Recognition, explanation, action, learning: Teaching and delivery of a consultation model for persistent physical symptoms

Kate Fryer, Tom Sanders, Monica Greco, Cara Mooney, Vincent Deary, Christopher Burton*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)
41 Downloads (Pure)


To describe the teaching and delivery of an extended consultation model designed for clinicians to use with patients with persistent physical symptoms and functional disorders. The model is underpinned by current scientific knowledge about persistent physical symptoms and the communication problems that arise in dealing with them.
Process evaluation of training and delivery of the Recognition, Explanation, Action, Learning (REAL) model within the Multiple Symptoms Study 3: a randomised controlled
trial of an extended-role GP “Symptoms Clinic”. Evaluation used clinician and patient
interviews and consultation transcripts
7 GPs were trained in the intervention and 6 of them went on to deliver the REAL
model in Symptoms Clinics either face-to-face or online. The Symptoms Clinic provided
a set of 4 extended consultations to approximately 170 patients. Evaluation of training
indicated that there was a considerable load in terms of new knowledge and skills.
Evaluation of delivery found clinicians could adapt the model to individual patients
while maintaining a high level of fidelity to its core components.
REAL is a teachable consultation model addressing specific clinical communication
issues for people with persistent physical symptoms.
Practice Implications
REAL enables clinicians to explain persistent physical symptoms in a beneficial way
Original languageEnglish
Article number107870
JournalPatient Education and Counseling
Early online date29 Jun 2023
Publication statusPublished - 1 Oct 2023

Cite this