervical spondylosis Electrolyte imbalance / dehydration Syncope / vasovagal episode Sick sinus syndrome / heart block/ arrhythmia

b. Take a full history

General health Previous or similar events Medication history Other history that is relevant

Examination Check blood pressure supine and standing Full cardiovascular examination including listening to carotids etc.

Investigations Electrolytes, urea, creatinine FBE/ESR ECG Holter ambulatory monitor Doppler scan carotids 24-hr BP monitor

Question 2 a. Maternal anxiety

Depression unrealistic expectations Need for support Other life crises Only child Other

b. Wetness is the main case

Some babies are predisposed to this condition because of underlying skin conditions such as eczema Infection is established quickly in a moist, warm skin by bacteria and or yeasts Soaps remove natural oils and sometimes sensitise the skin Advise mother to change the nappy and avoid plastic pants where possible Wash nappies thoroughly to remove irritating chemicals Use nappy liners to absorb moisture Watch for secondary infection, Monilia is the commonest one. Use protective creams e.g. Zinc or Lanoline Mild steroid creams are very effective, but need to be used cautiously


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Question 3 a. No treatment required at this stage as the child is well and the result is suggestive of

contamination rather than infection.

It would be reasonable to repeat the MSU with precautions to ensure a clean catch and prompt delivery to the laboratory to exclude missed UTI or chronic bacteruria.

Inform the mother of the result and its significance, advising her to have the child reviewed if he becomes ill again or develops any new symptoms.

b. Prescribe appropriate antibiotic (first line).

Inform the mother of the result and its significance, advising her to have the child reviewed if he becomes ill again or develops any new symptoms.

Repeat MSU a week after treatment ends.

Refer for investigation by paediatric urologist.


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Appendix I – Recorded Consultation/Examiner Clinical Visit (ECV) Rating Form

COMMUNICATION AND RAPPORT A competent Candidate demonstrates genuine respect, rapport and empathy. They allow the patient to talk freely and to feel at ease in a non-judgmental atmosphere. Communication and rapport includes active listening, appropriate maintenance of eye contact, recognition of verbal and non-verbal cues and body language. It demonstrates the effective use of silence and uses suitable language with an appropriate mix of open and closed questions. It enables the exploration of concerns and expectations and allows recognition of the significance of the patient’s words. HISTORY TAKING A competent Candidate will take a focussed, relevant and organised patient history, following appropriate cues and eliciting both positive and negative details important to the assessment and management of the patient. PHYSICAL EXAMINATION A competent Candidate will demonstrate respect for the patient and concern for their safety, comfort and modesty. They should perform an appropriate and a systematic examination, which is focussed and not overly inclusive. They should explain to the patient what they are doing and avoid painful manoeuvres. Specific findings relevant to the case should be elicited. PROBLEM DEFINITION A competent Candidate will demonstrate the ability to identify the problems and to define and prioritise the physical, psychological and social issues involved for the patient, the family and the community. Adequate knowledge of the physical, psychological and social processes involved should be demonstrated. MANAGEMENT AND INVESTIGATIONS The competent Candidate demonstrates the ability to deal with the issues identified in an appropriate order. They demonstrate the ability to select relevant, cost-effective investigations in an appropriate sequence, displaying consideration for the safety and comfort of the patient. They provide effective explanations and education, ensure patient comprehension and acceptance and involve the patient, family and relevant community resources in the immediate and ongoing management plans. They define appropriate further investigations, offer choices of therapy and outline a time frame to the patient. They demonstrate the taking of responsibility for the immediate and ongoing management of the patient.

