The MRCP(UK) Part 2 Clinical Examination

UK MRCP
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The MRCP(UK) Part 2 Clinical Examination (Practical Assessment of Clinical Examination Skills - PACES) is designed to test the clinical knowledge and skills of trainee doctors who hope to enter higher specialist training (ST3).

PACES 2020 Carousel

The review concluded that there are some elements of the examination that could be improved:

  1. History Taking

Station 2 tests candidates on their ability to take a full and structured history. This skill remains essential to daily practice. However, it was felt that history taking is not a skill that is practiced in isolation. Candidates are not asked to examine the surrogates, but this is something that they would be expected to do in day-to-day practice. The group felt that the testing of history taking should remain in the examination, but could be better assessed as part of a more integrated clinical encounter

  1. BCCs

The brief clinical consultations in station 5 integrate communication and physical examination skills in a more realistic way. These integrated encounters contribute to the validity of the examination. The limited amount of time available for the interaction means that station 5 can be pressured for candidate and examiners. The group discussed ways in which the brief clinical consultations could be expanded to give candidates more time to demonstrate their skills. A successful proof of concept study tested new clinical consultation that lasted 20 minutes was undertaken; where candidates are given more time to complete an integrated encounter.

  1. Communication and ethics

Station 4 tests candidates’ ability to communicate with patients and relatives, and demonstrate an understanding of ethical principles involved in the encounter. However, there was a sense that the 20 minute encounter is not being used as effectively as possible. Candidates often complete the clinical interaction before the end of the 15 minute allocated time, and the 5 minutes of examiner candidate interaction does not always add value to what the examiners have observed. The group concluded that there were opportunities to increase the number of communication encounters in the carousel while making the encounter shorter.

A second proof of concept study was undertaken to test ten minute encounters both with and without a minute of candidate/examiner interaction within the encounter. The results of the proof of concept and further discussion with the short life working group led to the decision to implement a ten minute communication encounter that is only observed by the examiners.

  1. Reliability and validity

Recent analysis of the current PACES marking system highlighted aspects of the examination that could be altered to improve the reliability. PACES reliability rests on the high number of independent judgements made by each of the examiners. However, not all examiners contribute the same number of marks to the overall score. Examiners on stations two and four make fewer judgements in fewer skills than examiners in stations one, three and five. This reduces their impact on the overall reliability of each of the skills assessed in the examination and effectively weights the examiners’ judgements. The SLWG discussed ways to sequence the new proposed encounters to ensure that the spread of judgements by skill would be more even, and thus improve the overall reliability as examiners mark all candidates on as many skills as possible. This could be achieved by testing communication encounters alongside physical examination encounters, as shown in the new carousel diagram below.

PACES for the MRCP with 250 Clinical Cases 3rd Edition PDF

Today, in this article, we will share the PACES for the MRCP with 250 Clinical Cases 3rd Edition PDF file with our valuable users. The PACES for the MRCP with 250 Clinical Cases 3rd Edition PDF file has been uploaded to our online repository for the safer downloading of the file. Enjoy the free book download!

General Description

Clinical examinations in the OSCE style of marked stations are daunting for all students, whether undergraduates or MRCP candidates. The recent introduction of the 5-station PACES (Progressive Assessment of Clinical Examination Skills) exam inspired a great deal of apprehension, so the appearance of the first edition of Hall’s PACES for MRCP was greatly welcomed by candidates and became an immediate success. This new edition builds on the book’s reputation. It provides, in one colorful and attractive volume, complete coverage of all the most common medical cases that will be covered in PACES and similar exams. Although designed specifically for the PACES part of the MRCP exam, its in-depth coverage means that it can be used by any student preparing for clinical examinations in medicine.

Key Features

  • A one-volume text giving candidates complete preparation for the PACES exam within one portable volume
  • 250 cases organized into the 5 stations of the PACES exam – respiratory and abdominal system, history taking, cardiovascular and nervous system, communication and ethics and skin, locomotion, eyes and endocrine systems
  • Engaging the question-and-answer approach at the end of each case – excellent preparation for the exam
  • Boxed tips highlight vital information – helps identify what is most important to remember
  • Fully revised for the new Station 5 and completely updated throughout.
  • Fully revised for the new Station 5 and completely updated throughout.
  • Promotes understanding and deeper learning of modern medicine applicable to PACES and the specialist registrar.
  • Emphasis on clinical assessment – history-taking, examination and communication skills – equipping candidates with appropriate differential diagnoses from which to develop the right diagnosis.
  • Encourages candidates to question why a diagnosis has arisen and considered its consequences. For example, ‘Heat failure’ is a not a diagnosis until a candidate has considered the differential diagnoses of breathlessness and decided why heart failure is most likely, and then considered its cause (not always ischemic heart disease), its presentation (acute, chronic, left or right ventricular or both) and, most importantly, the effects of it and its treatments on a patient’s life.

Table of Contents

INTRODUCTION

STATION 1 RESPIRATORY AND ABDOMINAL SYSTEM

  • RESPIRATORY SYSTEM
  • ABDOMINAL SYSTEM

STATION 2: HISTORY-TAKING SKILLS

  • Introduction to history-taking skills
  • Clinical reasoning
  • The traditional medical history model
  • Incorporating the patient’s perspective – ideas, concerns, and expectations
  • History-taking skills – the communication skills that make history-taking effective
  • The traditional model and communication skills – putting these two together
  • Cases
  • Respiratory problems
  • Abdominal problems
  • Cardiovascular problems
  • Neurological problems
  • Locomotor problems
  • Eye problems
  • Endocrine problems
  • Renal and metabolic problems
  • Hematological problems
  • Infectious disease
  • Other general internal medicine and elderly care problems

STATION 3: CARDIOVASCULAR SYSTEM AND NERVOUS SYSTEM

  • CARDIOVASCULAR SYSTEM
  • Examination of the cardiovascular system
  • NERVOUS SYSTEM
  • Examination of the nervous system

STATION 4: COMMUNICATION SKILLS AND ETHICS

  • COMMUNICATION SKILLS AND ETHICS
  • Introduction to communication skills and ethics
  • Communication in special circumstances
  • Breaking bad news
  • Confidentiality, consent, and capacity
  • End of life issues
  • Clinical Governance
  • Other communication, ethical and legal scenarios

STATION 5: SKIN, LOCOMOTOR SYSTEM, EYES, ENDOCRINE SYSTEM

  • SKIN
  • Examination of the skin
  • LOCOMOTOR SYSTEM
  • Examination of the joints
  • Examination of the hands and arms
  • Examination of the legs
  • Examination of the spine
  • EYES
  • Examination of the eyes
  • ENDOCRINE SYSTEM
  • Examination of the thyroid