PLAB 2 Mock Test Feedback :: 13/03/25 :: Paduhwan 30 :: Cases 11-16

Case 11:

Paediatrics Symptomatic Differentials

2 Years Infuenza Vaccination

Action Items:

• Practice and Review the case in the OSCE workbench: Click Here

• Read the Mock Feedback Blog:  Click Here

• Additional Resources: Click Here

• Deep Dive into your performance below:

Scenario Summary:

In this scenario, you are an FY2 doctor in a GP surgery, and you will be seeing Mrs. Danielle Brown, a 30-year-old mother who is concerned about her 3-year-old son's upcoming flu vaccine.

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 practicing, 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	Response	Remarks
Data Gathering	Confirm the patient's full name and age: Mrs. Danielle Brown, 30 years old	2:54	No	You confirmed the full name as Daniel Brown but did not confirm the age. In future, make sure to verify both name and age, as it is important for proper identification.
Data Gathering	Establish reasons for visit and concerns about the flu vaccine	3:08	Yes	You effectively asked about the reason for the visit and elicited the concern regarding the flu vaccine. Good job.
Data Gathering	Ask about the child's current condition: any fever, flu symptoms, diarrhea, or vomiting	-	No	You did not ask about the child’s current health condition, including fever, flu symptoms, diarrhea, or vomiting. This is crucial to assess if the child is currently unwell, which could influence vaccination decisions. Try to include this in future cases.
Data Gathering	Inquire about pregnancy and birth history, vaccination history, development history, past medical history, drug history, and allergies	4:03, 4:14, 4:23, 4:42, 4:53, 5:00	Partial	You asked about birth history, vaccination history, development, and allergies but missed past medical history and drug history. These are important to ensure there are no contraindications or relevant risk factors for vaccination. Next time, ensure to ask specifically about past illnesses and any medications Rick has taken.
Data Gathering	Confirm Danielle’s understanding of the flu vaccine and address specific concerns	7:02, 8:03	Yes	You asked if the patient knew what the flu vaccine does and clarified that it does not cause fits. Well done on addressing her concerns directly.
Data Gathering	Rule out contraindications for the flu vaccine (e.g., severe asthma, allergies to neomycin or eggs, low immune system)	-	No	You asked about general allergies but did not specifically rule out contraindications like severe asthma, allergy to neomycin or eggs, or low immune system. In future, explicitly screen for these contraindications before recommending the vaccine.
Management	Educate about the flu vaccine which contains a weakened virus that cannot cause severe infection and cannot multiply in the body	-	No	You reassured the patient but did not explicitly mention that the flu vaccine contains a weakened virus that cannot multiply or cause severe infection. Be sure to include this next time.
Management	Explain that it is a single dose administered nasally and is completely safe	-	No	You did not mention that it is a single dose and administered nasally. This information helps reassure the parent about the ease of administration.
Management	Highlight that the vaccine protects against the flu and that symptoms post-vaccination are mild compared to a normal flu infection	7:10	Yes	You explained that the vaccine prevents flu and emphasized that flu itself can lead to more serious complications. Well done.
Management	Clarify that the flu vaccine does not cause fits and there is no evidence supporting a link to such severe reactions	8:03	Yes	You clearly stated that research does not show a link between the flu vaccine and seizures. Good job.
Management	Discuss the potential mild side effects like runny or blocked nose, headache, general tiredness, and loss of appetite, which typically last for 2-3 days	8:38	Partial	You mentioned mild fever and irritation but did not cover headache, tiredness, or appetite loss. In future, list all common side effects so the parent knows what to expect.
Management	Explain the importance of the flu vaccine in preventing complications such as pneumonia, bronchitis, and ear infections	-	No	You explained the general benefit of preventing flu but did not mention specific complications like pneumonia, bronchitis, or ear infections. Including these details would strengthen your argument.
Management	Provide reassurance about the safety and necessity of the vaccine	7:32, 8:17	Yes	You provided strong reassurance and addressed parental concerns effectively. Well done.
Management	Offer a leaflet about the flu vaccine and the immunization schedule	9:44	Yes	You mentioned giving a leaflet and directing the parent to the NHS website. This is excellent patient education.
Management	Explain that while the vaccine is not compulsory, it is highly advisable for the child's health and the health of others in the community	10:35	Yes	You explained that while it is not compulsory, it is recommended for protection. Well done.
Management	Encourage Danielle to return if she has further concerns or if the child experiences any severe symptoms	9:55	Yes	You advised her to return if there were any concerning symptoms. Good job.
Interpersonal Skills	Acknowledge Danielle’s concerns and validate her feelings	5:27	Yes	You acknowledged her concerns about her neighbor’s child and reassured her. This was well done.
Interpersonal Skills	Use empathetic phrases like, 'I understand your worries,' and 'It’s normal to be concerned about vaccinations'	5:29	Yes	You used empathetic language, such as "I understand where you’re coming from," which is great.
Interpersonal Skills	Summarize the discussion to ensure understanding	-	No	You did not summarize the key points before ending the consultation. Summarizing helps reinforce important information and checks patient understanding. Make sure to include a brief summary next time.
Interpersonal Skills	Use simple language and avoid medical jargon	7:02, 8:03	Yes	You explained things clearly in a way the patient could understand. Well done.
Interpersonal Skills	Encourage questions and provide clear, concise answers	7:58	Yes	You invited questions and answered them directly. This is good communication.
Interpersonal Skills	Show patience and understanding	5:53	Yes	You listened carefully and did not rush the patient. Well done.
Interpersonal Skills	Create a supportive environment to make Danielle feel heard and respected	5:29	Yes	Your approach was respectful, which helped build trust with the patient.