Appendix J - Checklist for Practice Based Assessment Candidates

THIS IS DESIGNED TO BE A SIMPLE CHECKLIST OF THE KEY ELEMENTS OF PRACTICE BASED ASSESSMENT. IT IS NOT ALL-INCLUSIVE AND MUST ONLY BE USED IN CONJUNCTION WITH THE PRACTICE BASED ASSESSMENT HANDBOOK. 1. Enrolment Check eligibility: Am I eligible to sit the Practice Based Assessment? Completed enrolment form (including full payment applicable) Peer list (refer to Appendix A) Practice Profile (refer to Appendix B) Viva and ECV schedule form (refer to Appendix L)

All the above documentation must be received by the due date to [email protected] NB Please refer to http://www.racgp.org.au/becomingagp/imgaus/pba/ for applicable due dates 2. Recorded Consultations Please ensure that you start your video recordings as soon as possible after your enrolment has been confirmed. Arrange recording equipment, including: wide angled lens desk microphone new portable hard drives Record 90 consented patient consultations Log each consultation using the logbook in Appendix C and refer to the following guidelines:

Details of each consultation; location on the portable hard drives by the use of ‘chapter’ breaks. Logbook is submitted (preferably typed - illegible logbooks will be returned to the Candidate for rectification and the assessment process will be paused until the logbooks are returned to the RACGP) Most consultations should be between 8-20 minutes in duration

All video recordings are made in one of the following formats: AVI; DIVX; MOV; MPEG; MPG; MP4 All portable hard drives must be clearly marked with your name and RACGP ID number Make 2 copies of the portable hard drives and 2 copies of the logbook (Appendix C). Submit 1 copy of each to the RACGP. Ensure that the copy retained by you is secured to ensure confidentiality. All the above documentation must be received by the due date to: PRIVATE AND CONFIDENTIAL Attention: RACGP PBA Administrator, Education Services, 100 Wellington Parade, East Melbourne, Victoria 3002 NB Please refer to http://www.racgp.org.au/becomingagp/imgaus/pba/ for applicable due dates

RACGP PRACTICE BASED ASSESSMENT APPENDIX J

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mailto:[email protected]

http://www.racgp.org.au/becomingagp/imgaus/pba/

http://www.racgp.org.au/becomingagp/imgaus/pba/

Appendix J - Checklist for Practice Based Assessment Candidates

3. Viva Ensure Viva and ECV schedule form (Appendix L) is completed and submitted at time of enrolment Block out appropriate amount of practice time for the Viva Ensure that the room has sufficient light and minimal background noise Show the Examiner Photo ID prior to the Viva commencing You may take notes during the Viva and may return to any question if time permits, however you are

required to hand any notes you made to the Examiner at the conclusion of the Viva Ensure you sign a consent form to be videorecorded during the Viva. Without a signed consent form,

the Examiner will not proceed to conduct this examination segment. 4. The Examiner Clinical Visit (ECV) Ensure Viva and ECV schedule form (Appendix L) is completed and submitted at time of enrolment Ensure a minimum of 10 patients are booked in for the ECV Ensure patients have signed the consent form prior to their consultation. Without a signed consent form, the Examiner will not proceed to conduct this examination segment. Provide the visiting Examiner with clinical summaries of the patients to be seen prior to their

consultation Show Examiner Photo ID prior to the ECV commencing

RACGP PRACTICE BASED ASSESSMENT APPENDIX J

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Appendix K - Guidelines for Recording Consultations

