MRCP PACES · FREE PRACTICE TOOL

Mark the performance.
Find the next behaviour.

Use this formative checklist after a spoken rehearsal with a study partner—or after watching your own recording. Grade what was observable across the seven PACES skills, then leave with one precise improvement target.

FORMATIVE SCORECARD

Grade one encounter

0 of 7 focused skills graded

0 satisfactory0 borderline0 unsatisfactory
A

Physical examination

Was the examination focused, systematic, fluent and explained to the patient?

Observed grade
Show calibration examples
Strong
Chooses and completes a task-focused sequence while monitoring comfort.
Incomplete
Broadly correct but disorganised, rushed or missing a discriminating component.
Unsafe
Causes avoidable discomfort, ignores consent or uses materially incorrect technique.
B

Identifying physical signs

Were present signs identified accurately, without inventing absent findings?

Observed grade
Show calibration examples
Strong
Separates observation from interpretation and describes discriminating signs precisely.
Incomplete
Finds the main abnormality but misses, mislabels or overstates relevant signs.
Unsafe
Reports important signs that are not present or misses a sign that changes immediate safety.
C

Clinical communication

Was information elicited and explained clearly, accurately and in a usable structure?

Observed grade
Show calibration examples
Strong
Adapts language, listens, signposts and checks understanding rather than delivering a speech.
Incomplete
Covers the facts but uses jargon, poor structure or little checking of understanding.
Unsafe
Gives materially false reassurance, misleading information or fails to communicate urgent risk.
D

Differential diagnosis

Did the candidate build and prioritise a sensible differential from the assessment?

Observed grade
Show calibration examples
Strong
States a concise leading diagnosis and plausible alternatives linked to discriminating evidence.
Incomplete
Produces a list without prioritisation or a clear connection to the findings.
Unsafe
Prematurely closes on an unsupported diagnosis or omits a time-critical alternative.
E

Clinical judgement

Were investigations and management prioritised, proportionate and safe?

Observed grade
Show calibration examples
Strong
Makes a definite next-step plan, explains why and states what would change it.
Incomplete
Suggests reasonable actions but without sequence, urgency, ownership or follow-up.
Unsafe
Delays urgent care, proposes a contraindicated action or leaves major risk unmanaged.
F

Managing patient concerns

Were concerns actively sought, acknowledged and addressed?

Observed grade
Show calibration examples
Strong
Elicits the real concern, responds to emotion and negotiates around the patient’s priorities.
Incomplete
Answers an expressed question but does not explore the meaning or check whether it was resolved.
Unsafe
Dismisses, minimises or overrides the patient’s concern without explanation.
G

Maintaining patient welfare

Were dignity, comfort, respect and safety protected throughout?

Observed grade
Show calibration examples
Strong
Consent, positioning, exposure, pain and escalation remain visible throughout the encounter.
Incomplete
Generally respectful but misses a comfort, dignity or safety check.
Unsafe
Continues despite distress, breaches dignity or fails to act on a serious deterioration cue.

NEXT ATTEMPT

Complete the focused skills first

Grade only what you genuinely observed. Use the calibration examples if the evidence is unclear.

This profile is deliberately not converted into a total or pass/fail result. It is a rehearsal aid, not an official marksheet or validated prediction.

HOW TO USE IT

A five-minute debrief that changes the next attempt

  1. Candidate goes first. Give a concise self-assessment before hearing the observer’s view.
  2. Use evidence. Replace “communication was good” with the exact phrase or behaviour observed.
  3. Separate skills. A correct diagnosis does not automatically mean satisfactory judgement, communication or welfare.
  4. Choose one target. Repeat the same encounter and look for that behaviour—not a vague improvement in confidence.

CALIBRATION

What the three practice grades mean

SATISFACTORY

Consistent and usable

The behaviour is clear, appropriately prioritised and sustained without prompting. Minor omissions do not undermine the task or patient safety.

BORDERLINE

Partly demonstrated

The right intent is visible, but performance is incomplete, poorly prioritised, hesitant or dependent on prompting.

UNSATISFACTORY

Absent, incorrect or unsafe

A required behaviour is missing or materially flawed, or the approach risks patient harm, loss of dignity or serious miscommunication.

This is a Clinora formative tool, not the official PACES marksheet. It does not calculate an examination score or predict a pass. Official examiners calibrate cases and apply the current MRCP(UK) assessment standard.