CSRH Curriculum Module Clinical Skills

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					CSRH Curriculum Module 1: Clinical Skills
Learning Outcomes:

          Utilises the appropriate knowledge, skills and attitudes to perform assessment of women and men by means of clinical history taking and
           physical examination.
          Manages problems in a structured and flexible way.
          Communicates effectively with women and men from diverse ethnic and socio-behavioural groups in a variety of clinical situations and
           involving other professional groups where appropriate.
          Manages time effectively.

History Taking:
                                                                                  Professional Skills and
Knowledge Criteria                   Clinical Competency                                                                     Training Support                 Evidence/Assessment
           The pattern of              A sexual and reproductive health            Shows empathy and respect, and            e-DFSRH                         DFSRH
            common and                   history from women and men is taken          develops rapport with patients
            uncommon symptoms            and analysed in a succinct and logical
            in women and men             manner                                                                                 STIF course                     CbD
            presenting with sexual                                                   Acknowledges and respects cultural
            and reproductive                                                          diversity
            health issues               A gynaecological and obstetric history                                                                                  Mini CEX
                                         is taken and analysed in a succinct                                                 
                                         and logical manner                          Recognises the need for interpreters
           The pattern of                                                            and health advocates                                                       MSF
            common and                                                                                                          Local and regional generic
            uncommon symptoms           Manages and resolves difficulties of                                                    training courses
            in women presenting          language, physical, educational and         Recognises the hidden agenda/              eg Breaking Bad News,           Reflective diary
            with gynaecological          mental impairment                            unvoiced concerns (conscious and           Equality and Diversity
            and obstetric                                                             unconscious) in sexual health and
            problems                                                                  gynaecological consultations.
                                        Appreciates the importance of the
                                         interplay between social, clinical and
                                         psychological factors for patients &
                                         their relatives and carers

                                        Monitors and manages personal and
                                         professional ethical standards arising
                                         from patient interactions

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Clinical Examination and Investigation:

                                                                                   Professional Skills and
 Knowledge Criteria                 Clinical Competency                                                                        Training support                   Evidence/Assessment
     The pathophysiological           Performs a reliable, and selects an           Respect client’s dignity &                 GMC Good Medical Practice         DFSRH
      basis of physical signs           appropriate, examination in women,             confidentiality
                                         Breast examination                                                                      e-DFSRH                           Logbook
     The indications, risks,            Abdominal examination                       Acknowledge and respect cultural
      benefits and effectiveness                Non-pregnant                           diversity
      of investigations                         Pregnant                                                                          Clinical attachment to local      Reflective diary
                                         External genital examination                                                             Breast Unit
                                         Vaginal examination                         Involves relatives appropriately
     The applied clinical                      Bimanual                                                                                                             DOPS
      science of female and                     Speculum                                                                          RCOG Gynaecological
      male reproduction                  Microbiology and virology                   Acknowledges the need for a                 examinations; guidelines for
                                             samples:                                  chaperone                                   specialist practice 2002          MFSRH Part 1
                                                throat, vagina, cervix, urethra,                                         
     Clinical guidelines                       rectum, urine                                                                      rces/public/pdf/WP_GynaeE
      relevant to sexual health          Cervical cytology                           Acknowledges the need for a client          xams4.pdf
                                                                                       to seek a female or male attendant

     Ethical guidelines relevant      Performs a reliable, and selects an           Acknowledges the request for a             RCOG Standards in
      to intimate examination           appropriate examination, in men,               female or male doctor                       Gynaecology 2008
                                         Abdominal examination                                                                    rces/public/pdf/GYNStandar
                                                                                      Promotes shared awareness and               dsWPR(web)0608.pdf
                                         Examination of external genitalia
                                                                                       understanding by making
                                         Examination of groin
                                                                                       explanations to patients in language
                                         Rectal examination and                       they can understand                        NHS Cervical Screening
                                             proctoscopy                                                                           Programme
                                         Microbiology and virology                                                                http://www.cancerscreening.
                                             samples:                                 Recognises the limits of one’s    
                                                throat, urethra, rectum, urine         ability and the need to ask for help
                                                                                       and appropriate onward referral
                                                                                                                                  NHS Breast Screening
                                       Selects and performs relevant further                                                      Programme
                                        investigations competently                    Uses professional standards and             http://www.cancerscreening.
                                                                                       ethical guidelines to inform practice
                                       Applies sound clinical judgement to the
                                        Interpretation of the results of                                                          Laboratory visits e.g.
                                        investigations                                                                             microbiology, cytology,
                                       Liaise and discuss investigations with                                                    Urology/GUM attachment for
                                        colleagues                                                                                 male examination skills

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Note keeping:
                                                                               Professional Skills and
Knowledge Criteria              Clinical Competency                                                                        Training support                    Evidence/Assessment
    The importance and            Records and communicates concisely,           Maintains dialogue or rapport when         NHS Confidentiality Code of        DFSRH
     conventions of accurate        accurately, confidentially & legibly the       note taking and using the computer          Practice. 2007. Guidelines
     clinical note keeping          results of the consultation: history,                                                      on the use and protection of
                                    examination, investigations and                                                            patient information.               MSF
                                    management plan                               Mark each note entry with date,   
    The relevance of data                                                         signature, name and status                  nagingyourorganisation/Infor
     protection pertaining to                                                                                                  mationpolicy/PatientConfide        CbD
     patient confidentiality       Appreciates the importance of timely                                                       ntialityAndCaldicottGuardian
                                    dictation, cost effective use of medical      The limitations and problems of             s/DH_4100550
                                    secretaries & increasing use of                electronic communication in a
                                    electronic communication                       clinical setting
                                                                                                                              Clinical Standards for
                                                                                                                               Record Keeping. 2008
                                                                                  Communicates promptly and                   Faculty of Sexual and
                                                                                   accurately with primary care and            Reproductive Health
                                                                                   other agencies                    
                                                                                  Demonstrates courtesy towards
                                                                                   secretaries, clerical and other staff
                                                                                                                              NHS Caldicott Guardians

