Computer and AI in the Consultation – Bradford VTS

Communication Skills

The Computer and AI in the Consultation

Yes, you can type and listen at the same time. No, you can't do it well without being taught how. And yes, there's now an AI that wants to help — but read the small print first.

🎯 High-yield tips for AKT & SCA 💡 Knowledge not found elsewhere 👥 For Trainees, Trainers & TPDs

Last updated: April 2026

📥 Downloads 🔗 Web Resources 🏥 Why It Matters ⚡ Quick Summary 💻 Core Knowledge ▶ Training Videos ⚠️ Common Pitfalls 🗣 Consultation Phrases 🤖 AI in Consultations 📂 AI & ePortfolio 📚 AI for Revision 🟣 For Trainers 🔥 AKT Tips 🎯 SCA Tips ✅ Take-Home Points

📥 Downloads

Teaching resources, guides, and workshop materials — ready for learning, tutorial prep, or last-minute rescue revision.

path: USING THE COMPUTER IN THE CONSULTATION

🔗 Web Resources

A hand-picked mix of official guidance and real-world GP training resources. Because sometimes the best pearls are not hiding in the official documents.

Core Teaching Resources

▶ Bradford VTS: Computer in the Consultation Training Videos

The original five-part Bradford VTS video series — covering room setup, signposting, attention management, and shared screen use. The messages are timeless. Watch all five.

GP-Training.net: Computer in the Consultation

Comprehensive hub including Calgary Cambridge principles, skills-based approach, and teaching ideas.

Calgary Cambridge Computer Skills

Detailed guidance on applying the Calgary Cambridge framework specifically to computer use.

Skills-Based Approach — Notes for Trainers

Trainer-focused resource on structuring consultations around computer use effectively.

Teaching Ideas for the Computer Consultation

Workshop ideas and exercises for trainers exploring computer use with their trainees.

RCGP & Official Guidance

RCGP: AI in General Practice

RCGP position statement on AI in general practice — essential reading for context.

NHS England: AI Ambient Scribing Guidance (2025)

Official NHSE guidance on the use of AI scribes in primary care — including governance requirements.

GMC Good Medical Practice

Relevant to patient consent, data handling, and professional standards around technology.

AI Tools Referenced on This Page

Heidi Health — AI Medical Scribe

The most widely adopted AI scribe in UK general practice. Free tier available for daily clinical use.

Accurx Scribe (Tandem Health)

Integrated into Accurx — reaches 98% of GP practices. MHRA-registered Class I medical device.

Tortus AI Scribe

Ambient scribe with a major NHS nine-site evaluation — strong evidence base in hospital and primary care.

Learner+ AI Reflective Tool — KSS Pilot

Pilot of AI-enhanced reflective practice for GP trainees — 24-trainee study using CMEfy platform.

🏥 Why This Matters in GP

Because the computer is always there — and most of us were never taught how to manage it well.

The Hidden Third Presence

When a patient walks into your consulting room, there are three things in that room: you, the patient, and the computer. Most consultation models were developed before computers were ubiquitous. They focus on the doctor-patient relationship — but now there's a screen that demands your attention too.

How you manage that screen either enriches the consultation or damages it. There is no neutral. Every second you spend looking at the screen without signposting your attention is a moment the patient feels ignored. And ignored patients are dissatisfied patients.

Why Trainees Struggle Here

Very few medical schools teach computer use in consultations. Most trainees arrive in GP having learnt consultation skills purely as a human interaction — no screen, no keyboard, just eye contact and listening.

GP suddenly changes that. The result? Trainees often make one of two mistakes: either they stare at the screen for long stretches (losing rapport completely), or they avoid the computer entirely (and produce inadequate records). Neither is acceptable. There's a third way — and it's learnable.

💡 Insider Tip: What Your Notes Say About You

At Bradford VTS, we've noticed something consistent: the way a trainee writes up their consultation notes often mirrors the quality of their consultation itself. Unstructured, rambling notes usually mean an unstructured consultation. Orderly, comprehensive notes — covering presenting problem, relevant history, examination, assessment, and plan — usually reflect a similarly organised mind at work during the consultation. If you want to know how your consultation went, look at what you typed afterwards. It's a mirror.

🖥️ The Computer and AI in the Consultation — Key Points

The computer is a third presence in the room — and it affects rapport if you ignore it
Aim for the equilateral triangle: doctor, patient, and screen at equal distances
You cannot pay full attention to the screen AND the patient simultaneously — plan around this
Verbal signposting tells the patient where your attention has gone: "Let me just make a note of that…"
Non-verbal signposting — turning back to the patient, re-establishing eye contact — maintains rapport
Use natural pauses in the consultation to type — not when the patient is talking
The screen can be a shared resource — showing results, diagrams, or leaflets together
How a trainee writes up their notes often mirrors how they consult — structured notes = structured mind
AI scribes (e.g. Heidi) are transforming documentation in UK GP — 51% reduction in in-consultation documentation time in major trials
Bradford VTS believes: trainees should not use AI scribes as a substitute for developing consultation skills — earn the tools first
AI can be used by trainees as a reflective tool — run Heidi passively and use it to critique your own work
AI for revision? Absolutely — it is one of the most powerful learning tools available if used correctly

📐 Room Setup — The Triangle Principle

The single most important thing you can do before a consultation starts is arrange your physical environment well. Most consultation room problems with the computer are caused by poor room setup — not poor skills.

