PQRST: A framework for case discussion and practice-based teaching in general practice training.

BACKGROUND:One of the most important roles of the general practice supervisor is that of clinical teacher. Practice-based teaching comprises formal (structured) and informal (opportunistic) teaching, both of which are primarily based on case discussion. There is no simple framework to guide effective case discussion across both forms of practice-based teaching. OBJECTIVE:In this article, a new five-stage model of case discussion is proposed: PQRST. The stages are: P - What is the patient's problem?, Q - What is the registrar's question?, R - How well does the registrar reason?, S - What is the solution?, and T - What can be taught? DISCUSSION:The PQRST framework has many benefits. It is a simple framework for case discussion for both formal and informal teaching settings. It emphasises the assessment of clinical reasoning, is time efficient and explicitly prioritises patient and registrar safety. Additionally, it is adaptable for registrars at all levels of training and/or competence.