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Article: Breaking Bad News

This article focuses on strategies and best practices for delivering bad news in a medical setting. It highlights the importance of communication skills and empathy when managing sensitive patient situations.

For convenience, you can read through this resource here, or use the pdf tools at the top of the document to download and / or print the file. 

Date reviewed: 17 July 2026

Please note that while reasonable care is taken to provide accurate information at the time of creation, we frequently update content and links as needed. If you identify any inconsistencies or broken links, please let us know by email.

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Article: Difficult Doctor Patient Relationships

Navigating difficult doctor-patient relationships is a critical skill for medical professionals. This resource offers practical strategies to foster positive outcomes.

For convenience, you can read through this resource here, or use the pdf tools at the top of the document to download and / or print the file. 

Date reviewed: 17 July 2026

Please note that while reasonable care is taken to provide accurate information at the time of creation, we frequently update content and links as needed. If you identify any inconsistencies or broken links, please let us know by email.

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Consultation Skills Toolbox​

The GPSA Consultation Skills Toolbox is a repository of useful references and resources for GP supervisors, external clinical teaching visitors and medical educators.

The toolbox is divided into the following sections:

  • The consultation
  • Consultation models
  • Consultation skills
  • Challenging consultations.

The primary resources in this toolbox are the GPSA consultation skills teaching plans. References and other resources referred to in the teaching plans are not duplicated in the toolbox.

Two practical resources we recommend reading are the 2014 AFP article Consultation skill tips for new GP registrars and its 2024 companion article Consultation skill tips for new GP registrars – an update.

It is recognised that International Medical Graduates (IMGs) may have specific teaching and learning needs. For specific tools and resources for IMGs, visit the Supervising International Medical Graduates (IMGs) webpage.

For a broad overview of the teaching consultations skills, have a look at this webinar recording.

At the heart of general practice is the consultation, the means by which GPs deliver best practice care. In its simplest form, the consultation is the sharing of information between patient and doctor, to develop both a common understanding and a plan of management.

Consultation skills encompass communication skills, but also skills such as relationship building, identifying agendas, shared decision-making, time management and follow-up. Development of consultation skills is a fundamental element of Australian general practice training.

2014 AFP paper Consultation skill tips for new GP registrars

Understanding common pitfalls in the consultation can be very useful to guide teaching and learning.

In this video, Dr Andy Morgan discusses common pitfalls in consultations.

There have been a number of formal models of the consultation described in the international literature. Consultation models can be used as a framework to teach registrars about the importance of a structured, patient-centred and safe consultation.

Neighbour’s model proposed that the general practice consultation is ‘a journey, not a destination’, and described five ‘checkpoints’ along the way.

  • Connecting: Have we got rapport
  • Summarising: Do I know why the patient that has come today?
  • Handing over: – Have we agreed on a management plan?
  • Safety netting: – Have I covered the ‘what ifs’?
  • Housekeeping: – Am I in good shape for the next patient?

Neighbour R. The Inner Consultation: how to develop an effective and intuitive consulting style. 2nd ed. Oxford: Radcliffe Medical Press; 2004

The Calgary Cambridge Model incorporates the physical, psychological and social aspects of the consultation. In addition to its five stages, there are two ‘threads’ that run throughout the consultation.

Ron Roth, a GP supervisor from Victoria, has developed his own model as discussed in this recent journal article published in the AJGP (2022): A new framework for teaching the art of general practice consultation to registrars and supervised doctors.

He presents his model in this GPSA webinar.

Teaching the art of general practice consultation

Registrars often struggle to facilitate an effective, organised, and time-efficient consultation with their patients.

Resources

A critical first step in the consultation is to connect with the patient and establish a relationship. This includes building rapport and limiting use of the computer.

Resources

Effective communication is an essential skill in general practice consultations. There is strong evidence linking good communication with improved outcomes for both patients and doctors.
The ‘art of communication’ has been described as applying the most appropriate skills to suit each unique patient-doctor interaction.

Resources

Gathering data comprises the skills of effective history taking and physical examination.

Resources

In this video Dr Skye Boughen discusses how to teach evidence based medicine to your registrar.

