COTS are only undertaken in general practice placements- whether this be in ST1,2 or 3. Their hospital based equivalent is the mini CEX. The starting point for discussion is either a video recorded consultation or a consultation directly observed by your trainer eg in a joint surgery. In either case the patient must give consent in accordance with the guidelines for consenting patients.
Consultations should be selected across a range of patient contexts and over the entire period of training spent in general practice and should include at least one case from each of the following categories:
- Children (a child aged 10 or under)
- Older adults (an adult aged more than 75 years old)
- Mental health
It is likely that more evidence will be generated from consultations with greater complexity . Your trainer will then use the COT framework to discuss your performance with you and record their observations in your eportfolio.