The Goal: An Equilateral Triangle

Position yourself, the patient, and the screen so all three are roughly equidistant from each other. This gives you easy visual access to the screen without completely turning away from the patient.

Setup Type	Advantages	Disadvantages
Screen beside you, angled towards patient (ideal)	Natural triangle; patient can see screen; easy to share information; minimal body rotation needed	Requires some room setup effort; patient sees all your notes
Screen directly in front, patient beside	Familiar for many doctors	Turning to screen = turning away from patient; shoulders signal cut-off
Screen behind doctor, patient faces doctor	Maximum face-to-face focus	Must turn full 180° to use computer; awkward and disruptive

🔧 Practical Tip: Extension Cables

If your room setup is suboptimal, use extension cables for the screen, keyboard, and mouse to allow repositioning. Most GP consulting rooms allow this. It's a simple change that makes a big difference. Ask your practice manager.

🧠 The Dual-Attention Problem

Here is the central truth about the computer in the consultation: you cannot give full attention to two streams of information simultaneously, especially when both involve language.

When you are reading from or typing into the computer, your attentional capacity for listening to the patient is significantly reduced. This is not a personal weakness — it is a feature of human cognition. The research on this from the original iiCR (Information in the Consulting Room) project makes this clear: GPs whose attention was fully on the screen consistently failed to notice — or respond to — what patients said.

What You Can Do About It

Identify natural pauses in the consultation where typing won't interrupt the patient's story

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Signpost clearly — verbally and non-verbally — when your attention shifts to the screen

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Look back at the patient and re-establish eye contact before continuing the conversation

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Chunk your keyboard work: brief bursts, not long stretches of typing mid-flow

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Structure the consultation so history-taking and computer-use don't overlap

⚠️ The Most Common Mistake

Typing while the patient is speaking. This is almost universal in new trainees. It says to the patient: "My notes are more important than what you're saying right now." The fix is simple: stop typing, look at the patient, listen. Then type. Not simultaneously.

📢 Signposting: Verbal and Non-Verbal

Signposting is the skill of telling the patient where your attention is going — and then bringing it back. Done well, it maintains rapport even when you're looking at the screen. Done poorly (or not at all), it makes every moment at the keyboard feel like a rejection of the patient.

🗣️ Verbal Signposting

Telling the patient what you're doing:

"Let me just make a note of that…"
"I'm going to pop that into your records."
"Just typing that in while it's fresh…"
"I just need to check something in your notes — bear with me a moment."
"Let me pull up your last blood results so we can look at them together."
"I'm going to note down what we've decided — that way it's there for you next time too."

👁️ Non-Verbal Signposting

Showing the patient what you're doing:

Deliberately turning towards the screen (signalling the shift)
Turning back to the patient after typing (re-engaging)
Making eye contact before resuming conversation
Open body posture even while typing
Brief nodding while typing to show you're still listening
Leaning slightly back from the screen to maintain open posture

🟢 The Turn-Back Signal

The most powerful non-verbal signpost is the moment you turn back from the screen to the patient. It says: "I was briefly elsewhere, and now I'm fully back with you." Practise making this deliberate and clear. Combine it with a brief phrase or an open question and it becomes almost seamless.

🎓 The Calgary Cambridge Way: Computer-Specific Skills

The Calgary Cambridge Guide to the Medical Interview is the gold standard framework for GP consultation skills. It explicitly recognises the computer as part of the consultation environment. Here are its key computer-specific guidance points:

Calgary Cambridge Point	What It Means in Practice
Uses notes/computer in a manner that does not interfere with dialogue or rapport	Your computer use must serve the consultation — not disrupt it. The moment typing starts to fracture the conversation, stop typing.
Uses verbal and non-verbal signposting when shifting attention to screen	Never silently turn to the computer. Always signal the shift — verbally, physically, or both.
Controls consultation structure to minimise risk of patient talking when attention is on screen	Be proactive. Use natural pauses — after a summary, after a closed question — to type. Not mid-story.
If using computer as an information source, negotiates this with patient	"Would you mind if I just looked that up quickly — I want to make sure I give you the right information." The patient feels included, not excluded.
Lets patient read information from screen when appropriate	The screen is a shared resource. Turn it towards the patient. Show them their results. Share a diagram. Make it collaborative.
Responds to patient cues even when attending to computer	You are never so absorbed in typing that you miss a patient's change in tone, hesitation, or distress signal. Peripheral awareness must stay active.