Resource

Undifferentiated presentations are very common in general practice and establishing a pathological diagnosis is often not a realistic goal. Management of uncertainty of both diagnosis and management is an essential skill for general practitioners.

Resources

In this video Dr Gerard Ingham discusses a simple ‘3R’ approach to managing uncertainty.

In this video, Simon Morgan and Justin Coleman discuss some practical strategies to support registrars to better manage anxiety.

Further reading:

Patient-centred care can be regarded as where ‘the provider tries to enter the patient’s world to see illness through the patient’s eyes’. Common elements of patient-centred care include informing and involving patients; eliciting and respecting patient preferences; engaging patients and sharing decisions in management planning; and continuity of care.

Resources

Cultural competence is defined as ‘the development of awareness and respect for differences in social structure and culture, and acknowledgement of the impacts of these on health and wellness beliefs and ability to engage with health services’. Cultural competence is a core aspect of safe general practice.

Resources

In this video, Karen Nicholls discusses an approach to providing culturally safe care to Aboriginal and Torres Strait Islander patients.

Further reading:

Aboriginal and Torres Strait Islander health teaching plans
Aboriginal and Torres Strait Islander health guide
2008 AFP. ‘Patient-centred care – cultural safety in Indigenous health’

Clinical reasoning has been defined as ‘the sum of thinking and decision-making processes associated with practice … it enables practitioners to take … the best judged action in a specific context.’ It is a core element of high-quality general practice. Clinical reasoning encompasses skills in effective data gathering (history, examination and investigation); data synthesis and interpretation; communication; managing uncertainty; patient-centred care, and evidence-based medicine.

In this video, Simon Morgan explores clinical reasoning in the general practice training setting.

Resources

Risk communication is an essential part of shared decision making and evidence-based patient choice.

Resources

Medical professionalism is regarded as one of the core factors in providing high-quality patient care. Professionalism is closely associated with improvements in doctor-patient relationships, patient satisfaction, and healthcare outcomes.

Resources

In this video, Justin Coleman and Simon Morgan discuss teaching and learning professional and ethical practice in general practice.

Further reading:

Preventive healthcare is a core aspect of many consultations. It includes the prevention of illness, screening activities for the early detection of specific disease, and the promotion and maintenance of health. Preventive health is particularly important in addressing the health disparities faced by disadvantaged population groups, like Aboriginal and Torres Strait Islander people.

Resource

Effective health education involves the provision of accurate, timely, evidence-based, quality health information to patients, taking into account sociocultural factors and their level of health literacy. Two core skills for effective delivery of health education are brief intervention and motivational interviewing.

Resources

Counselling is a common element of the general practice consultation.

Resource

Non-rational testing, and/or over-testing, is increasingly recognised as an important issue in health care. Rational use of investigations is one of the core skills of Australian general practice training and previous research has demonstrated that this is a challenging area for GP registrars.

Resource

Rational prescribing is ‘the judicious, appropriate, safe and efficacious use of medicines’, and is known to be a challenging area for GP registrars.

Resources

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Management planning is a core aspect of the effective and safe consultation.

Resources

 

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The basis of effective continuity of care in general practice is appropriate patient follow up. Safety netting is a key element of follow-up to ensure patient safety and help manage uncertainty.

Resources

Maintaining good quality medical records is a core aspect of good quality practice.

Resources

Recognising one’s limitations and appropriate help-seeking is a core general practice skill, and a fundamental aspect of safe practice and effective learning.

Resource

In this video, Gerard Ingham discusses the call for help list.

Further reading:


2020 AJGP. A ‘call for help’ list for Australian general practice registrars

Time management in the general practice environment is particularly challenging, where every clinical assessment is required to be sufficiently comprehensive in scope to manage the presenting issues and exclude potentially serious causes, but also time efficient in order to meet patient demand. Time management is a core consulting skill but one that can take some time to develop.

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Telehealth, using either phone or video technology, has increased significantly over recent years as a result of the COVID-19 pandemic. Telehealth consultations can be particularly challenging for IMG doctors as they require high level oral language skills to compensate for unavailability of non-verbal clues.

Resources


In this video, Simon Morgan discusses how to assess the registrar undertaking a telehealth consultation.

