Consultation Observation Tool – COT

COTS are only undertaken in general practice placements – whether this be in ST1,2 or 3. Their hospital based equivalent is the mini CEX. The starting point for discussion can be

  • – a video recorded consultation
  • – an audio recorded consultation (audio COT)
  • – a consultation directly observed or listened to by your trainer eg in a joint surgery.


Consultations should be selected across a range of patient contexts and over the entire period of training spent in general practice and should include at least one case from each of the following categories:

  • Children (a child aged 10 or under)
  • Older adults (an adult aged more than 75 years old)
  • Mental health

It is likely that more evidence will be generated from consultations with greater complexity . Your trainer will then use the COT framework to discuss your performance with you and record their observations in your eportfolio. You can use a COT mapping sheet like the one below, to demonstrate how you have covered the range of capabilities in your COTS and upload this as supporting documentation in your e-portfolio. In all cases the patient must give consent in accordance with the guidelines for consenting patients.

cot mapping sheet