Feedback:: Subcutaneous Injection Teaching:: Attempt 1:: A PLAB 2 Mock

Mock Date: 14/06/2025
Case 1:
Topic: Teaching Case UID: TeachingProcedures5
Case Name: Subcutaneous Injection
Action Items:
Practice and Review the case in the OSCE workbench:	Click Here
Watch the (Private) Mock Test Video Recording:	Click Here
Read the Case Blog:	Click Here
Additional Resources:	Click Here
Deep Dive into your (Private) performance below:
Scenario Summary:
You are an FY2 doctor in the Emergency Department. Dale Morton, a 3rd-year medical student, approaches you to learn how to perform subcutaneous injections because he understands its significance. He is eager and motivated. Your task is to teach him the detailed steps and answer his questions about the procedure, without asking him to perform it.
My Performance:
🔍Let’s Deep Dive into your performance:
The Domain-wise evaluation shows areas where you did well and others where you have room to grow.
A "Yes" means you covered that point effectively
A "Partial" indicates that you did some of it well but missed some key details.
A "No" means there was an important opportunity that wasn’t addressed.
Don’t worry if you see several areas marked "No" or "Partial"—this is common and simply highlights where you can focus your learning.
By reflecting on these areas and practising, you’ll be able to improve and feel more confident in your consultations. Remember, every bit of feedback is an opportunity to grow, and you’re on the right path by taking these steps.
Timestamps are provided to show exactly when during the consultation you covered or missed key points. Reviewing these can help you see how well you're managing your time and where you might need to be more efficient in addressing important areas.

Domain	Point	Timestamp	Remarks
Data Gathering	Friendly Greeting: 'Hi, you must be Dale. I’m Dr. [Your Name], one of the FY2 doctors. How is your rotation going?'	1:00	You introduced yourself but did not greet Dale in the friendly and complete format as suggested. You missed a chance to ask how the rotation was going to help reduce tension.
Data Gathering	Initiate light conversation to build rapport and reduce tension (e.g., “How’s your rotation going?”).	1:00	You missed this simple opportunity. Asking something light like “How’s your rotation going?” could’ve helped the student feel more comfortable right at the start.
Data Gathering	Gauge Understanding: 'What do you know so far about subcutaneous injections?' Explore the student’s current understanding of the technique.	1:01	You asked Dale what he knows about subcutaneous injections, and he explained his limited experience. This was a good start.
Data Gathering	Ask why the student wants to learn this skill and how it fits into their current goals.	1:01	You let Dale explain why he wants to learn the skill and how it’s relevant to his career, which was appropriate.
Data Gathering	Ask if the student has ever seen or assisted with a subcutaneous injection before.	1:01	This was covered when Dale shared he had seen injections being given.
Data Gathering	Ask Dale to summarize key points at intervals, to gauge understanding	–	At no point did you ask Dale to summarize anything. This would have shown whether he was retaining the key steps.
Data Gathering	Check comprehension periodically by asking the student to summarise or repeat important points. Use open-ended questions.	–	You didn’t check Dale’s understanding during or after your explanations. Asking “Can you explain back to me the steps?” would have helped both you and Dale.
Data Gathering	Correct misunderstandings immediately.	–	No obvious misunderstandings were corrected. However, you also missed a chance when Dale asked, “Why this layer?” to elaborate better on the pharmacokinetics.
Management	Set the learning agenda: explain that you will go through preparation, technique, safety and precautions	–	You didn't clearly set out the learning agenda. It helps to break it down for the student e.g. “We’ll start with preparation, then the procedure itself, followed by safety precautions, okay?”
Management	Set the Scene: 'Today, we’ll go through the steps of performing a subcutaneous injection. If you have any questions, feel free to ask. Ready to start?'	1:01	You mentioned the topic of teaching but didn’t set a formal scene or invite questions clearly at the start. A structured intro would help orient the student more effectively.
Management	Explain the Importance: Subcutaneous injections are widely used for...	2:00:00	You explained the importance partially (mentioning insulin, heparin), but missed vaccines and palliative care drugs. Try to be more comprehensive for full marks.
Management	Equipment Preparation: Gather syringe, needle, medication, alcohol swabs, gauze, and a sharps bin.	–	You did not describe the necessary equipment. This is essential for procedural teaching.
Management	Medication Check: Verify medication name, expiry date, and dosage, preferably with a witness.	–	This was not mentioned. Teaching safe practice includes emphasizing this important check.
Management	Pre-Procedure: Confirm patient identity and check for allergies	5:00:00	You did well to include confirming identity and allergies, although this could have been presented more clearly.
Management	Inspect and select an appropriate injection site. Describe the proper injection sites and rationale	3:00:00	You mentioned abdomen, thigh, arm – but did not include buttocks or explain the rationale for choosing sites like tissue quality or patient preference.
Management	Clean the area, pinch the skin, inject at a 45 to 90-degree angle, and apply gauze	6:00:00	You explained this clearly with appropriate technique.
Management	Explain post-injection steps: withdraw needle, apply gauze gently, and safely discard sharps	7:00:00	You described withdrawing the needle, applying gauze, and disposing of sharps. Good job.
Management	Discuss key precautions: avoid inflamed or scarred areas, rotate sites, maintain aseptic technique	1:07	You explained site rotation and mentioned cleaning the area, but didn’t mention avoiding inflamed/scarred areas or maintaining aseptic technique explicitly.
Management	Describe potential complications of poor site rotation, like lipodystrophy, and why they matter	7:00:00	You mentioned fat reducing in an area with repeated use, which implies lipodystrophy.
Management	Proactively offer your contact details for follow-up or to schedule another session. Offer safety netting.	–	You did not offer further support or contact. Ending with a line like “Feel free to reach out if you’d like to practice this” could really help.
Management	Offer the student relevant leaflets or direct them to trusted online resources (e.g., NHS guidelines)	–	No mention of additional resources or reading material. Consider directing students to university portals or NHS skills videos.
Interpersonal Skills	Use Simple Language. Do not use any technical terms without explaining them after	1:02	You avoided heavy jargon and explained terms like “subcutaneous layer.” Keep up the clear, simple phrasing.
Interpersonal Skills	Encourage Questions: 'Feel free to ask questions anytime.'	1:04	You explicitly encouraged questions. Good use of inclusive teaching style.
Interpersonal Skills	Be Supportive: 'It’s normal to feel a bit anxious about this procedure. I’m here to help.'	–	You missed an opportunity to reassure Dale. Even a small supportive phrase like “Don’t worry, I’ll guide you through” would help.
Interpersonal Skills	Use simple language to explain concepts	1:02	You used simple and understandable terms throughout.
Interpersonal Skills	Actively listen and provide constructive feedback	–	While you responded to questions, there was no constructive feedback or praise for the student’s input. A simple “That’s a good observation” would’ve been helpful.
Interpersonal Skills	Suggest additional resources for further learning	–	This was not mentioned. Suggesting ClinicalSkills.net or NHS Learning Hub could add value to your teaching.

