ST EMLYN’S · MLA REVISION GUIDE
The Clinical and Professional Skills Assessment
01 / CHAPTER 2
What the CPSA assesses
The CPSA asks you to bring knowledge, clinical skills and professional behaviour together. Taking a history is only part of the task: you need to make sense of what you hear, respond to the patient, recognise important findings and explain a safe next step.
Your medical school sets and delivers its CPSA against national GMC requirements. It may use an OSCE, an OSLER or another approved format. There is no single identical national circuit: station numbers, timings, reading time, marking arrangements and local rules must come from your school. See the GMC explanation for students and CPSA quality-assurance requirements.
Read the role assigned in each task. You may be asked to assess a patient as a student, discuss a management plan, demonstrate a skill in simulation or explain what you would do as a newly qualified doctor. Show the knowledge expected at graduation while being explicit about the supervision and authorisation required for real clinical practice. Do not assume the role of a specialist simply because the scenario is urgent.
A station can combine several tasks: for example, a focused respiratory history, interpretation of observations and an explanation of the proposed plan. Real patients, simulated patients, models, recordings and clinical information can be used in assessment. The apparent ease of organising a station is not a reliable way to predict what your school will assess.
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Practise adaptable clinical performance
Prepare across the curriculum
Use your school’s learning outcomes and the MLA content map to choose a balanced programme of practice. Include common presentations, time-critical problems, long-term conditions, mental health, children, pregnancy, older people and community care. Do not restrict revision to conditions that could be demonstrated by a healthy volunteer.
Work in a small group and rotate through patient, clinician and observer roles. Agree the task and time available before you begin. The observer should watch the clinical reasoning as well as the visible steps: was the history relevant, were important findings recognised, did the explanation answer the patient’s concern, and was the plan safe? Use your school’s published examples and feedback criteria where available.
Practise short component skills first, then combine them. For example, rehearse explaining a medicine, then incorporate that explanation into a consultation where the patient is worried about adverse effects. Introductions, consent and closure become more natural through repetition, but they must still fit the person and the task. A fixed speech can sound polished while missing what matters.
- Attempt the task without interruption, within the agreed time.
- Ask the patient-role colleague what they understood and how the interaction felt.
- Identify one clinical issue and one communication issue to improve.
- Repeat the difficult part immediately, then revisit the full task on another day.
Seek observed practice on placement with patient consent and appropriate supervision. Ask for specific feedback rather than simply whether you “passed”. If a finding is absent, explain what you looked for and how a positive finding would alter your reasoning; do not invent signs. Books, videos and commercial courses can supplement this work, but choose material pitched at graduate level and check it against your school’s guidance.
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Prepare for the day
Read the joining instructions early. Confirm the venue, arrival time, accepted identification, clothing, equipment, permitted resources, infection-prevention requirements and arrangements for breaks. Discuss reasonable adjustments with your school in good time. Do not assume that another university’s instructions, or a postgraduate examination’s rules, apply to you.
Plan travel and allow time for registration. Bring only the equipment and resources permitted for your assessment. Eat and drink as appropriate, and follow the briefing about movement between stations, timing signals, emergencies and how to raise a concern. If you are unwell or a problem occurs, tell the examination team promptly and follow the school’s procedure.
You may be asked to present your findings, discuss a differential diagnosis or describe the next investigation. Practise making those transitions so you can finish with a useful clinical conclusion rather than a list of everything you did.
04 / CHAPTER 2
Use the task, the patient and the available information
- Read the instruction for the clinical task, your role and what you are expected to deliver. Identify any limits, such as taking a focused history without examination.
- Begin appropriately: identify yourself and the patient, explain the task and obtain consent. Use hand hygiene and other precautions when relevant to the activity.
- Respond to the patient and findings. Change your questions or examination when new information changes the clinical problem.
- Summarise the important positives and negatives, explain your interpretation, and give a proportionate plan including immediate safety needs.
- Check understanding, invite relevant questions and close respectfully when the task involves a patient conversation.
When a station becomes difficult
Pause briefly, return to the instruction and prioritise the most useful next action. Clarify an ambiguous answer rather than guessing what the patient means. State uncertainty accurately and explain how you would resolve it. Extra examinations, questions or treatments are not automatically harmless: they can waste time, cause discomfort or expose unsafe judgement.
If you notice an error, correct it clearly while there is time. Do not rely on unsupported reassurance about “no negative marks” or “no sudden-death stations”; use your school’s assessment rules. After a difficult station, give the next patient your attention. The examiner can assess only the performance you demonstrate in the current task.
Example phrases throughout this guide illustrate a way to communicate. They are not compulsory scripts or a guarantee of marks. The purpose of rehearsal is to make your clinical approach organised enough that you can listen, think and adapt.