Feedback Statement Checklist:

	Feedback Statements:	Needs Improvement
Consultation	Disorganised / unstructured consultation	✔️
Diagnosis
Examination
Findings
Issues
Management	Does not develop a management plan reflecting current best practice	✔️
Rapport	Does not appear to develop rapport or show sensitivity for the patient’s feelings and concerns	✔️
Listening
Language	Does not use language or explanations that are relevant and understandable to the patient	✔️
Time

Case 12:

Medicine Symptomatic Differentials

Acute Gout

Action Items:

• Practice and Review the case in the OSCE workbench: Click Here

• Read the Mock Feedback Blog:  Click Here

• Additional Resources: Click Here

• Deep Dive into your performance below:

Scenario Summary:

You are an FY2 doctor in a GP surgery, and your patient is Unity Brown, a 54-year-old lady presenting with sudden pain in her right big toe. She has a history of hay fever and hypertension, for which she takes cetirizine and bendroflumethiazide, respectively. She is a smoker and consumes alcohol regularly. Her main concern is the severe pain and swelling in her toe, which is affecting her ability to work as a taxi driver.

My Performance:

🔍Let’s Deep Dive into your performance:

Domain	Point	Timestamp	Response	Remarks
Data Gathering	Confirm patient identifiers: full name and age	1:47-1:50	Yes	You did well in confirming the patient’s full name and age early in the consultation.
Data Gathering	Acknowledge and validate patient's emotions before proceeding	2:14, 2:30, 3:27	Partial	You showed some empathy by saying "sorry about that" multiple times, but a more structured validation, such as "I can see how distressing this must be for you," would have been better. Try to explicitly acknowledge feelings before diving into questions.
Data Gathering	Use SOCRATES for presenting complaint: Site, Onset, Character, Radiation, Associated symptoms, Timing, Exacerbating/Relieving factors, Severity	2:16-3:27	Partial	You covered most elements but did not explicitly ask about Radiation and Associated Symptoms beyond fever. Next time, ensure all components are addressed.
Data Gathering	Rule out trauma: Ask about any recent injury to the toe	3:54	Yes	You asked about recent trauma, which was good.
Data Gathering	Consider gout: Inquire about swelling, redness, and previous episodes	3:46-4:08	Partial	You asked about previous episodes but did not specifically ask about swelling and redness. Next time, directly inquire about these symptoms.
Data Gathering	Consider rheumatoid arthritis: Ask about morning stiffness	N/A	No	You did not ask about morning stiffness. This is important in differentiating rheumatoid arthritis from other joint conditions.
Data Gathering	Consider osteoarthritis: Ask if pain worsens by the end of the day	N/A	No	You did not ask about worsening pain in the evening. A simple, “Does the pain get worse as the day progresses?” would help rule out osteoarthritis.
Data Gathering	Consider septic arthritis: Ask about recent fever or steroid use	3:51-3:54	Partial	You asked about fever but did not inquire about steroid use, which is crucial for assessing immunosuppression and risk of infection.
Data Gathering	Conduct systemic review using PMAFTOSA: Past medical history, Medication history, Allergic history, Family history, Travel history, Occupational history, Social history, Alcohol and smoking	4:11-6:11	Partial	You covered most aspects but missed travel and family history. Family history is especially relevant for conditions like gout and autoimmune diseases.
