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The three domains
Every SCA case is marked in three domains, each graded from 1 to 5.
Scoring
- 4–5
- Clear pass
- Exceeds the expected standard
- 3
- Marginal pass
- Meets the standard, with room to improve
- 1–2
- Clear fail
- Significant improvement needed
Data gathering, technical and assessment skillsHistory taking, examination and information gathering.
Clear pass (4–5)
- Comprehensive information gathering
- Clinically appropriate working diagnosis
- Targeted examination
- Efficient use of time and resources
Marginal pass (3)
- Essential information gathered
- Safe but limited working diagnosis
- Covers the essential examination elements
- Some inefficiency in time and resources
Clear fail (1–2)
- Inadequate information gathering
- Incorrect working diagnosis
- Missing crucial examination elements
- Poor use of time and resources
Clinical management skillsDecision making, treatment planning and clinical reasoning.
Clear pass (4–5)
- Appropriate, comprehensive management plan
- Clinically indicated prescribing and referrals
- Clear safety-netting and follow-up
- Excellent shared decision making
Marginal pass (3)
- Addresses the main issues but lacks nuance
- Appropriate, with some unnecessary elements
- Basic safety-netting
- Some attempt at shared decisions
Clear fail (1–2)
- Inappropriate or harmful management
- Clinically inappropriate prescribing
- Inadequate safety-netting
- Paternalistic decision making
Interpersonal skillsCommunication, empathy and patient-centred care.
Clear pass (4–5)
- Strong rapport
- Thorough exploration of the patient's perspective
- Excellent active listening
- Clear, tailored explanations
- Consistent empathy and respect
Marginal pass (3)
- Basic rapport established
- Some exploration of the patient's perspective
- Listens, but may miss cues
- Mostly clear explanations
- Shows some empathy
Clear fail (1–2)
- Poor rapport, or damages the relationship
- Fails to explore the patient's perspective
- Poor listening, frequently interrupts
- Confusing explanations, full of jargon
- Lacks empathy or respect
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