🗂️ Structuring the Consultation Around the Computer

The best GPs have learnt to sequence their computer use — placing it at points in the consultation where it adds value and causes minimum disruption. Here is a practical framework:

+ Before the Patient Comes In — Preparation

Briefly review the reason for attendance and recent relevant entries
Note any outstanding results, medications, or alerts that may be relevant
Check problem list, active medications, and allergies
This takes 60–90 seconds but can save significant time in the consultation itself
The well-prepared doctor can look at the patient during the consultation, not at the screen to find basics

+ During the Opening — Minimal Computer Use

The opening of the consultation is the most relationship-critical moment. This is where rapport is built or lost. During the first minute:

Maintain eye contact — do not look at the screen
Allow the patient to start their story without interruption
Use active listening skills fully — the computer can wait
If you must note something urgently, do so with verbal signposting: "Let me just note that…"

+ During History Taking — Strategic Typing

History-taking is when most trainees get into trouble. They try to type everything the patient says in real time — and end up doing neither well.

Take brief mental notes or jot on paper first, then type at natural pauses
Type after the patient completes a story segment — not while they're mid-sentence
Use brief verbal signposts to normalise computer use: "I'm keeping up with your story — just noting that…"
Learn to touch-type if you haven't already — it keeps your eyes on the patient more

+ During Examination — Pause Computer Work

When examining the patient, stop typing entirely
After the examination, summarise findings and note them together: "Let me just record what I found…"
Recording findings verbally while examining ("blood pressure is 128 over 80") works well and keeps the patient informed

+ During Explanation & Management — Shared Screen

This is where the computer can be your greatest ally — if you use it actively with the patient:

Show the patient their results on screen — turning the screen towards them is powerful
Display a relevant diagram or patient leaflet from an approved source
Show the patient the safety-netting advice you're generating so they understand it
Involve the patient in documenting the agreed plan: "I'm writing down that we've agreed to try X for four weeks — is that right?"

+ At the Close — Final Check

Complete the consultation record fully before moving on — brief notes mid-consultation mean more thorough completion is still needed
Check prescriptions are correct before printing or sending electronically
Make sure safety-netting instructions are documented, not just said
Check coding — a well-coded consultation makes your data valuable for audit and QI work

✍️ Writing Up Consultations

The medical record is both a clinical document and a communication tool. In UK general practice, it is also a legal record. What you write — and how you write it — matters enormously.

The Structure of a Good Consultation Record

Component	What to Include	Why It Matters
Presenting complaint	The patient's main concern in their words or a brief summary	Identifies the agenda at a glance; legally establishes why they attended
History	Key features, duration, relevant positives and negatives	Provides context for decisions; supports any future medicolegal review
Examination	Relevant findings (and relevant negatives)	Demonstrates clinical reasoning; relevant negatives can be as important as positives
Assessment/Impression	Your working diagnosis or differential	Shows clinical thinking; supports continuity of care
Plan	What was agreed, prescribed, investigated, or referred	Actionable; enables follow-up; creates a shared record with the patient
Safety-netting	What was said about red flags, follow-up, and return criteria	Medico-legally critical; documents that appropriate advice was given

🚨 Medico-Legal Alert: If It Isn't Written, It Didn't Happen

In any complaint or legal review of a consultation, what matters is what is in the notes. "I said it but didn't write it" provides almost no protection. Always document safety-netting advice, shared decision-making discussions, and any significant uncertainty about the diagnosis. These are the things that protect both patient and doctor.

🟢 Good Coding = Good Medicine

Accurate Read/SNOMED coding is not just bureaucracy. It drives QOF, disease registers, population health management, and audit. A well-coded consultation record is a contribution to your practice's data quality and your patients' long-term care. Make it part of your habit from day one.

🤝 The Computer as a Shared Resource

Used wisely, the screen becomes a tool that enhances — rather than disrupts — the consultation. Here are some examples of excellent shared use:

📊 Showing Results Together

Turn the screen towards the patient and walk through their blood results or ECG together. "This number here is your cholesterol — you can see it's come down since last time." Patients find this highly engaging and it builds trust.

📋 Shared Decision-Making

Show the patient the options you're considering. Some GPs open a relevant NICE patient decision aid on-screen and work through it together. This transforms a prescription into a joint decision.

🔍 Looking Things Up Together

"I want to check the latest guidance on this — would you mind if I looked it up quickly?" Patient sees you as thorough and honest, not uncertain. You model intellectual humility rather than hiding it.

📄 Patient Information Leaflets

Show the patient a PIL on-screen before printing or sending it to them. Review the key points together so you know they understand it, not just that they have it.

▶ Bradford VTS Training Videos

These five videos — from the Bradford VTS YouTube channel — cover the key skills of computer use in the consultation. They are a little older but the teaching is timeless and still directly relevant to SCA preparation today. The messages, as the original page says, are "simply ace."

📺 How to Use These Videos

Watch them actively — not passively. After each video, ask yourself: what did the doctor do well with the computer? What would I do differently? What can I apply tomorrow in clinic? Even better — watch them with your trainer and discuss using the Calgary Cambridge guide as a framework.

▶️ Part 1: Introduction & Room Setup

Part 1 — Introduction to the Computer in the Consultation

Covers the rationale for why computer skills matter in the consultation and the basic principles of room setup and the triangle model.

