Consulting in General Practice

The AKT tests your understanding of consultation models and communication frameworks in the context of general practice. You need to know the theory, but more importantly, you need to recognise how these models apply to clinical scenarios in exam questions.

The Calgary-Cambridge model is the most commonly referenced framework. It structures a consultation into five phases: initiating the session, gathering information, physical examination, explanation and planning, and closing. AKT questions often present a clinical scenario and ask which phase of the consultation a particular action belongs to, or what the most appropriate communication technique is at a given point.

Shared decision-making is a core principle in modern general practice. NICE guidance emphasises that clinicians should present options, discuss benefits and risks, and support patients in making informed choices. In AKT questions, the correct answer often involves acknowledging the patient's perspective and involving them in the decision rather than directing them.

Breaking bad news follows structured approaches like SPIKES (Setting, Perception, Invitation, Knowledge, Emotions, Strategy). Questions may ask about the appropriate order of steps, or how to handle a specific emotional response from a patient. The key principle is responding to the patient's emotions before delivering information.

Motivational interviewing techniques appear in questions about behaviour change, particularly around smoking cessation, alcohol reduction, and weight management. The OARS framework (Open questions, Affirmations, Reflections, Summaries) is worth knowing well.

You should also understand concepts like health literacy, the use of interpreters, capacity in the context of communication (distinct from Mental Capacity Act assessments), and telephone and video consultations. Since the pandemic, remote consultation skills have become a more prominent part of the RCGP curriculum.

AKT Navigator covers all consultation models with questions, audio revision, and detailed explanations aligned to the RCGP curriculum.