Data Gathering	Explore ICE: Ideas, Concerns, Expectations	7:18-7:31	Partial	You asked about concerns and expectations but did not explore the patient’s own ideas about the condition. Next time, explicitly ask, “What do you think might be causing this?”
Management	Provisional diagnosis: Likely gout	6:51	Yes	You identified gout as the most likely diagnosis, which was appropriate.
Management	Explain gout: Arthritis caused by high uric acid levels leading to crystal formation in joints	7:01-7:15	Yes	Your explanation was clear.
Management	Identify risk factors: Hypertension, alcohol consumption, smoking, diet, and lifestyle	5:28-6:11	Yes	You effectively identified these risk factors. Well done!
Management	Start treatment: Colchicine and NSAIDs (e.g., Ibuprofen), Paracetamol if needed	8:22-8:29	Partial	You prescribed diclofenac but did not mention colchicine or paracetamol as alternative options. Ensure you provide full treatment choices.
Management	Plan follow-up: Review in 4-6 weeks for blood tests and BMI monitoring	9:03-9:10	Partial	You mentioned a follow-up, but it was in two weeks rather than 4-6 weeks. Also, you did not mention BMI monitoring. Ensure to align with best practices.
Management	Consider changing hypertension medication to a calcium channel blocker	8:44-9:03	Partial	You identified that bendroflumethiazide may be contributing to gout but did not explicitly state switching to a calcium channel blocker. This should have been clearly recommended.
Management	Provide general advice: Rest, elevate limb, avoid alcohol, keep joint cool, use ice packs	N/A	No	You did not provide any lifestyle advice on rest, elevation, or ice packs.
Management	Advise lifestyle changes: Reduce alcohol, stop smoking, lose weight, balanced diet, exercise	5:28-6:11	Partial	You asked about lifestyle but did not counsel on reducing alcohol, stopping smoking, or diet changes. Providing specific advice here would have been beneficial.
Management	Safety netting: Return if severe joint pain, fever, or general unwellness develops	N/A	No	You did not provide safety netting. Always tell the patient when to seek urgent help.
Management	Provide educational materials: Leaflet about gout	N/A	No	No mention of an educational leaflet. Try to include this next time.
Management	Summarize discussion and confirm understanding	8:50	Partial	You checked understanding briefly, but a structured recap of key points would have been more effective.
Management	Address any further expectations from the patient	N/A	No	You did not ask, “Is there anything else you were expecting from today’s consultation?” This would ensure patient-centered care.
Interpersonal Skills	Ensure thorough history taking and physical examination	6:13-6:32	Partial	Your history was thorough but missed key differential questions. You also mentioned examination but did not describe findings.
Interpersonal Skills	Address patient’s concerns and expectations effectively	7:25-7:31	Partial	You asked about concerns but did not explore all expectations. Try asking, “What were you hoping we could do today?”
Interpersonal Skills	Provide clear and concise explanations of the diagnosis and management plan	7:01-7:15	Yes	Your explanation of gout was clear. Well done!
Interpersonal Skills	Maintain clear communication throughout the consultation	Throughout	Yes	You maintained a good flow of conversation.
Interpersonal Skills	Provide patient-centered care, ensuring the patient feels heard and understood	3:27, 5:22, 7:25	Partial	You showed some empathy but could have been more explicit in addressing emotions and expectations.
Interpersonal Skills	Ensure safety netting and appropriate follow-up are clearly communicated	N/A	No	You did not provide proper safety netting. Always inform the patient when to seek urgent care.

