CSA Troubleshooting: 9 - Providing health promotion advice

Think about all aspects of health promotion and disease prevention, says Dr MeiLing Denney.

Health promotion and preventing disease may be part of many of the cases a candidate will encounter, but there are also specific instances where it is the main focus of the case.

How it is covered in the CSA exam

Many candidates assume that giving health promotion advice is confined to smoking, alcohol, and diet and exercise. Certainly these are important but there are other topics that may also be covered, including screening programmes, vaccinations, including those for travel, and promoting safer sex.

Remember that each consultation will run differently according to the context.

What to do in the exam

It is not usually sufficient to give out a standard piece of advice, without tailoring it in some way to the patient in front of you.

An examiner is looking for an approach which will achieve the desired outcomes, rather than a mechanistic delivery of facts. A patient-centred approach, where the patient is accurately informed about the specific risks, and then involved in the decision-making about an appropriate course of action is most important here.

You should be able to explain the risks and benefits of particular lifestyles, and negotiate an acceptable management plan. An evidence-based approach is likely to result in you being awarded higher marks.

Although you should be prepared to talk this through with a patient yourself, do not forget that you have the wider primary healthcare team to help in the subsequent management.

How to prepare

Familiarise yourself with the different therapeutic options for smoking cessation, and the services related to modifying or ceasing alcohol intake.

Think through practical aspects of giving advice on diet and exercise to patients of different ages and social classes. Brush up on your knowledge of travel advice, including vaccinations.

Do not forget the routine vaccination programmes in the UK, particularly any current controversial ones, and be prepared to discuss the pros and cons of different approaches.

Consider how you might explain risk to a wide variety of patients, and how you could explain the positives and negatives of various screening programmes, such as breast and bowel cancer screening.

Finally, you could use role-play with peers to practice using your negotiation skills in persuading patients to follow a healthier lifestyle.

  • Dr Denney is an MRCGP examiner, and a GP in Edinburgh.

Read more from this series and find further advice for GP registrars

Photo: JH Lancy

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