Further reading:

RACGP Guide to providing telephone and video consultations in general practice

Resources

Date reviewed: 17 July 2026

Please note that while reasonable care is taken to provide accurate information at the time of creation, we frequently update content and links as needed. If you identify any inconsistencies or broken links, please let us know by email.

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Checklist: Call for Help

The Call for Help List is a resource for general practice educators and supervisors, providing support and guidance. This list is designed to assist supervisors in identifying and addressing specific challenges in the learning environment.

For convenience, you can read through this resource here, or use the pdf tools at the top of the document to download and / or print the file. 

Date reviewed: 16 July 2026

Please note that while reasonable care is taken to provide accurate information at the time of creation, we frequently update content and links as needed. If you identify any inconsistencies or broken links, please let us know by email.

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FAQ: Behavioural Issues in Children

The FAQ section provides valuable insights into teaching registrars about managing children’s behavioral issues. It offers guidance on handling common concerns, with a focus on practical strategies and resources for general practice supervision.

For convenience, you can read through this resource here, or use the pdf tools at the top of the document to download and / or print the file.

Date reviewed: 16 July 2026

Please note that while reasonable care is taken to provide accurate information at the time of creation, we frequently update content and links as needed. If you identify any inconsistencies or broken links, please let us know by email.

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Teaching and Learning Toolbox

The GPSA teaching and learning toolbox is a repository of useful references and resources for GP supervisors, external clinical teaching visitors and medical educators.

The toolbox is divided into the following sections:

  • Introduction to teaching and learning – includes the ‘why to teach’
  • Learning needs and planning learning – includes identification of learning needs and the ‘what to teach’
  • Teaching and learning methods – includes the ‘how to teach’
  • Formative assessment and feedback.
  • Performance management

Another practical resource we recommend is the GPSA In-practice teaching guide.

For teaching and learning specific to the consultation, please see the Consultation skills toolbox and the GPSA consultation skills teaching plans.

It is recognised that International Medical Graduates (IMGs) may have specific teaching and learning needs. For specific tools and resources for IMGs, visit the Supervising International Medical Graduates (IMGs) webpage.

For a broad overview of teaching and learning, have a look at this webinar recording.

The role of teacher is the probably the most apparent of all the GP supervisor’s roles.

Resources

  • 2014 AFP paper. GP supervisors – an investigation into their motivations and teaching activities.
  • In this brief video, Nicole Higgins talks about the reasons supervisors teach, and the learning journey.

Resource

  • In this video, Dr Simon Morgan gives a brief overview of practice-based teaching and formal teaching.

Resources

  • Informal teaching webinar and FAQ 
  • In this video, Dr Simon Morgan gives a brief overview of informal teaching.

Resource
In this video Dr Nicole Higgins discusses disruptive teaching.

Resources

Learning needs identification is the process of using tools and methods to uncover the learning needs of the registrar, both known and unknown. These include clinical topics, as well as other domains of practice such as professionalism, communication skills, and organisational skills.

Resource
In this 13 minute video, Dr Simon Morgan discussed the key aspects of ‘what to teach’ and learning needs assessment.

One of the core roles of the supervisor is to assist their registrar to identify their learning needs and plan their learning, using a range of resources and tools.

Resources

Apart from clinical content, there are a range of important aspects of general practice that supervisors should focus teaching and learning.

Resources

There are a wide range of possible teaching and learning methods that the supervisor can employ. Ideally, supervisors should use a diversity of methods to make the learning experience engaging and rewarding for the registrar (and themselves!). Each method has particular strengths and/or shortcomings, and therefore the specific method should be matched to content and registrar leaning needs.
Most teaching methods can be ‘reversed’, where the supervisor takes on the role of learner. This can be a powerful teaching technique and supports collaborative learning.

In this video, Drs Tony Saltis and Simon Morgan give an overview of formal teaching and learning methods.

There is no better way for a GP supervisor to assess (and teach) their registrars clinical, consultation and communication skills than by directly observing their interactions with patients. Direct observation, or ‘sitting-in’, is known to be acceptable to the patient, as well as highly regarded as a learning experience by GP registrars.