Information Patients must be informed at the time of booking an appointment that video recording is planned for that clinical session. On arrival, the patient will be given a consent form and the receptionist at the practice will explain the process to the patient, including that should the patient be unwilling to be video recorded this will not affect their consultation with the doctor. The receptionist at the practice must ensure that the patient understands the purpose of the recording, who will see it and how long it will remain in existence. The patient consent form must be fully completed and signed by the patient. There is no need to switch off the camera between consultations unless the gap is likely to be a large one. The examination area should not be in view, and sensitive examinations should not be in view, however the recording device must be re-directed so that sound is recorded while the physical examination takes place. IMPORTANT: The recording should be checked for quality of sound and picture, prior to submission and each Candidate is required to verify the quality of after the recording of every 10 consultations (Appendix C). The picture should show both the doctor’s and patient’s face. The video timer is important, as it allows you and the assessor to navigate through the recording. Consent Form All patients being video recorded must sign a consent form, before their consultation. If the consent form is unsigned, the video camera must be switched off. It must be made clear to patients that a recording will not be undertaken without a patient’s consent, and the camera will be switched off at any time during the consultation at their request. Where patients are unable to give consent because they suffer from mental disability, or for any other reason, consent may be sought from a close relative or carer with guardianship rights over the patient. In the case of persons under the age of 18 years or children/young people who lack the understanding to consent on their own behalf, the consent of an adult with parental responsibility must be obtained. After the consultation The patient must be offered the opportunity to view the recording, in the form in which it is intended to be shown, before the recording is used, and have the right to withdraw consent to the use of the recording at that stage. If a patient, following the consultation, wishes the recording to be erased from the portable hard drive, then he/she should advise the Receptionist. The doctor will then erase the consultation at the first available opportunity and confirm to the patient that this has been completed. The receptionist must make clear to the patient that if after leaving the surgery they would prefer the recording to be erased, they must notify the practice as soon as possible. The recording is only to be used for the purposes to which consent has been given. Storage and Erasure The recordings should be stored with the same security and confidentiality as patient medical records. Consent forms should be kept with the medical records of the patient. The responsibility for security, confidentiality, storage and erasure falls to the general practitioner in the practice. The portable hard drives will be returned to the Candidate and must be erased as soon as possible, but definitely no later than one year after the date of the recordings taking place.

RACGP PRACTICE BASED ASSESSMENT APPENDIX K

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Transport Portable hard drives must be transported by the general practitioner or their representative. Recordings must be couriered to the RACGP. Tips for creating a video recording

a. Setting the camera Familiarise yourself with the video camera before you use it. Position the camera so both the

doctor’s and patient’s head can be seen. As a guide, it should be possible to see by looking at the recording when eye contact is made between doctor and patient.

The examination area must not be in view and examinations of a sensitive nature should not be filmed, but you must keep the recording running while the examination takes place since the consultation usually continues during the examination.

b. Lighting

Use daylight has much as possible but try to avoid having a window in view as this may cause the subjects to be underexposed. If necessary, close the curtains or blinds. For the same reason, take care that no bright lights appear in the shot. The general rule is to have lamps illuminating the scene, but not in it.

c. Focus

Ensure that the camera is focused on the doctor and patient. If possible, override the autofocus and operate manually, so that the camera will not attempt to focus on the wall when subjects move about.

d. White balance

Ensure the “white balance” is adjusted for the light in your consulting room. This will ensure a high/appropriate picture quality.

e. Recording date and time

Enable the video camera to automatically record the date and time. Alternatively, ensure that there is a clock in view of the video camera.

f. Sound Poor sound quality is the most common technical problem. Where possible, use desk or personal

microphones connected to the video recorder. Check the sound level before you start recording. Avoid large, bare rooms that suffer from echo. If necessary close curtains to absorb echoes and

cut out background traffic noise etc. Ensure that the noise of the computer keyboards and printers does not mask conversation

between doctor and patient.

g. Consent All consultations should be recorded except where the patient withholds consent. Consent must be obtained in writing.

h. Consultations

Your recording should include a variety of problems, including ‘challenging’ consultations. You must delete incomplete consultations but do not delete consultations which appear unsatisfactory to you. You do not need to switch off the camera between consultations unless the gap is likely to be a long one.


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i. Length of consultations The average time for a consultation should be between 5 minutes and 20 minutes in duration.

j. The log

Candidates must complete a log entry for each consultation and note the time for each consultation is the same time as that of the video camera clock, and comment on each consultation. Candidates are required to personally verify the audio and picture quality of every 10 consultations recorded and signs where indicated at the intervals indicated on the log book.

Submission of Recorded Consultations

Candidates must adhere to the following guidelines:

1. Consultations are to be copied onto the portable hard drives from the digital camera holding the recording.

2. Portable hard drives should be formatted in one of the following format: AVI; DIVX; MOV; MPEG; MPG; MP4; so they can be viewed on either a PC, Apple or on a home DVD player.

3. Each portable hard drive should contain all consultations and the logbook information should be accurate and correspond with your recordings.

4. It is the Candidate’s responsibility to ensure the quality of each portable hard drive. Inaudible

recordings will be rejected.

