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Intensive CASC training day An introduction

Intensive CASC training day An introduction. 9:15 Introductory lecture/discussion 9:45 Workshops – Dr's mess (groups of 6; switch at half time) 12:15 Lunch 13:00 Mock exam Linked > feedback > single > feedback. Today.

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Intensive CASC training day An introduction

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  1. Intensive CASC training day An introduction

  2. 9:15 Introductory lecture/discussion 9:45 Workshops – Dr's mess (groups of 6; switch at half time) 12:15 Lunch 13:00 Mock exam Linked > feedback > single > feedback Today.....

  3. A/B : Appeared rather ill-at-ease. Dressed in formal suit/two piece (?with shoulder pads). Appearing uncomfortable in such formal attire. Avoiding eye contact. Somewhat preoccupied with sympathy, empathy, etc. Extremely apologetic and obsessed with social convention (asked how I wished to be addressed), told me that they were “sorry to hear” of my woes and unnecessarily apologetic throughout our encounter S: Hesitant, difficulty in maintaining goal direction, appears to communicate in a “tick box”/robotic fashion and lose focus when challenged to move “outside the box” M : clearly anxious, restriction of affect noted (as if our encounter had been repeated many times before…..) R :Denies suicidal ideation but intimated that life has not been worth living for the past two months T : Expressing paranoid ideas about a certain Royal College; Claims that the college are trying to “control” them and is forcing them to conform to a stereotypical psychiatrist (Caucasian, public school educated, speaking BBC English, Maudsley trained, etc.) P : Admits to a persecutory voice in the third person commenting on their “interview skills” I : Partial insight into the impact of a significant psychosocial stressor and the effect of being judged, humiliated and scrutinised. ?learned helplessness Mental State Examination of a CASC candidate

  4. The bigger picture…. • RCPsych is probably not trying to fail candidates • Unlikely to generate much of a profit • GMC places pressure on all colleges to standardise the assessment process • CASC not geared up to look for exceptional candidates • Levels of competency must be defined in the curriculum • Its not an OSCE!

  5. Spectrum of station failure Psychological factors Competency factors

  6. Worry/rumination Emotionality Task generated interference / “choking” Study skills deficits Rx Repetition/exposure - graded Feedback and its acceptance/use Use of video/audio Curriculum coverage Don’t relax too much! Psychological factors

  7. Knowledge base • The essential reading • Icing on the cake • Techniques • PSE/SCID/SCAN/CAPS • Standardised clinical assessment • Safety • K.I.S.S.

  8. Areas of concern • Poor management of interview/discussion • Poor communication skills • Significant deviations from the task • Lack of professionalism • Limited depth and/or range to the task

  9. The “borderline” CASC candidate (please see hand-out)

  10. Scenario Types • History • Mental state • Formulation/synthesis/prioritisation • +/- Risk assessment • +/- Integrative management plan • “Address concerns” • Negotiation/information giving • Physical/cognitive examination

  11. Official college advice!

  12. Advice • Preparation time • The curriculum • Who writes the scenario? • Use video/audio • On groups….. • Hassle senior clinicians

  13. Procedure for workshops • Scenarios (material) • Planning time • Hot seat • Group facilitators • Live supervision • Pause and play • Facilitated discussion • Video

  14. Mock CASC Format6 single & 3 pairs of linked stations Time / mins 7m (single), 10m (linked) 0 1-2m 1-2m Read Think Read Move Read Think Read Scenario

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