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

Mock Date: 14/06/2025
Case 2:
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	Covered	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?'	Yes	You introduced yourself and asked how the student’s year is going, which helped create a relaxed and friendly environment. Well done.
Data Gathering	Initiate light conversation to build rapport and reduce tension (e.g., “How’s your rotation going?”)	Yes	You asked about the student’s third year, which encouraged a casual conversation and built rapport.
Data Gathering	Gauge Understanding: 'What do you know so far about subcutaneous injections?' Explore the student’s current understanding of the technique and its purpose.	Yes	You asked Dale to share what he knew about the topic and explored it briefly, allowing you to tailor your teaching.
Data Gathering	Ask why the student wants to learn this skill and how it fits into their current goals.	Yes	You explicitly asked how this skill fits into his learning schedule, which helped explore his motivation.
Data Gathering	Ask if the student has ever seen or assisted with a subcutaneous injection before.	Yes	You asked both where he saw it done and whether he had assisted, addressing this point fully.
Data Gathering	Ask Dale to summarise key points at intervals, to gauge understanding	No	You did not ask Dale to summarise or repeat back any steps at any point. This would have helped confirm his understanding.
Data Gathering	Check comprehension periodically by asking the student to summarise or repeat important points. Use open-ended questions to assess the depth of their understanding (e.g., “Can you tell me what you know about common injection sites?”).	No	You checked in with “Do you have any questions?” but did not use open-ended questions or ask for summaries to verify comprehension. Try asking questions like “Can you tell me which sites are suitable and why?”
Data Gathering	Correct misunderstandings immediately.	Partial	Dale initially said he didn’t know the difference from “normal” injections. You gently affirmed his answer but didn’t explicitly explain what makes subcutaneous different (e.g., depth, rate of absorption). That could’ve solidified his understanding.
Management	Set the learning agenda: explain that you will go through preparation, technique, safety and precautions	No	You mentioned that the student will observe, but didn’t clearly outline the structure of the session (preparation, technique, safety, etc). This would have helped him follow along better.
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?'	Partial	You said “feel free to ask questions” and began explaining, but didn’t clearly state the goal or invite readiness. Stating the plan helps prepare the learner mentally.
Management	Explain the Importance: Subcutaneous injections are widely used for administering medications such as insulin, low-molecular-weight heparin, certain vaccines, and various palliative care drugs, making this technique essential in many clinical settings.	Yes	You explained its importance well, naming insulin, heparin, and even explained that patients can be taught to self-administer. Nicely done.
Management	Equipment Preparation: Gather syringe, needle, medication, alcohol swabs, gauze, and a sharps bin.	No	This was not mentioned in the session. It’s essential for students to know the preparation checklist before performing the procedure.
Management	Medication Check: Verify medication name, expiry date, and dosage, preferably with a witness.	Partial	You covered name, expiry, and inspection, but did not mention dosage check or witness verification. That’s an important omission in safety protocol.
Management	Pre-Procedure: Confirm patient identity and check for allergies	Yes	You clearly mentioned confirming identity (verbal or band) and checking for allergies and bleeding disorders. Well done.
Management	Inspect and select an appropriate injection site. Describe the proper injection sites: abdomen, upper arm, thigh, buttocks, and the rationale for site choice.	Yes	You listed all appropriate sites and asked the student why site rotation matters. Good technique.
Management	Clean the area, pinch the skin, inject at a 45 to 90-degree angle, and apply gauze'	Yes	You covered these steps well and clearly explained the injection angle and use of gauze.
Management	Explain post-injection steps: withdraw needle, apply gauze gently, and safely discard sharps.	Yes	You mentioned withdrawing the needle, applying gauze, and discarding the sharp safely.
Management	Discuss key precautions: avoid inflamed or scarred areas, rotate sites, maintain aseptic technique.	Partial	You advised inspecting the area for rashes or tears but did not explicitly mention avoiding inflamed or scarred areas or aseptic technique.
Management	Describe potential complications of poor site rotation, like lipodystrophy, and why they matter.	Yes	You explained lipodystrophy and its effects on medication absorption clearly. Well done.
Management	Proactively offer your contact details for follow-up learning or to schedule another teaching session. Offer safety netting by reassuring the student that it’s okay if all questions aren’t addressed during the session.	Yes	You offered your contact details and encouraged future questions, which was excellent safety netting.
Management	Offer the student relevant leaflets or direct them to trusted online resources (e.g., NHS guidelines, university portals, or clinical skills websites) for further reading on subcutaneous injections.	Yes	You offered a QR code or leaflet, depending on preference. Very good practice.
Interpersonal Skills	Use Simple Language. Do not use any technical terms with out explaining them after	Yes	You explained “subcutaneous” in simple terms, even repeating “hence the name”, which is good technique.
Interpersonal Skills	Encourage Questions: 'Feel free to ask questions anytime.'	Yes	You said “feel free to ask questions” multiple times, which encouraged open dialogue.
Interpersonal Skills	Be Supportive: 'It’s normal to feel a bit anxious about this procedure. I’m here to help.'	No	01:30 – You were warm, but did not explicitly reassure the student or normalise their anxiety. You could’ve added: “It’s okay to feel nervous learning this.”
Interpersonal Skills	Use simple language to explain concepts.	Yes	Throughout, you used layman terms like “sharp scratch” and explained terms like “lipodystrophy.” Well done.
Interpersonal Skills	Actively listen and provide constructive feedback.	Partial	You listened well, but did not provide any feedback based on Dale’s understanding. For example, when he answered about rotation, you could have affirmed it.
Interpersonal Skills	Suggest additional resources for further learning.	Yes	You gave learning leaflets and QR code, which was thoughtful.

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
2	3	4