Resources

Video recording of consultations has all the advantages of direct observation without the potential intrusiveness of the observer being in the room. Its strength lies in the capacity for the registrar to critically watch the encounter as a third person. Analysis of the recording allows stopping and rewinding to assess a range of communication and consultation skills, and scrutiny of registrar and patient behaviours. Of importance, recent changes to Australian privacy legislation have impacted the use of videorecording of consultations.

Registrar observation of supervisor consultations has particular utility in teaching communication skills, time management and a range of specific consultation skills. It is commonly employed at the start of the training term as part of orientation to the practice. Registrars should take on the role of active participant rather than passive observer and be willing to offer basic feedback to their supervisor.

Resource

The most common practice-based teaching and learning method is problem case discussion (PCD), where the registrar presents their challenging patients to the supervisor and seeks guidance on diagnosis or management. While meeting the registrar’s immediate patient care needs, PCD also allows the supervisor to assess and teach on the registrar’s clinical knowledge, clinical reasoning skills and tolerance of uncertainty.

Resources

Random case analysis (RCA) has been described as ‘one of the most powerful teaching methods we have at our disposal’. It allows identification and exploration of areas of unconscious incompetence and is a particularly effective method of exploring a registrar’s clinical reasoning. RCA has educational utility for all stages of learner, and across all levels of competence.

Resources

Reviewing test results by ‘inbox review’ is an effective method to address rational test ordering, but also provides an ‘entry point’ for broader case discussion. Test result audit and feedback has a specific focus on exploring clinical reasoning and using hypothetical scenarios to extend registrar skills.

Resource
2016 AFP article ‘Test result audit and feedback (TRAFk) as a supervision method for rational test ordering in general practice training’

Near misses and critical incidents are unfortunately not uncommon in general practice. While potentially distressing for the GP involved, critical incident review (or significant event analysis) has been strongly promoted as a quality assurance activity.

Resource

Most practice-based teaching is based around assessing and managing a patient presentation like cough or headache, rather than discussion of a clinical topic, like asthma or migraine. However, teaching about specific topics, whether they be diagnoses e.g. lupus, patient populations e.g. adolescent health, or themes e.g. travel medicine, can be a valuable teaching method.

GPSA Teaching plans.

Physical examination skills may be lacking in registrars. Demonstration of physical examination skills, either on real patients, or on the registrar (where appropriate) is a valuable teaching method.

Resource

Best practice involves starting with a ‘big picture’ concept of the skill and its place in clinical care and then the skill becomes fixed through deliberate practice with specific, constructive feedback based on observation.

Resource
2011 AFP article ‘Teaching procedural skills in general practice’ Teaching a Skill

Role play has particular strengths in communication skills development but is also well suited to discussion of ethical issues and management of uncertainty. Role plays are typically used in small group learning but are readily adaptable to the one-on-one format. They are highly interactive, and rather than just talking about a topic, focus on the ‘doing’. As a result, learners generally find them a deep and memorable learning experience.

Clinical audit and feedback have been found to lead to improvements in clinical practice. Audit can therefore act as a powerful teaching tool. It allows a critical review of current practice, highlights the need for specific knowledge and skills, and encourages self-reflection. Audit may be informal and small e.g. reviewing the prescribing patterns of the past five patients with UTI, or formal and more comprehensive. One of the most common examples is a prescribing audit.

Being involved in teaching other learners, so-called ‘near peer teaching’ is a well-recognised driver of learning. Registrars who teach have been shown to demonstrate enhanced knowledge retention, self-reflection, time management, and leadership skills.

Resource
AFP article ‘General practice registrar teaching roles – is there a need for shared understanding?’
Thampy H et al. Near peer teaching in general practice. BJGP 2019; 69 (678): 12-13.

Resources

Giving Effective Feedback in General Practice

Communication and Feedback in GP Training – A Cultural Lens

Identifying and Supporting GP Registrars at Risk

Helping Registrars Shine – Performance Issues

Assessing and managing registrars with performance issues to work well 

Empowering Neurodivergent Registrars

Date reviewed: 26 April 2026

Please note that while reasonable care is taken to provide accurate information at the time of creation, we frequently update content and links as needed. If you identify any inconsistencies or broken links, please let us know by email.