                                                                                                                              NHS Guidance on patient

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Time Management & Decision Making:

                                                                                  Professional Skills and
Knowledge Criteria                   Clinical Competency                          attitudes                                    Training support                     Evidence/Assessment

    Clinical priorities and their      Prioritises clinical tasks                  Keeps consultations to time and to          Local and regional generic           DFSRH
     Identification, evaluation                                                       task                                         courses in consultation skills
     and categorisation                                                                                                            such as:
                                        Works with increasing efficiency as                                                       ‘Time management’                    MSF
                                         clinical skills develop                     Has realistic expectations of tasks to
                                                                                      be completed, and timeframe for
                                                                                      tasks                                       GMC Consent: Doctors and             CbD
                                        Knows when- and where - to get help,                                                      patients making decisions
                                         is self aware and self caring                                                             together 2008
                                                                                     Prioritises workload                         http://www.gmc-
                                        Anticipates future clinical events and                                                    ance/consent_guidance/inde
                                         plans appropriately                         Appreciates the internal signs of            x.asp
                                                                                      one’s own stress and asks for help

                                        Solves problems with a structured,                                                       FSRH clinical standards
                                         flexible and open decision making           Willingness to consult and work as           documents
                                         approach                                     part of a team

                                                                                                                                  GMC Good Medical Practice
                                                                                     Receptive to feedback on

                                                                                     Learns to be flexible, and willing to
                                                                                      take advice, and change practice in
                                                                                      the light of new information

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                                                                           Professional Skills and
Knowledge Criteria            Clinical Competency                                                                     Training support                      Evidence/Assessment
    Methods of effective        Communicates clearly both verbally &        Involve clients in decision making        e-DFSRH                            DFSRH
     verbal and non-verbal        in writing to clients, including those
     communication                whose first language may not be
     associated with good         English                                     Offers choices                            Local and regional generic         MSF
     doctor/patient/ client                                                                                               courses in consultation skills
     interactions                                                                                                         such as:
                                 Gives clear information & feedback          Acknowledges and respects                  ‘Breaking bad news’                  Mini CEX
                                  and shares information with clients,         diversity                                  ‘Dealing with difficult people’
                                  and relatives where appropriate and
                                  with consent                                                                                                               Reflective diary
                                                                              Respects clients’ views and right to   
                                                                               confidentiality                            Communication skills e-
                                 Deals sensitively with embarrassing                                                     tutorial
                                  and disturbing topics, able to respond
                                  effectively to disclosure                   Uses appropriate non-verbal
                                                                               communication                             RCOG Standards for
                                                                                                                          Gynaecology 2008
                                 Breaks bad news sensitively                                                   
                                                                              Checks client’s level of knowledge         rces/public/pdf/GYNStandar
                                                                               and understanding                          dsWPR(web)0608.pdf
                                 Shares information in an honest and
                                  unbiased way
                                                                              Uses listening skills                     RCOG Clinical Governance
                                                                                                                          Advice no.7
                                                                              Uses open questions where

                                                                              Avoids medical jargon but can use
                                                                               judgement with reference to
                                                                               appropriate colloquial language

Module 1 Page 5
Module 1: Clinical Skills

                                                       Competency level: Basic training          Intermediate training        Advanced training
                                                       Not required
                                                       Level 1                            Level 2                           Level 3

                                                       Date      Signature of trainer     Date       Signature of trainer   Date      Signature of trainer

History taking

Take and evaluate a sexual history from a woman

Take and evaluate a sexual history from a man

Take and evaluate a gynaecological history

Take and evaluate an obstetric history

Appropriate use of interpreters and health advocates

Clinical examination and investigation of a woman

Breast examination

Abdominal examination:

Non pregnant


Vaginal examination:

Bimanual examination in non-pregnant woman

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Bimanual examination in pregnant woman

Speculum examination

Perform cervical cytology screening

Take microbiology and virology samples:




Clinical examination and investigation of a man

Genital examination


Take microbiology and virology samples in men:



Consultation skills

Communicate effectively with patients including those
whose first language may not be English

Deal sensitively with embarrassing or disturbing topics

Module 1 Page 7
Elicit specific and relevant information from patient
and/or their records to clarify management
Formulate management plan appropriate to findings in
collaboration with the patient
Record history, examination finding and act on results of

Interpret and act on the results of investigations

Manage and document a consultation in a timely and
accurate fashion

Training courses or sessions

Title                                                Signature of Educational Supervisor   Date

Breaking bad news

Equality and diversity

Module 1 Page 8
Authorisation of signatures – please print your name and sign

Name and designation (please print)                                             Signature

Completion of Module 1:
I confirm that all components of the module have been successfully completed.


Name of Educational Supervisor

Signature of Educational Supervisor

Module 1 Page 9