Feedback Statement Checklist:

	Feedback Statements:	Needs Improvement
Consultation	Disorganised / unstructured consultation	✔️
Diagnosis
Examination
Findings
Issues
Management	Does not develop a management plan reflecting current best practice	✔️
Rapport	Does not appear to develop rapport or show sensitivity for the patient’s feelings and concerns	✔️
Listening
Language	Does not use language or explanations that are relevant and understandable to the patient	✔️
Time

Case 13:

Dermatology Symptomatic Differentials

Psoriasis

Action Items:

• Practice and Review the case in the OSCE workbench: Click Here

• Read the Mock Feedback Blog:  Click Here

• Additional Resources: Click Here

• Deep Dive into your performance below:

Scenario Summary:

You are an FY2 doctor in a GP surgery. Your patient, Darlene Litterman, is a 35-year-old woman presenting with a rash on her knees and elbows. She has been experiencing this rash for about 6 weeks, and it has not improved despite using petroleum jelly and some creams from the pharmacy. The rash is red with white patches, mildly itchy, and sore. Darlene is generally healthy, has no significant past medical or family history, and is currently stressed due to being jobless.

My Performance:

🔍Let’s Deep Dive into your performance:

Domain	Point	Timestamp	Response	Remarks
Data Gathering	Confirm the patient's full name and age.	0:09	Yes	You asked for and confirmed the patient's full name and age. Good start.
Data Gathering	Ask about the onset, duration, and progression of the rash.	0:44, 1:16	Yes	You asked about how long the rash had been present and its progression. Well done.
Data Gathering	Inquire about previous episodes, site, and appearance changes.	1:06, 1:29, 1:49	Yes	You asked about previous episodes, site, and some aspects of appearance. Great work.
Data Gathering	Explore aggravating/precipitating factors (stress, infections, contact history).	1:24, 5:43	Partial	You asked about what makes it worse but didn't explore stress, infections, or contact history. Make sure to cover these explicitly.
Data Gathering	Discuss relieving factors and treatments tried.	6:20	Yes	You inquired about treatments the patient had tried. Good job.
Data Gathering	Assess associated symptoms (local and systemic).	1:35, 2:05	Yes	You asked about itchiness and systemic symptoms like fever. Well covered.
Data Gathering	Perform a full systems review (CVS, RS, CNS, GIT, GU, Eyes, MSK).	2:41, 2:45, 2:50, 2:53	Partial	You covered MSK (joints), eyes, and GU but missed CVS, RS, GIT, and CNS. A more structured review is needed.
Data Gathering	Check past medical, medication, allergic history, and family history.	3:15, 3:20, 5:14	Yes	You asked about medical history, medications, allergies, and family history. Good work.
Data Gathering	Investigate psychosocial aspects (stress, smoking, alcohol, diet, exercise, home and work situation).	3:01, 3:50	Partial	You covered smoking, alcohol, and work but missed stress, diet, exercise, and home situation. These are key in dermatology cases.
Data Gathering	Understand patient's ideas, concerns, and expectations (ICE).	6:26, 6:32, 6:49	Yes	You asked about the patient's concerns and expectations. Well done.
Data Gathering	Lesion Description: SCLEDERMA - Size, Color, Location, Elevation, Relation to other structures, Other symptoms, Duration, Edges, Recurrence, Morphology, Additional findings.	1:49, 1:56, 2:16	Partial	You covered size, color, location, and elevation but missed edges, recurrence, and relation to other structures.
