Completing the Recorded Consultations


1. Introduction

This guidance document outlines the steps which candidates should follow when completing the Recorded Consultations in the Practice Based Assessment Pathway.

2. Definitions

Candidate A medical practitioner enrolled in the Practice Based Assessment Pathway

PBA Practice Based Assessment

RACGP Royal Australian College of General Practitioners

AKT Applied Knowledge Test

KFP Key Feature Problems

3. Guidance

All PBA Pathway candidates are required to record and submit 90 Recorded Consultations before the relevant deadline as stated on timelines and fees. These Recorded Consultations will be assessed by RACGP examiners and must be accompanied by a corresponding Logbook and a completed Reflective Learning Tool for each consultation.

3.1 Enrolment process

Candidates will be contacted via e-mail by the PBA Team and directed to enrol in the Recorded Consultations. Enrolment must be completed before the relevant date outlined on timelines and fees. Candidates must pay the prescribed Recorded Consultations fee, details of which can be found on timelines and fees.

When candidates have received enrolment confirmation, they may commence recording consultations for submission and assessment.

3.2 Storage and retention of Recorded Consultations

Some states have legislation requiring the retention of Recorded Consultations (as they form health information). For example, practitioners in NSW, the ACT and Victoria must retain Recorded Consultations for at least 7 years from the patient’s last medical services, whereas practitioners in South Australia must use their discretion for the same. Candidates should refer to the relevant legislation in their state or their MDO for further information on retention requirements.

3.3 Use of RACGP encrypted hard drive

Candidates will be provided with an external hard drive. The files for all Recorded Consultations must be transferred to the hard drive for submission to the RACGP. The hard drive is loaded with encryption software which must be activated to secure the consultations prior to transport and submission to the RACGP. This is to protect the privacy of the patients in the consultations and to ensure that the recordings cannot be accessed should they be intercepted by a third party. Until the encryption software on hard drive is activated, it must be stored securely in the practice with access restricted to the candidate only.

3.4 Preparation

Candidates are responsible for sourcing video equipment for use in the Recorded Consultations. Recording materials will not be provided by the RACGP.

Candidates must familiarise themselves with the recording equipment and ensure that all recordings are in one of the following formats:

  • AVI
  • DIVX
  • MOV
  • MPEG
  • MPG
  • MP4.

Candidates are encouraged to create a simulated consultation with a member of practice staff to allow them to review sound and picture quality before proceeding to record any real consultations.

Candidates must ensure that all recordings are of an acceptable audio-visual quality. Recordings which are of poor sound or visual quality will not be assessed.

Candidates may wish to consider the following when setting up their consultation room ahead of recording:

  • Avoid recording in large bare rooms that suffer from echo as this will affect the sound quality of the recording.
  • Avoid having a window or other light source (e.g. lamps or computer screens) appearing in the shot as this may cause overexposure.
  • Ensure that the camera is focused on you and the patient – your faces should be clearly visible and the viewer should be able to see when eye contact is being made.
  • Ensure that noises from equipment in the consultation room, e.g. printers, do not drown out the conversation between you and the patient.
  • Make practice staff aware that recording is in progress to ensure that there are no interruptions during the consultation.
  • Place signage within the practice requesting that the noise level outside the consultation room is kept to a minimum.

3.5 Informed Consent

Candidates should ensure that informed consent is received from patients prior to recording including by:

  1. Ensuring that, at the time of booking an appointment, their practice reception staff inform the patient that recording is planned for the clinical session and the reason for this recording.
  2. On arrival at the practice, the patient must again be advised that recording is planned for the clinical session and the reason for this recording.
  3. Patients who are happy to proceed must sign the Recorded Consultations Patient Consent Form and proceed to their consultation. All other patients should be assured that no recording will take place during their consultation.
  4. In the case of persons under the age of 18 years or who lack the understanding to consent on their own behalf, the consent of an adult with parental responsibility must be obtained. Where patients are unable to give consent for any other reason, consent may be sought from an appropriate authorised person.
  5. After the consultation, the patient should be offered the opportunity to view the recording and reserves the right to withdraw consent to the use of the recording at that stage. If the patient wishes for the recording to be erased, this should be done at the first available opportunity and confirmed for the patient.
  6. All signed consent forms must be retained within the patient’s medical record.

The Recorded Consultations Patient Consent Form will be provided to candidates at time of enrolment in the Recorded Consultations.

3.6 Physical Examination

Candidates must include as much physical examination in their consultations as possible and as appropriate to the presentation. This is to ensure that skills in this area can be adequately assessed. Examples of suitable physical examinations could include but are not limited to the following:

  • feet
  • knees
  • shoulders
  • chest (in men)
  • ears
  • nose
  • throat
  • eyes (including visual acuity)
  • mental state examination.

For examinations that are intimate or may embarrass the patient, the camera should be turned away and candidates should talk through the steps of the examination.