▶️ Part 2: Signposting Skills

Part 2 — Verbal and Non-Verbal Signposting

Demonstrates how to tell the patient where your attention is going — and bring it back. Key signposting phrases demonstrated in action.

▶️ Part 3: The Dual-Attention Problem

Part 3 — Managing Attention in the Consultation

Explores the dual-attention problem and demonstrates strategies for structuring the consultation to minimise conflict between patient-focus and computer-use.

▶️ Part 4: Screen as Shared Resource

Part 4 — Using the Screen as a Shared Resource

Practical demonstrations of showing results, patient information, and decision-support tools on-screen with the patient.

▶️ Part 5: Good vs Poor Computer Use

Part 5 — Putting It All Together

A comparative demonstration of poor versus good computer use in the same consultation scenario — ideal for tutorial discussion using the Calgary Cambridge observation guide.

▶ Watch the Full Bradford VTS Playlist on YouTube →

🚫 During Consultations

Typing while the patient is speaking — the single most damaging habit
Long silences at the keyboard with no signposting whatsoever
Shoulders turning away from the patient while reading the screen
Hunching over the keyboard — uncomfortable for you, isolating for the patient
Failing to re-establish eye contact after a period of screen use
Reading the previous notes during the consultation as if the patient isn't there

⚠️ In Medical Records

Incomplete records — "See history" or blank fields
No safety-netting documented
No record of shared decision-making
Vague assessments: "URTI — antibiotics" with no examination findings
Missing relevant negatives that justify a decision not to refer
Poor or missing coding

😬 In the SCA Context

The SCA is observed — examiners note non-verbal behaviour including how you manage the computer (in real practice COTs)
Trainees who type mid-consultation often miss cues — the patient's hesitation, a change in tone, a moment of distress
Some trainees use the computer as a displacement activity when a consultation is difficult — they type instead of addressing the awkwardness
The COT/audioCOT assessment explicitly includes non-verbal skills — poor computer management is visible on video review

🟣 What Trainers Notice

Trainees who write up notes after the patient leaves often produce better notes — but this isn't always feasible in busy clinics
The quality of notes often mirrors the quality of the consultation — poor structure in both tends to appear together
Trainees with good typing skills paradoxically sometimes have poorer consultation skills — they type faster, so they type more, so they look at the screen more
The best trainees integrate computer use so smoothly it's barely noticeable — the key is signposting and deliberate structure

🗣️ Useful Consultation Phrases: Computer-Specific

Natural phrases you can use today. Read once, use in clinic. These should feel human — not scripted.

Signposting — Typing

"Let me just make a note of that while you're telling me…"

Signposting — Typing

"I'm going to pop that into your records — carry on, I'm still with you."

Signposting — Reading

"Bear with me one moment — I just want to check something in your notes."

Shared Screen

"Let me show you what I'm looking at — can you see this result here?"

Looking Things Up

"I'd like to double-check the latest guidance on this — would you mind if I looked it up quickly?"

After Examination

"Right — let me note down what I found just now so we have it on record."

Closing Record

"I'm writing down our plan — that way it's there for any doctor you see in the future too."

Safety-Netting Documentation

"I'm going to note the warning signs we discussed — so it's on your record and you can check it via the app if you need a reminder."

Returning Attention

"Right — that's noted. Now, you were saying…" [turn back to patient, re-establish eye contact]

Re-engaging After Long Record Review

"Sorry for that pause — I needed to go through what happened last time. Now tell me more about…"

A Technology Shift That Is Already Here

In 2024 and 2025, AI-powered medical scribes quietly but rapidly transformed UK general practice documentation. These tools — of which Heidi Health is currently the most widely adopted in UK primary care — listen to the consultation in real time and generate structured clinical notes, referral letters, and care plans automatically. This isn't a future technology. It's already being used across thousands of GP consultations every day.

51%

Reduction in in-consultation documentation time (Modality/Heidi trial, 2025)

61%

Drop in after-hours admin work in the same trial

78%

GPs in trial reported building better patient rapport with AI scribe

40%

Approximate proportion of UK GPs now using AI tools (RCGP 2025)

🎙️ How AI Scribes Work

Patient gives verbal consent at start of consultation ("I use an AI tool to help me document our conversation — is that OK?")

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The AI scribe (e.g. Heidi) listens to the consultation via microphone — no audio is permanently stored

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During or immediately after the consultation, a structured clinical note is generated automatically

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The clinician reviews, edits, and approves the note before it enters the patient record

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Note is written directly into EMIS or SystmOne — no copy-paste required

⚠️ Non-Negotiable: The Clinician Always Approves

AI scribes occasionally make errors — omitting nuanced patient comments, misrepresenting clinical emphasis, or occasionally confabulating. The clinician must review and edit every AI-generated note before saving to the record. The AI generates the draft; the doctor is responsible for the final content. This principle is absolute.