Data Gathering	Symptoms: Any other lesions on any other part of the body.	—	No	You didn't ask if the patient had lesions on other body parts. Make sure to cover this.
Data Gathering	Systemic symptoms: Any fever, weakness, weight loss.	2:05	Partial	You asked about fever but didn't ask about weakness or weight loss. Always complete the systemic inquiry.
Management	Explain Diagnosis: Psoriasis is a chronic skin condition causing flaky patches and scales.	4:25	Partial	You mentioned psoriasis but didn't explain it clearly as a chronic condition with scaling. Ensure the patient fully understands the condition.
Management	Discuss risk factors: Genetics, immune system disorders, infections, stress, obesity, smoking, alcohol, vitamin D deficiency, medications, weather, hormonal changes.	5:14	Partial	You touched on genetics and possible triggers but didn't comprehensively discuss all risk factors.
Management	Offer symptomatic treatments: Emollients, potent topical corticosteroids, vitamin D preparations, topical salicylic acid.	6:07	Partial	You mentioned ointments but didn't specify corticosteroids or vitamin D preparations. Always name treatments to ensure clarity.
Management	Provide lifestyle advice: Quit smoking, limit alcohol, manage weight, reduce stress.	—	No	You didn't provide lifestyle advice on smoking, alcohol, weight, or stress. These are crucial in psoriasis management.
Management	Arrange follow-up in 4 weeks to assess treatment response.	7:12	No	You offered a two-week follow-up instead of four. Ensure alignment with standard guidelines.
Management	Advice on application: Emollients before other treatments, steroid and vitamin D preparations once daily at different times.	—	No	You didn’t explain the correct application sequence of treatments. Always clarify how to apply them.
Management	Safety Netting: Contact GP if experiencing joint pain or swelling, inform about signs of severe psoriasis complications.	7:19	Partial	You mentioned coming back if symptoms worsen but didn't specifically discuss joint pain or complications of severe psoriasis.
Management	Provide written information and resources about psoriasis (Psoriasis Association, British Association of Dermatologists, NHS patient leaflet).	7:03	Partial	You mentioned giving a leaflet but didn't specify reliable sources like NHS or BAD.
Interpersonal Skills	Use open-ended questions and actively listen to the patient's concerns.	0:44, 6:26	Yes	You used open-ended questions and acknowledged concerns well. Good job.
Interpersonal Skills	Provide clear and empathetic explanations about the condition and its management.	4:25, 6:07	Partial	Some explanations were unclear (e.g., psoriasis pathophysiology, treatment application). Aim for clarity and simplicity.
Interpersonal Skills	Involve the patient in decision-making, ensuring they understand the treatment plan.	6:12, 7:12	Partial	You included the patient but didn’t fully explain all treatment options or their role in decision-making. Try to engage them more.
Interpersonal Skills	Offer psychological support, acknowledging the stress related to joblessness.	—	No	You didn’t acknowledge the emotional impact of psoriasis, particularly work-related stress. Show empathy here.
Interpersonal Skills	Encourage lifestyle changes positively, providing resources and support where needed.	—	No	You missed discussing lifestyle improvements for psoriasis. Encouraging self-care is important.
Interpersonal Skills	Schedule a follow-up appointment to reassess the condition and treatment efficacy.	7:12	Partial	You scheduled a follow-up, but the duration was incorrect (two weeks instead of four). Stick to standard guidelines.