5. Candidates are to follow the guidelines for completion of the logbook as printed in the PBA Guidelines with the following variation:

Each portable hard drive must have the Candidate RACGP ID number printed on it and must also be numbered and correspond with the information provided in the logbook.


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Appendix L – Viva & Examiner Clinical Visit (ECV) – Exam scheduling form

Candidate Name: __________________________ Candidate RACGP No: _________ Please indicate by circling the boxes with dates which are suitable for you to sit the Viva and ECV examinations. Due to constraints, Examiner and availability issues, no guarantees are provided that you will be examined on the day you have selected. Week commencing: ________________________ Preferred days available to be examined: (please circle)

Monday Tuesday Wednesday Thursday Friday

RACGP PRACTICE BASED ASSESSMENT APPENDIX L

Appendix M - Assessment Matrix

Figure 1a: The Exam matrix – domains of general practice 1. Communication skills and the doctor patient relationship

1.1 The general practitioner as a therapeutic agent 1.2 Patient-centredness 1.3 Establishing rapport 1.4 Communication with patients’ significant others 1.5 Consultation models 1.6 Counselling skills 1.7 Advocacy role for the individual patient 1.8 Interaction of family dynamics with health and illness 1.9 Communication with patients from differing cultural backgrounds

1.10 Communication with special needs groups 1.11 Individual and opportunistic health education promotion 1.12 Care coordination, referrals and networking 1.13 Written communication skills

2. Applied professional knowledge and skills 2.1 Knowledge of medical conditions – common 2.2 Knowledge of medical conditions – treatable 2.3 Knowledge of medical conditions – preventable 2.4 Knowledge of medical conditions – dysfunctional, disabling or life-threatening 2.5 Knowledge of medical conditions – uncommon, but serious 2.6 Knowledge of medical conditions – masquerading illnesses 2.7 Approach to undifferentiated problems 2.8 Information gathering 2.9 Physical exam skills

2.10 Procedural skills 2.11 Clinical decision making 2.12 Continuity of care 2.13 Integration of care 2.14 Cost-effective treatment and investigations 2.15 Critical appraisal

3. Population health and the context of general practice 3.1 Demographic and epidemiological issues – health needs of special groups 3.2 Knowledge of public health problems 3.3 Population based preventive strategies 3.4 Cultural aspects of health care 3.5 Socio-political dimensions of health 3.6 Advocacy role in the community 3.7 Patient context – family, work and significant others 3.8 Community resources

4. Professional and ethical role 4.1 Special duty of care 4.2 Maintenance of professional standards 4.3 Adherence to contemporary ethical principles 4.4 Reflective skills and self-appraisal 4.5 Lifelong learning and continuous professional development 4.6 Teaching role 4.7 Research, evaluation & audit skills 4.8 Professional networks 4.9 Self and family care

5. Organisational and legal dimensions 5.1 Arrangements for availability and accessibility 5.2 Safety netting 5.3 Screening and recall systems 5.4 Information management – patient and practice 5.5 Information technology 5.6 Medical records 5.7 Legal responsibilities 5.8 Practice Management

RACGP PRACTICE BASED ASSESSMENT APPENDIX M

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Appendix M - Assessment Matrix

Figure 1b: The exam matrix – frequency and patterns of problems presenting to general practice

ICPC chapter heading BEACH (%)

General 26.2% Respiratory 13.5% Musculoskeletal 10.1% Skin 10.1 Cardiovascular 7.3 Digestive 6.8 Psychological 5.1 Neurological 3.1 Female Genital 3.4 Endocrine 4.2 Ear 2.4 Reproductive 2.1 Eye 1.6 Urological 1.6 Blood 0.9 Social 0.7 Male Genital 0.8

Age group BEACH (%) 0-4 4.5 5-14 5.5 51-24 9.5 25-44 23.4 54-64 28.1 65-74 12.6 Over 75 14.7 Gender BEACH (%) Male 43 Female 57

RACGP PRACTICE BASED ASSESSMENT APPENDIX M

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