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LGBTQIA+ Health and Inclusive Healthcare​

This collection of resources aim to support GP supervisors in their teaching and supervision of registrars who are providing medical services to lesbian, gay, bisexual, trans and non-binary, queer, intersex, asexual and other (LGBTQIA+) patients in general practice. 

Diverse sexual orientation, gender identity and sex characteristics are all included in the LGBTQIA+ acronym. A Standard for Sex, Gender, Variations of Sex Characteristics and Sexual Orientation Variables has been produced by the Australian Bureau of Statistics (ABS) in 2020 and provides a useful starting point of terms for clinicians to gain an understanding of the appropriate terminology.

The Victorian Government LGBTQIA+ Inclusive Language Guide expands on the above definitions

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Teaching LGBTQIA+ inclusive healthcare provides confidence and competence in your registrar’s ability to deliver appropriate care. A GP or practice nurse may be the first person someone talks to about their emerging diverse sexual orientation or gender identity, and this could happen at any age. Having a health professional who affirms their identity can be very therapeutic.

There are two major reasons for making the effort to know about an individual patient’s LGBTQIA+ status in clinical practice:

It provides a more holistic context about the life of that person, which is often desired by patients.
There are major health disparities for LGBTQIA+ people that require our attention and care.

LGBTQIA+ inclusive care requires a whole of practice approach, so that the person’s journey through the clinic is safe. Encouraging disclosure of LGBTQIA+ identities starts at the front door, as they need to feel they will be acknowledged and supported. This is particularly important for LGBTQIA+ patients who may have experienced negative attitudes from healthcare providers in the past.

In helping to create an inclusive environment, there are a range of readily available Australian tools to assist. One example is the Rainbow Tick, an accreditation program and framework for planning and implementing organisational change to facilitate LGBTQIA+ inclusive services. Another is the Pride in Health online benchmarking. Intersex community organisations offer the ‘Yellow Tick’ to improve understanding of the health needs of people with intersex variations.

  • Contraception, fertility, and pregnancy
  • Sexual Health
  • STIs
  • Smoking, Alcohol, and Drug Use
  • Cancer screening
  • Mental health

Date reviewed: 02 July 2026

Please note that while reasonable care is taken to provide accurate information at the time of creation, we frequently update content and links as needed. If you identify any inconsistencies or broken links, please let us know by email.

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Aboriginal and Torres Strait Islander Health

GP supervisors play a valuable and important role in promoting and supporting the cultural competence of their learners in Aboriginal and Torres Strait Islander health.

GP supervisors and the wider practice team should strive to create a culturally safe workplace and learning environment.
This page links to resources specific to Aboriginal and Torres Strait Islander health.

Resources
The key summary resource is the GPSA Guide to General Practice Training in Aboriginal and Torres Strait Islander Health.

Introduction to Aboriginal and Torres Strait Islander People and Their Health
Identifying Aboriginal and/or Torres Strait Islander Status
Clinical Yarning
Aboriginal and Torres Strait Islander Health Assessments
Acute Rheumatic Fever and Rheumatic Heart Disease
Best practice Aboriginal and Torres Strait Isander health – part 1Webinar and Podcast
Best practice Aboriginal and Torres Strait Islander health - part 2Webinar and Podcast
Clinical YarningWebinar and Podcast
Culturally Safe GP Registrar Supervision – Decolonisation and a Strengths-Based ApproachWebinar and Podcast
Teaching Yourself and Your Registrar About Aboriginal and Torres Strait Islander HealthWebinar and Podcast

FAQ
Telehealth and Aboriginal and Torres Strait Islander patientsWebinar and FAQ
Telehealth with Aboriginal patients who are hard of hearingFAQ
Australian Indigenous HealthInfoNet
Cultural Safety for Health Professionals
Overview of Aboriginal and Torres Strait Islander health status
RACGP Five Steps resource
Languages examples of the first nations people of Australia

Date reviewed: 02 July 2026

Please note that while reasonable care is taken to provide accurate information at the time of creation, we frequently update content and links as needed. If you identify any inconsistencies or broken links, please let us know by email.

This website uses cookies. Read our privacy policy.