Feedback Statement Checklist:

	Feedback Statements:	Needs Improvement
Consultation	Disorganised / unstructured consultation	✔️
Diagnosis
Examination
Findings
Issues
Management	Does not develop a management plan reflecting current best practice	✔️
Rapport	Does not appear to develop rapport or show sensitivity for the patient’s feelings and concerns	✔️
Listening
Language	Does not use language or explanations that are relevant and understandable to the patient	✔️
Time

Case 14:

Medicine Symptomatic Differentials

Guillian Barre Syndrome

Action Items:

• Practice and Review the case in the OSCE workbench: Click Here

• Read the Mock Feedback Blog:  Click Here

• Additional Resources: Click Here

• Deep Dive into your performance below:

Scenario Summary:

You are an FY2 doctor in a GP surgery. Your patient, Sarah Harrison, is a 45-year-old woman presenting with progressive weakness in her legs and arms. She had an upper respiratory tract infection 2 weeks ago that resolved without antibiotics. Your task is to assess her condition and discuss initial management.

My Performance:

🔍Let’s Deep Dive into your performance:

Domain	Point	Timestamp	Response	Remarks
Data Gathering	Patient identifiers: Confirm full name and age	2:04	Yes	You asked for the patient’s full name and age at the start. Well done.
Data Gathering	Clarify presenting complaint: Ask about the nature and progression of weakness	2:26, 2:37, 2:51, 3:04, 3:48	Yes	You asked about the nature and progression of the weakness, including how it affects the patient. Good job!
Data Gathering	Systemic review: Inquire about lightheadedness, dizziness, headaches, fever, cough, chest pain, palpitations, abdominal pain, constipation, diarrhea, appetite, sensory loss, mobility, joint pain, and rashes	3:27, 3:34, 3:57, 4:16, 4:26	Partial	You asked about dizziness, fever, flu-like symptoms, and sensory loss, but you missed several important areas like headaches, cough, chest pain, palpitations, abdominal pain, constipation, diarrhea, appetite, joint pain, and rashes. Try to ensure a more comprehensive review.
Data Gathering	Differential diagnosis: Rule out multiple sclerosis, Guillain-Barre syndrome, myasthenia gravis	7:50	Partial	You mentioned Guillain-Barre syndrome, but you did not explicitly rule out multiple sclerosis or myasthenia gravis. It would have been good to explore symptoms suggestive of these conditions.
Data Gathering	Red flags: Check for respiratory issues, stroke symptoms, and spinal cord compression signs	3:57, 8:30	Partial	You asked about shortness of breath, which is good. However, you did not explicitly check for stroke symptoms (e.g., facial drooping, speech difficulties) or spinal cord compression signs (e.g., urinary retention, saddle anesthesia). These should have been explored.
Data Gathering	PMAFTOSA: Past medical history, family history, social history	4:55, 6:21, 6:39, 6:46	Partial	You covered past medical history and social history (smoking and alcohol), but family history was missing. Try to include this next time.
Data Gathering	ICE: Ideas, concerns, expectations	8:21, 8:40	Partial	You addressed some concerns about the condition being scary, but you did not ask explicitly about the patient’s own ideas or expectations regarding the illness and treatment. This would have helped to gauge her understanding and address any misconceptions.
Data Gathering	Effects of symptoms: Assess impact on daily life and activities	6:21	Yes	You asked about how the weakness affected her daily activities, such as work and driving. Good job!
Data Gathering	Summary: Confirm understanding and completeness of information gathered	—	No	You did not summarize the key points of the history back to the patient to confirm completeness. Doing this ensures nothing important is missed.
Management	Routine investigations: Perform blood tests (FBC, U&E, LFT, blood sugar, ESR, CRP)	7:06	Yes	You listed relevant blood tests, which was good.
Management	Immediate action: Refer to hospital for neurology team admission	8:30	Yes	You appropriately referred the patient to the hospital. Well done!
Management	Arrange transportation to hospital if needed	—	No	You did not discuss how she would get to the hospital. You could have asked if she had someone to take her or if an ambulance was needed.
Management	Inform patient about possible treatments: Plasma exchange, immunoglobulin medication, steroids	—	No	You did not mention any treatment options. Providing this information would have reassured the patient and improved understanding.
Management	Advise to stop driving and inform DVLA	9:04	Partial	You told the patient not to drive but did not mention the need to inform the DVLA, which is a legal requirement. Make sure to include this next time.
Management	Consult with seniors for additional advice	—	No	You did not mention consulting a senior doctor. In complex cases like this, mentioning senior input would demonstrate good clinical judgment.
Management	Patient education: Provide information leaflets about Guillain-Barre syndrome	—	No	You did not mention providing patient education materials. Patients benefit from written information they can review later.
Management	Recap discussion to ensure patient understanding	—	No	You did not summarize the management plan back to the patient to ensure they understood everything. This is crucial for clarity.
Management	Address any further questions or concerns	9:16	Partial	The patient asked how she could contact you, and you gave some information. However, you did not explicitly invite her to ask further questions about the condition or treatment.
Interpersonal Skills	Use empathetic and clear language	3:27, 8:40	Partial	You showed some empathy, such as acknowledging the patient’s fear. However, when she expressed concern about the condition being scary, your response, "Yes, it's not scary, it's just the condition," could have been more reassuring. Try validating her concerns while providing reassurance.
Interpersonal Skills	Ensure the patient feels heard and understood	3:27	Yes	You acknowledged her difficulties and repeated key points, showing active listening.
Interpersonal Skills	Provide reassurance about the condition and treatment plan	8:40	Partial	You reassured her that referral was needed, but a more structured reassurance about prognosis and available treatments would have helped.
Interpersonal Skills	Explain the necessity of hospital admission and further tests	8:30	Yes	You clearly explained why hospital admission was necessary. Good job!
Interpersonal Skills	Encourage the patient to involve family support, such as calling her mother	—	No	You did not ask if she had someone for support. Encouraging her to involve a family member could have helped.
Interpersonal Skills	Discuss the follow-up plan and next steps after hospital admission	—	No	You did not discuss what would happen after admission. A brief mention of possible follow-up with a neurologist would have been helpful.