🔒 Governance, Consent & Data Protection

Requirement	What This Means in Practice
Patient consent	Verbal consent before every consultation where AI is used. Patient has the right to decline without prejudice. A simple practice notice in the waiting room supports this but does not replace verbal consent.
DTAC compliance	Any AI tool used must meet the NHS Digital Technology Assessment Criteria. Check your tool is listed on the NHSE Assured Vendor Tool (AVT) registry.
MHRA registration	AI tools that summarise consultations must be registered as MHRA Class I medical devices. Heidi and Accurx Scribe are both registered.
GDPR / UK Data Protection Act	Audio is processed, not permanently stored. All data must be hosted in the UK. Heidi, Tortus, and Accurx Scribe all meet these requirements.
Practice DPIA	Your practice must complete its own Data Protection Impact Assessment (DPIA) before deploying any AI scribe tool locally.
NHSE April 2025 Guidance	NHS England published definitive guidance on ambient scribing in April 2025. This is the authoritative national framework for safe adoption.

🤔 Should GP Trainees Use AI to Transcribe Consultations?

🏛 Bradford VTS Position: Not as a Substitute — Earn the Skill First

Bradford VTS believes that GP trainees should not use AI scribes as a replacement for developing their own consultation documentation skills — at least not until they have demonstrated core competency in both the SCA and in writing up consultations independently.

Here's why. The way a trainee writes up their consultation notes is often a direct mirror of their clinical thinking. A structured, orderly write-up usually reflects a structured, orderly consultation. A vague, incomplete record usually reflects vague or incomplete clinical reasoning. Writing up is not an administrative afterthought — it is an active part of the learning process.

If trainees begin with AI scribes from day one, they risk outsourcing this formative thinking to a machine before they have developed the underlying skill themselves. The result is a generation of doctors who can produce good notes with AI assistance but cannot structure a consultation or a clinical record without it. That is a dependency, not a competence.

Our view: first learn to drive without power steering. Then use it, because why wouldn't you? The key word is "then." Use Heidi once you can do what Heidi does — it will then speed you up, not carry you.

📖 What Does the Research Say?

The evidence base specifically for AI scribes in GP training is still emerging. The current evidence — largely from qualified GP and hospital settings — shows real benefits in efficiency, documentation time, and clinician wellbeing. A 2024–2025 RCGP survey found approximately 40% of GPs now use AI tools, with significant time savings reported.

However, there is as yet limited published research on the specific impact of early AI scribe use on the development of consultation and documentation skills in medical trainees. What the broader educational literature does tell us — consistently — is that excessive reliance on AI tools before mastery of underlying skills can impair skill development (excess dependence on AI leading to "memory erosion" and reduced skill acquisition has been flagged in multiple educational systematic reviews, including Springer IJETHE 2025).

The pedagogical principle is well-established even if the specific GP evidence is still catching up: tools should augment mastered skills, not substitute for skills not yet acquired. Bradford VTS's position is consistent with both educational theory and clinical common sense.

✅ The Smart Way Forward: Heidi as a Reflective Tool

Here is something genuinely exciting. You can use Heidi Health as a trainee — but as a reflective and self-improvement tool, not a documentation shortcut. This is actually one of the most powerful learning applications available to trainees today.

🔍 Approach 1: Compare Your Write-Up with Heidi's

Write up your consultation yourself. Then look at what Heidi generated. What did you miss? What did Heidi structure differently? Where was your reasoning explicit in your notes — and where wasn't it? This comparison is illuminating and often humbling in the best possible way.

📋 Approach 2: Paste Your Notes into Heidi and Ask for Critique

If Heidi was running during the consultation, paste what you wrote into the chat and ask: "How could I improve this write-up?" or "What did I miss in this consultation?" You get immediate, specific, actionable feedback — without waiting for your tutorial.

💬 Prompts for Using Heidi Reflectively

Use these prompts in the Heidi chat interface (or any AI tool) after a consultation. Be specific — the more context you give, the more useful the feedback.

📝 Prompt 1: Reviewing Your Write-Up

Here is my write-up of a GP consultation I just had [paste your consultation notes here]. Please review this as a GP educator and tell me: 1. What is missing from these notes? 2. What is unclear or vague? 3. Is the safety-netting adequately documented? 4. What coding issues might arise from this entry? 5. How would you improve this record?

🎯 Prompt 2: Reflecting on Your Consultation Skills

Here is a transcript of my GP consultation [paste transcript from Heidi if available, or summarise the consultation]. Please evaluate my consultation on the following domains: 1. How well did I explore the patient's Ideas, Concerns, and Expectations? 2. How empathic was I — give me a score from 1 to 10 and specific examples. 3. What did I do well in this consultation? 4. What are two or three specific things I should do differently next time? 5. Were there any moments where my language was inadvertently dismissive or not patient-centred?

🌐 Prompt 3: Checking Your Language for Bias and Microaggression

Please review the following consultation transcript [paste transcript]. I would like to know: 1. How non-confrontational was my language overall — give me specific examples of phrases that worked well. 2. Were there any moments of microaggression or unintentional dismissiveness in my speech? Be direct. 3. Were there any assumptions I appeared to make about this patient? 4. How did I perform on inclusive, culturally sensitive communication? 5. Give me concrete examples of phrases I could use differently next time.