	Feedback Statements:	Needs Improvement
Consultation	Disorganised / unstructured consultation. Includes illogical and disordered approach to questioning. You did not demonstrate sufficiently the ability to follow a logical structure in your consultation. For example, your history taking may have appeared disjointed, with your line of questioning erratic and not following reasoned thinking. You may have undertaken practical tasks or examination in an illogical order that suggested you did not have a full grasp of the reason for completing them or a plan for the consultation.	✔️
Diagnosis	Does not make the correct working diagnosis or identify an appropriate range of differential possibilities.
Examination	Does not undertake physical examination competently, or use instruments proficiently.
Findings	Does not identify abnormal findings or results or fails to recognise their implications. You did not identify or recognise significant findings in the history, examination or data interpretation.
Issues	Does not recognise the issues or priorities in the consultation (for example, the patient’s key problem or the immediate management of an acutely ill patient). You did not recognise the key element of importance in the station. For example, giving health and lifestyle advice to an acutely ill patient.	✔️
Management	Does not develop a management plan reflecting current best practice, including follow up and safety netting.
Rapport	Does not appear to develop rapport or show sensitivity for the patient’s feelings and concerns, including use of stock phrases. You did not demonstrate sufficiently the ability to conduct a patient centred consultation. Perhaps you did not show appropriate empathy or sympathy, or understanding of the patient’s concerns. You may have used stock phrases that show that you were not sensitive to the patient as an individual, or failed to seek agreement to your management plan.	✔️
Listening	Does not make adequate use of verbal & non-verbal cues. Poor active listening skills. You did not demonstrate sufficiently that you were paying full attention to the patient’s agenda, beliefs and preferences. For example, you may have asked a series of questions but not listened to the answers and acted on them.
Language	Does not use language or explanations that are relevant and understandable to the patient, including not checking understanding. The examiner may have felt, for example, that you used medical jargon, or spoke too quickly for the patient to take in what you were saying.
Time	Shows poor time management. You showed poor time management, probably taking too long over some elements of the encounter at the expense of other, perhaps more important areas.	✔️

Data_gathering	Management	IPS
1	2	3