MEDICATION-RELATED CONSULTATION FRAMEWORK (MRCF)

Name: ………………………………………………………..Date: ……………………………………..

Assessor’s name: …………………………………………Signature: ………………………………

Rating Scales for Evaluation

Three different rating scales are included in the framework:

(1) Individual rating scales

The assessments of individual activities and behaviours require a “yes/ no” assessment (marked as tick/ cross). Some activities may not be relevant in every type of consultation and can therefore be marked as “not applicable (N/A)”. Please refer to the example below.

e.g. Did the practitioner undertake the following activities when consulting with the patient?

A1. Introduces self to patient / √ / If your answer is yes, place a tick in the space provided
A2. Confirms patient’s identity / NA / If the described activity is not applicable to this consultation, please state N/A
A3. Discusses purpose and structure of the consultation / X / If your answer is no, place a cross inthe space provided

(2) Ratings for each framework section

Section rating scales are included at the end of the individual framework sections A to E. These ratings are intended to assess whether the overall aim of each individual framework section was achieved. This is measured on a 5 point scale with the middle and extreme points anchored by explicit descriptors; and ranges from “fully”, “partially”, “not achieved”.

(3) Final overall rating scale

This allows for a final reflective assessment of the entire consultation and the assessment is on a 5 point scale ranging from “poor”, ”borderline”, “satisfactory”, “good” and “very good”

Space for comments

In addition to above rating scales a comment box is provided that gives the evaluator the option to provide the learner with more specific feedback about his/her strengths and weaknesses and/or to clarify ratings given.

THE MEDICATION-RELATED CONSULTATION FRAMEWORK (MRCF)

(A) SET THE SCENE Did the practitioner undertake the following activities when consulting with the patient?
A1. Introduces self to patient / A4. Invites patient to discuss medication and/or health related issues
A2. Confirms patient’s identity / A5. Negotiates shared agenda
A3. Discusses purpose and structure of the consultation / A6. Pays attention to comfort and privacy
Practitioner did not build a therapeutic relationship with patient / 0 1 2 3 4 / Practitioner fully built a therapeutic relationship with patient
Comments
(B) DATA COLLECTION & PROBLEM IDENTIFICATION
B1. Documents full medication history /

Adherence assessment

B2. Assesses patient’s understanding of the rationale for prescribed treatment / B9. Asks how often patient misses dose(s) of treatment
B3. Elicits patient’s (lay) understanding of his/her illness / B10. Identifies reasons for missed dose(s) (unintentional or intentional)
B4. Elicits concerns about treatment / B11. Explores patient’s attitudes towards taking medication
B5. Explores social history /

Exploring patient’s wish for involvement

Illness management

/ B12. Asks how much/ what information patient wants before discussing solutions
B6. Explores patient’s experience/ control of symptoms / B13. Asks how involved patient wants to be in decision making
B7. Asks how patient monitors the illness /

Problem identification

B8. Undertakes appropriate physical assessment (when indicated) / B14. Identifies & prioritises patient’s pharmaceutical problems (summarising)
B15. Re-negotiates agenda (prioritising issues to be discussed)
Practitioner did not identify patient’s pharmaceutical needs / 0 1 2 3 4 / Practitioner fully identified patient’s pharmaceutical needs
Comments
(C) ACTIONS & SOLUTIONS
C1. Relates information to patient’s illness & treatment beliefs / C5. Checks patient’s understanding
C2. Involves patient in designing a management plan for identified problem(s) / C6. Discusses lifestyle issues/ prevention strategies
C3. Gives advice on how & when to take medication & length of treatment / C7. Determines whether patient wants additional information/ explanation
C4. Checks patient’s ability to follow plan / C8. Refers appropriately to other healthcare professional(s)
Practitioner did not establish an acceptable management plan with patient / 0 1 2 3 4 / Practitioner fully established an acceptable management plan with patient
Comments
(D) CLOSING
D1. Explains what to do if patient has difficulties to follow plan and whom to contact / D3. Offers opportunity to ask further questions with regard to issues discussed in the consultation
D2. Provides further appointment or contact point
Practitioner did not negotiate ‘safety netting’ strategies with patient / 0 1 2 3 4 / Practitioner fully negotiated ‘safety netting’ strategies with patient
Comments
(E) CONSULTATION BEHAVIOURS - Did the practitioner demonstrate the following consultation behaviours?
E1. Listens actively & allows patient to complete statements without interruption / E8. Shares thinking with the patient to encourage patient’s involvement (if wanted)
E2. Asks relevant questions / E9. Uses information from test results to explain treatment option(s)
E3. Uses open & closed questions appropriately / E10. Uses evidence based medicine-type information to explain treatment option(s)
E4. Avoids or explains jargon / E11. Adopts a structured & logical approach to the consultation
E5. Is non judgemental or patronising / E12. Keeps interview “on track” or regains ‘control’ when necessary
E6. Demonstrates empathy with and supports patient / E13. Manages time effectively (works well within the time available)
E7. Deals sensitively with embarrassing & disturbing topics / E14. Provides logical and correct documentation
Practitioner did not demonstrate any of these consultation behaviours / 0 1 2 3 4 / Practitioner fully demonstrated these consultation behaviours
Comments
OVERALL IMPRESSION
Overall the practitioner’s ability to consult was… / Not competent - Poor / Not competent -Borderline / Competent - Satisfactory / Competent - Good / Competent -Very good
Comments