3.7 General requirements for consultations

All consultations must meet the following general requirements:

  • Consultations must be undertaken in English or with the use of an interpreter who is clearly audible throughout the recording.
  • Consultations must be a minimum of 5 minutes in duration
  • Consultations must contain assessable content; candidates should avoid recording vaccination sessions and referral/prescription writing
  • All age groups must be represented, including patients under 12 months and over 75 years.
  • Both genders must be represented in approximately equal numbers.
  • At least two consultations should be submitted for each of the following International Classification of Primary Care categories:
    • Blood, Blood Forming Organs and Immune Mechanism
    • Cardiovascular
    • Digestive
    • Ear
    • Endocrine/Metabolic and Nutritional
    • Eye
    • Female Genital
    • General and Unspecified
    • Male Genital
    • Musculoskeletal
    • Neurological
    • Psychological
    • Pregnancy, Child Bearing and Family Planning
    • Respiratory
    • Skin
    • Social
    • Urological.

3.8 Specific requirements for consultations

Within the 90 Recorded Consultations, candidates must submit the following:

  • A consultation with a new patient with no existing medical record at the practice.
  • A long case of at least 20 minutes duration.
  • A paediatric case.
  • A counselling session or mental health presentation.
  • A procedure or demonstration of a technique, for example:
    • Suturing a laceration
    • Excision of a lesion
    • Cryotherapy
    • Wound management
    • Dressings
    • Plastering
    • Spirometry or peak flow measurement
    • Immunisation
    • Demonstration of inhaler technique
    • Demonstration of exercises to perform at home.

3.9 Recorded Consultations Logbook

A logbook must be completed with important information about the specifics of each Recorded Consultation. The logbook must be submitted in excel format using the drop down menus where applicable. The logbook must be included on the encrypted hard drive provided by the RACGP.

The following information is required in the logbook:

  • Date of consultation (free text) – enter the date upon which the consultation took place.
  • Age group (select from the options provided) – select the age group of the patient.
  • Age (free text) – enter the exact age of the patient.
  • Gender (select from the options provided) – select the patient’s gender, as identified by the patient.
  • Primary complaint (free text) – enter the primary complaint discussed during the consultation.
  • Other complaint (free text) – enter any other complaint(s) discussed during the consultation.
  • Physical examination (select from the options provided) – indicate whether or not a physical examination took place during the consultation and if this occurred on or off camera.
  • ICPC heading (select from the options provided) – select the most appropriate ICPC for the ‘primary complaint’ discussed during the consultation.
  • Patient status (select from the options provided) – indicate whether the patient is an existing patient or a new patient.
  • Complexity of consult (select from the options provided) – indicate how complex the consultation was.
  • File name on hard drive (free text) – enter the file name of the corresponding video file on the encrypted RACGP hard drive.
  • Duration of consult (free text) – enter the precise duration of the consultation as indicated on the corresponding video file. The duration should not be rounded up or down to the nearest minute.

The Recorded Consultations Logbook will be provided to candidates at time of enrolment in the Recorded Consultations.

3.10 Completion of the Reflective Learning Tool

Candidates must complete a Reflective Learning Tool for each consultation they intend to submit. Candidates must review and reflect on each of their consultations to determine how adequately they have covered each of the statements on the tool which will provide the candidate with insight into any performance areas requiring improvement.

Candidates must indicate on the scale shown above how they feel they have performed against each of the statements. These statements have been developed from the Competency Profile of the Australian general practitioner at the point of Fellowship and reflect a selection of the core skills a competent general practitioner is expected to demonstrate.

For the section on physical examination, this should be marked “Not applicable” if no physical examination has taken place during the consultation.

Candidates must also provide a response to 4 questions about each of their consultations. These questions are designed to encourage reflection on performance and highlight areas for improvement.

The completed Reflective Learning Tools for all 90 consultations must be submitted along with the candidate’s recordings.

3.11 Submission of recordings

Candidates must ensure the files for all Recorded Consultations are transferred to the hard drive for submission to the RACGP. Submissions on other hard drives, USB devices or CDs/DVDs will not be accepted.

With their submission, candidates must provide a certified copy of proof of identity which includes a photograph. Accepted forms of proof of identity include:

  • Australian passport, not expired more than 2 years
  • current overseas passport
  • current Australian photo driver’s license
  • proof of age or identity card issued by an Australian State or Territory Police Force
  • current Australian student identity card
  • any other Australian entitlement or identity card, issued by the Commonwealth or a State or Territory Government, that includes a photo of the candidate.

Candidates should send the hard drive, along with a certified copy of their photo identification, by registered mail or courier service to:

PBA Delivery Team
Education Services
The Royal Australian College of General Practitioners
100 Wellington Parade
East Melbourne 
VIC 3002

Candidates should contact the PBA Delivery Team to advise of expected delivery date and to provide any relevant tracking numbers.

Candidates must retain a copy of their Recorded Consultations to ensure that a backup is available in the event of any loss or damage in the mail. Retention of recordings must be in accordance with the requirements set out in clause 3.2.

4. References

Practice Based Assessment Pathway - Entry Policy

Practice Based Assessment Pathway - Examination Eligibility Policy

Practice Based Assessment Pathway - Recorded Consultations Policy

Practice Based Assessment Pathway - Requirements for Fellowship Policy


Enquiries

 1800 626 901

 racgpeducation@racgp.org.au