Feedback Statement Checklist:

	Feedback Statements:	Needs Improvement
Consultation	Needs improvement in organizing safety-netting and psychological exploration​.	✔️
Diagnosis
Examination
Findings
Issues	Does not recognise the issues or priorities in the consultation (Missed key differentials, DVLA notification)	✔️
Management	Does not develop a management plan reflecting current best practice (Missed treatment discussion, transportation, patient education)	✔️
Rapport
Listening	Does not make adequate use of verbal & non-verbal cues (Reassurance could have been stronger)	✔️
Language	Does not use language or explanations that are relevant and understandable (Response to "Is it scary?" could have been more comforting)	✔️
Time	Shows poor time management (Did not fully cover systemic review or summarization)	✔️

Case 15:

Medical Ethics

LGBTQ Pap Smear

Action Items:

• Practice and Review the case in the OSCE workbench: Click Here

• Read the Mock Feedback Blog:  Click Here

• Additional Resources: Click Here

• Deep Dive into your performance below:

Scenario Summary:

As an FY2 doctor in a GP surgery, you need to call Ellen Taylor, a 25-year-old woman, and address her concerns about a recently received invitation for a cervical smear screening.

My Performance:

🔍Let’s Deep Dive into your performance:

Domain	Point	Timestamp	Response	Remarks
Data Gathering	Confirm Identity and Details: 'Hello, am I speaking with Miss. Ellen Taylor?' 'Could you please confirm your age and the first line of your address?'	1:39, 2:25	Yes	You confirmed the patient's identity and details effectively. Well done!
Data Gathering	Check Communication: 'Can you hear me clearly?' 'Is this a good time to talk?' 'If this line gets disconnected can I call you back on this number?'	0:06, 2:36	Yes	You ensured that the patient could hear you and that this was a good time to talk. Great!
Data Gathering	Acknowledge the patient's concerns empathetically: 'I understand that you have some concerns.'	3:14	Partial	You acknowledged the patient’s feelings but could have expressed more direct empathy with phrases like, 'I understand this might be concerning for you.'
Data Gathering	Ask for permission to ask further questions to understand the confusion regarding the invitation for PAP smear.	3:52	Partial	You did ask for permission to ask personal questions, but it could have been framed more clearly in relation to the patient’s confusion about the smear test.
Data Gathering	Sexual History: 'Are you sexually active?' 'Is your partner male or female?' 'What kind of sexual intercourse do you practice?' 'Have you ever been in a sexual relationship with a male partner?' 'Do you use any sex toys?' 'Do you share sex toys with your partner?' 'Have you ever been diagnosed with a sexually transmitted infection?' 'Have you had a pap smear before?'	4:11, 4:23, 4:44	Partial	You asked about sexual activity and sex toys but missed key details like STI history, previous Pap smears, and sharing of sex toys. Ensure to ask all relevant history comprehensively.
Data Gathering	Check Understanding: 'What do you know about cervical smears or pap smears?' 'Do you know why it is usually offered?'	3:26	Yes	You asked about the patient's understanding, which is good practice. Well done!
Management	Explain Pap Smear: It's a screening test offered in the UK to women aged 25-64 years. Done every 3 years until 49, then every 5 years from 50-64. It checks the health of the cervix and screens for pre-cancerous conditions to prevent cervical cancer.	8:22	Yes	You provided a clear explanation of the screening process, including frequency and purpose. Well done!
Management	Explain HPV: Cervical cancer is usually caused by human papillomavirus (HPV), a sexually transmitted infection. HPV can be asymptomatic. There is an increased risk of HPV with male partners or sharing sex toys with female partners.	6:03	Partial	You mentioned HPV and transmission through sex toys but could have elaborated on it being asymptomatic and its role in cervical cancer.
Management	Results Explanation: If HPV is positive but no abnormal cells, screening is done again in 1 year and again in 2 years if HPV persists. If HPV is positive and abnormal cells are found, a colposcopy is needed. If results are unclear, a repeat test in 3 months is required, known as an 'inadequate result.'	7:18, 7:46	Partial	You explained HPV testing and follow-up but did not mention the 3-month repeat for inadequate results. Ensure to cover all possible outcomes.
Management	Safety Netting: Advise on what to do if she experiences any symptoms or has further questions.	-	No	You did not explicitly provide safety netting. Always reassure the patient and advise on when to seek further help.
Management	Leaflets and Pamphlets: Offer informational leaflets about cervical screening and HPV.	-	No	You did not mention offering any written resources. Providing NHS leaflets would be useful.
Management	Follow Up: Arrange a follow-up appointment if needed to discuss results or further concerns.	-	No	No mention of follow-up. Always offer a follow-up discussion for any concerns or test results.
Interpersonal Skills	Communication: Maintain a calm, empathetic tone. Use simple, non-technical language. Allow the patient to express concerns and feelings.	3:14, 5:06	Partial	Your tone was mostly calm, but some explanations were overly technical (e.g., 'mouth of the womb'). Using simpler language and a more reassuring tone would help.
Interpersonal Skills	Summarize the information given to ensure understanding. Encourage questions and provide clear, concise answers.	-	No	You did not summarize the information at the end of the consultation. Always check understanding and recap key points before ending.
Interpersonal Skills	Empathy and Reassurance: Validate the patient's feelings and concerns. Reassure the patient about the safety and importance of the screening. Provide support and encouragement throughout the conversation.	3:14, 6:37	Partial	You provided some reassurance, but more could have been done to acknowledge concerns about discomfort and anxiety over the test.
Interpersonal Skills	Signposting: 'I will explain what a pap smear is and why it is important for you.'	-	No	You did not explicitly signpost before explaining the test. Using phrases like 'I’d like to explain what this test is and why it is recommended' would make the conversation smoother.

