Many candidates and unfortunately many from outside the UK do not do well in these two stations.
One of the main reasons for this is failure to ask and take into account the patient’s, or in the case of a scenario in the communication skill station, the relation or carer’s perspective.
This may be due to the fact that this has not been standard teaching or standard practice when taking histories. Indeed many clinical skills books do not give a structure or framework for asking about the patient’s perspective.
It is essential to include the patient’s perspective in standard history taking. This is the only way in which one will do this naturally rather than in an artificial way in exams.
In order to do so it is vital to have a structure of framework for doing so.
In ACES for PACES I have provided such a structure (see chapters 4 and 18)
I have also provided an acronym as an aid to memorising this structure
It is I PASSED By Employing ACES, which stands for :
Identification and Introduction
Purposefully
Analyse
Symptoms
Systems
Elicit
Details
Beliefs
Expectations
Anxieties (regarding)
Causes
Effects
Survival