⏰ Prompt 4: Time Management and Consultation Structure

Here is a summary of my 10-minute GP consultation [paste summary]. Please comment on: 1. How well did I prioritise the agenda? 2. Were there any consultation skills I rushed or skipped? 3. Did I attempt all the components of a well-structured consultation? 4. How could I have managed the time more effectively while maintaining quality?

🏛 Bradford VTS Position: Yes — But to Think, Not to Write

The short answer is: yes, trainees should use AI to help with ePortfolio entries — but not to write them.

Here is the distinction that matters. The value of a FourteenFish ePortfolio entry does not come from the words on the page. It comes from the thinking that generates those words. The process of deciding what to write about, identifying a learning need, exploring your response to a clinical situation, and articulating your evolving understanding — that is what creates professional development. If an AI writes that for you, the words appear on the page but the learning does not happen.

AI can be genuinely valuable in helping trainees think more deeply about what to write. It can prompt reflection, help identify relevant RCGP capabilities, suggest angles the trainee hadn't considered, and challenge shallow entries. What it should never do is produce the entry in place of the trainee's own thinking.

👥 A Trainer's Responsibility

This doesn't just fall on trainees. Trainers need to be trained too. Using AI well in ePortfolio work requires trainers to understand what good AI-assisted reflection looks like — so they can support it, and so they can recognise when a trainee has used AI as a ghost-writer rather than a thinking partner. This is a legitimate area of trainer development in 2025 and beyond.

💬 Prompts for AI-Assisted ePortfolio Reflection

💭 Prompt 1: Choosing What to Write About

I am a GP trainee completing a Learning Log entry for my FourteenFish ePortfolio. I saw a patient today with [describe the clinical presentation briefly]. What happened was [describe what you did and what made this interesting or challenging]. Help me identify: 1. What the key learning points from this encounter are 2. Which RCGP Professional Capabilities this might map to 3. What reflective questions I should be asking myself about this case 4. What I should consider doing differently next time

📈 Prompt 2: Deepening a Shallow Reflection

Here is a draft Learning Log entry I've written for my FourteenFish ePortfolio: [paste your draft entry] Please act as a critical GP educator and challenge this entry. Tell me: 1. Where is this reflection too shallow or descriptive rather than truly reflective? 2. What questions should I be asking about my own values, assumptions, or clinical reasoning? 3. What would make this a stronger, more meaningful entry? 4. Is there relevant RCGP curriculum content I should reference? Note: I want to improve my OWN entry — please do NOT rewrite it for me. Just guide my thinking.

🗂 Prompt 3: Mapping Evidence to Capabilities

I have completed the following clinical activity [describe it]. I want to use this as evidence in my FourteenFish ePortfolio. Please help me think through: 1. Which of the 13 RCGP Professional Capabilities this activity most strongly demonstrates 2. How I might articulate my learning in relation to those capabilities 3. What additional evidence I might gather to strengthen this area 4. Whether this experience reveals any gaps in my training that I should address in my PDP

🚀 The Learning Potential is Extraordinary

Here's what the research suggests: AI tutoring systems — when used with active engagement, spaced repetition, and deliberate practice — produce learning gains that significantly exceed passive study methods. Studies consistently show meaningful improvements in retention and performance compared to static textbooks or reading alone. Intelligent tutoring systems have been found to be among the most effective educational interventions available (Frontiers in Education, 2025; Springer 2025).

What this means for a GP trainee is simple: a well-prompted AI revision session is more effective than reading the same page for the fifth time. The AI can ask you questions, quiz you, explain the reasoning behind answers, correct your misunderstandings in real time, adapt to your level, and create entirely new practice scenarios on demand.

📌 Two Important Caveats

1. AI needs to be verified. For any clinical fact, prescribing information, or guideline content — verify against NICE CKS or the BNF. AI tutors occasionally produce errors, especially on specific thresholds or recently updated guidelines. Treat AI content as a starting point for active retrieval — not as a definitive clinical source.

2. Trainees need training to use AI for revision. This is genuinely a skill. Passive AI use ("explain this topic to me") is less effective than active AI use ("quiz me, test my understanding, challenge my reasoning"). The prompts below are designed to teach active use.

🔥 AI Prompts for AKT Revision

These prompts use active learning — quiz, challenge, and spaced repetition strategies. Use them in Claude, ChatGPT, or any capable AI tool.

📝 AKT Prompt 1: Topic-Based Quiz

You are an expert RCGP AKT examiner. I am a GP trainee preparing for the AKT. Quiz me on [TOPIC — e.g. hypertension management, type 2 diabetes, contraception]. Format: 5 single-best-answer MCQs with 5 options each, at AKT difficulty level. After each question I answer, explain why the correct answer is right AND why each distractor is wrong. Focus on guideline-specific thresholds, first-line vs second-line distinctions, and common MCQ traps on this topic. Start with question 1.

