Knows How, Shows How, Does? Assessing the Impact of Facilitated Small-Group Learning on GP Trainees’ Consultation Skills

Dr Richard Elliott, Professor Johnny Lyon-Maris, Dr Alice Mavrogordato, Dr Duncan Platt, Dr Selina Sawhney, Dr Samantha Scallan, Dr Kelly Thresher

Background
Preparation for high stakes assessments such as the CSA (membership exam for the RCGP, UK) can lead trainees to focus on the assessment process and rigid consultation models rather than their knowledge and skills, resulting in them losing sight of the interaction at the heart of the consultation. This innovative programme of education aimed to help trainees gain insight into their consulting skills whilst preparing for the CSA. Using role-play with facilitated feedback, sessions helped trainees identify and focus on aspects of the consultation that required further development.

Summary of Work
Trainees worked in small groups facilitated by three newly qualified GPs, the ‘Near Peer Educators,’ with recent experience of passing the CSA assessment. Each group met for four sessions, during which they role-played CSA-style thumbnail scenarios devised by the facilitators.  During the first two sessions they gave and received feedback using the ALOBA approach; in the last two sessions feedback was structured using the generic RCGP marking guidelines.  At the end of the programme, the trainees attended a mock CSA circuit comprising cases written by the facilitators. Trainees were scored using the RCGP marking scheme and received oral and written feedback. Feedback was gathered from participants (pre-, mid and post the programme), the group facilitators and the assessors.

Findings
Major benefits reported by the participants were: insight into areas for development, improved feedback skills and refocused learning needs. Facilitators reported observing improved consultation skills.

Conclusions
Approaches to learning that promote shared reflection and constructive feedback can have an impact on trainees’ learning and consultation skills.