⚡ AKT Prompt 2: Rapid-Fire High-Yield Facts

Give me the 10 most commonly tested AKT facts on [TOPIC]. Format as: "Key Fact: [fact] — Why It's Tested: [brief explanation of why examiners love this one]." Include any recently updated NICE guidance that changed the 'right answer' on this topic. Include specific numbers, thresholds, and first-line choices. Then quiz me on these 10 facts one by one — wait for my answer before revealing the correct one.

🕳️ AKT Prompt 3: Finding Knowledge Gaps

I am going to answer 10 rapid-fire questions on [TOPIC] without looking anything up. Ask me one question at a time. After all 10, give me a personalised summary of: 1. Which specific areas I answered correctly 2. Specific knowledge gaps identified from my wrong answers 3. Which NICE guidelines I should read to address these gaps 4. 3 mnemonics or memory frameworks that might help me remember the areas I missed Start question 1 now.

🔄 AKT Prompt 4: Spaced Repetition Review

I studied [TOPIC] last week. I'm going to test my retention now. Give me 8 questions that target specifically: - The threshold numbers and trigger values (e.g. BP targets, HbA1c targets, cholesterol thresholds) - First-line treatment choices vs second-line - Contraindications and cautions - Monitoring requirements After I answer all 8, tell me what I've retained well and what I need to re-study. Start question 1.

🎯 AI Prompts for SCA Revision

Use these to practise consultation skills, get feedback on your approach, and explore difficult SCA scenarios.

🎭 SCA Prompt 1: Role-Play Consultation

You are a patient in a GP consultation. I am a GP trainee practising for the SCA. The scenario is: [describe the scenario — e.g. "You are a 45-year-old woman presenting with low mood for 6 weeks. You are worried it might be more serious but haven't said this yet. You're also concerned about medication side effects."] Start the consultation as the patient. Stay in character throughout. When I signal "STOP — feedback please," come out of character and give me detailed feedback on: 1. How well I explored your ICE 2. How empathic I was — with specific examples 3. What I did well 4. What I should do differently 5. What specifically would have scored marks in the SCA Ready? I'll begin: [type your opening]

🔑 SCA Prompt 2: High-Yield Scenario Debrief

I just completed a practice SCA consultation on [scenario description]. Here is what I did: [describe your approach]. Please give me feedback as an experienced RCGP SCA examiner: 1. What would have scored well? 2. What would have lost marks? 3. What did I miss that examiners specifically look for in this type of case? 4. How should I approach this type of scenario differently? 5. What are the 3 most important things to do in any consultation of this type?

💬 SCA Prompt 3: Practising Difficult Conversations

Help me practise handling a difficult consultation moment for the SCA. The scenario is: [e.g. "A patient is angry because they feel they have been waiting too long for a referral. They are raising their voice."] Give me 3 different ways I could respond to this patient — ranging from least to most effective. Then explain what makes the most effective response work, and how I can adapt it to different patients. Then role-play as the patient so I can practise responding myself.

🗣️ SCA Prompt 4: Safety-Netting Practice

Help me practise safety-netting for the following clinical scenario: [describe it]. First, explain what the key safety-netting points are for this presentation. Then role-play as the patient and ask me to deliver the safety-netting to you. After I've done it, tell me: 1. Did I include all the essential points? 2. Was my language clear and understandable for a patient? 3. Was I appropriately specific about when to return and what to watch for? 4. What would have scored marks in the SCA?

🟣 Teaching Pearls for Trainers & TPDs

Common Trainee Blind Spots

Most trainees don't realise how much time they spend looking at the screen until they watch themselves on video
Fast typists often have worse screen habits than slow typists — the fluency makes them less deliberate
Trainees who came from surgical backgrounds or specialties without computers in consultations often find this hardest
IMGs may have encountered completely different consulting environments — some have never consulted with a computer at all

Tutorial Ideas

Video review exercise: Watch a COT video together and use the Calgary Cambridge guide's computer items specifically — count the signposts, identify the missed cues
Comparison exercise: Ask the trainee to write up two consultations — one immediately after seeing the patient, one from memory an hour later. Compare the quality. Discuss what this reveals about their consultation structure.
The 30-second rule: Ask the trainee to time how long they spend at the screen without signposting in their next five consultations. The results are usually surprising.
The notes as mirror: Discuss the trainee's consultation notes with them — ask them to walk you through the consultation based on what they wrote. Gaps and ambiguities in the notes usually map to gaps in the consultation itself.

Reflective Questions for Trainees

"Watch your COT video back — count the number of times you looked at the screen for more than 10 seconds without signposting. What's your number?"
"When you look at your notes from that consultation — does the record tell the story of the consultation? Would another doctor be able to understand what happened and why you made the decisions you did?"
"What is your strategy for typing when a patient is in mid-story? Talk me through it."
"Can you think of a consultation where the computer helped you — where you actively used the screen to add value? What did you do?"
"You've been using Heidi in clinic — what has comparing your notes to the AI transcript taught you about your consultations?"

The AI Conversation with Your Trainee

Have an explicit conversation about AI scribes early in the placement — what they are, when they're appropriate, and Bradford VTS's position on their use in training
Consider introducing Heidi reflectively with trainees who are ready — using the reflective prompts on this page as a tutorial tool
Trainers themselves should be familiar with Heidi and similar tools — it is no longer acceptable to be completely unfamiliar with technology your trainees are using or will soon be using
Discuss the distinction between AI as a crutch and AI as a tool — trainees need to understand this clearly to make good decisions independently

🔥 AKT High-Yield Tips

The computer in the consultation is unlikely to appear as a direct AKT topic — but the related themes of data protection, GDPR, consent, and medical records absolutely do.

🔥 AKT High-Yield: Data, Records & Consent

GDPR and the UK Data Protection Act 2018 — patients have rights of access to their records; erasure rights are limited in medical records (public interest exception usually applies)
GP records are retained for the patient's lifetime ("continual for a living patient" — NHS Records Management Code of Practice 2021; NHS England GP Records guidance) — they follow the patient throughout their life and are not routinely destroyed while the patient is alive
Hospital/secondary care records: minimum 8 years for adults after last treatment; children/young people — retained until 25th birthday (or 26th if aged 17 at conclusion of treatment); mental health records — 20 years after last contact (or 8 years after death if sooner)
Subject Access Requests (SAR) — must be fulfilled within one month (extendable by two further months for complex requests)
Information governance — the Caldicott Principles govern NHS use of patient data; there are now 8 principles (updated 2020 to add "the duty to share" as Principle 8)
Read/SNOMED coding — accuracy matters for QOF, disease registers, and public health; coding errors can affect patient care
Patient's rights to view records — GP systems (e.g. SystmOne, EMIS) allow patient-facing record access; patients can request entries be marked sensitive
AI tools in NHS primary care — must be DTAC compliant and MHRA-registered if performing summarisation; clinician always responsible for final clinical record
Third party information in records — information provided by a third party about a patient cannot be disclosed to the patient if the third party would be identified without their consent

🎯 SCA High-Yield Tips

How computer use — and the skills around it — appear in SCA performance.

🎯 SCA High-Yield: Computer Consultation Skills

🚩 Red Flags You Must Not Miss in the SCA

The COT (Consultation Observation Tool) assessment explicitly includes non-verbal skills — poor computer management is visible on video review
Any moment where typing prevents you from responding to a patient cue is a potential mark-loser
Failing to safety-net — and failing to document that you safety-netted — are both assessed

💡 What Examiners Love to See

Smooth, natural verbal signposting when using the computer — it shows awareness and communication skill simultaneously
The screen used as a shared resource — showing the patient their results, walking through options together
Clear, structured consultation notes that demonstrate the same structure as the consultation itself
Safety-netting that is documented and explicitly mentioned to the patient
Shared decision-making that is evidenced in both the verbal interaction and the written record

⚠️ Common Candidate Mistakes in Observed Consultations

Typing during the patient's narrative — misses cues, damages rapport visibly on video
Long silent periods at the keyboard with no signposting
Writing inadequate or vague notes after an otherwise good consultation — notes are assessed too
Forgetting to turn back to the patient after a period of screen use
Using the computer as an avoidance behaviour in difficult consultations — typing rather than addressing the moment

🎯 SCA Consultation Pearl

The computer should be invisible. The best consultation is one where the patient barely notices the computer is there — because your signposting is so fluent, and your return to them so natural, that it feels like a seamless conversation. That's the standard to aim for. It takes practice. Start practising now.

✅ Final Take-Home Points

The computer is the third presence in every GP consultation — manage it deliberately or it will manage you
Aim for the equilateral triangle: doctor, patient, and screen at equal distances from each other
You cannot pay full attention to the screen and the patient simultaneously — structure your consultation to prevent this conflict
Verbal signposting ("Let me just note that down…") and non-verbal signposting (turning back, re-establishing eye contact) are learnable skills — practise them until they are automatic
Your consultation notes are both a clinical document and a mirror of your clinical thinking — make them count
AI scribes are transforming UK general practice documentation — 51% reduction in documentation time, 78% of GPs reporting better patient rapport in major trials
Bradford VTS believes trainees should earn their consultation skills before using AI to shortcut them — learn to drive before using power steering
That said, Heidi Health used reflectively — comparing your notes to the AI transcript, asking for feedback on your consultation — is one of the most powerful learning tools available to trainees today
AI for ePortfolio: use it to think, not to write. Guide your reflection, don't outsource it.
AI for revision: transformative if used actively. The prompts on this page are your starting point.
Whatever AI tools you use — always verify clinical content against NICE CKS or the BNF. AI makes mistakes. Clinicians are responsible for the final record.

Using the computer in the consultation

Using the Computer in the Consultation – part 1

Using the Computer in the Consultation – part 2

Using the Computer in the Consultation – part 3

Using the Computer in the Consultation – part 4

Using the Computer in the Consultation – part 5