Feedback Statement Checklist:

	Feedback Statements:	Needs Improvement
Consultation	Disorganised / unstructured consultation – Some sections lacked structure, especially in transitioning to personal questions.	✔️
Diagnosis
Examination
Findings
Issues	Does not recognise the issues or priorities in the consultation – Missed reassurance, safety netting, and full explanation of test results.	✔️
Management	Does not develop a management plan reflecting current best practice – Missed safety netting, follow-up, and leaflets.	✔️
Rapport	Does not appear to develop rapport or show sensitivity for the patient’s feelings and concerns – Could have used more empathy when addressing concerns.	✔️
Listening	Does not make adequate use of verbal & non-verbal cues – Could have picked up on patient’s concerns and offered more reassurance.	✔️
Language	Does not use language or explanations that are relevant and understandable to the patient, including not checking understanding – Overly technical explanations at times and lack of summarization.	✔️
Time	Shows poor time management – Missed follow-up discussion and safety netting, likely due to time constraints.	✔️

Case 16:

Breaking Bad News

RTA in Child Pelvic Fracture

Action Items:

• Practice and Review the case in the OSCE workbench: Click Here

• Read the Mock Feedback Blog:  Click Here

• Additional Resources: Click Here

• Deep Dive into your performance below:

Scenario Summary:

You are an FY2 doctor in the Paediatrics department. Your patient, Ryan Howard, a 5-year-old child, has been involved in a road traffic accident. An X-ray has revealed an unstable pelvic fracture, and Ryan is currently being prepared for theatre. You need to speak to his mother, Melissa Howard, and address her concerns.

My Performance:

🔍Let’s Deep Dive into your performance:

Domain	Point	Timestamp	Response	Remarks
Data Gathering	Confirm parent's identity and relationship to Ryan	2:00	Yes	You confirmed the parent's identity and relationship early in the conversation, which is good practice.
Data Gathering	Gather details about the event leading to the injury	2:35	Yes	You effectively asked about what happened to Ryan and received a clear response.
Data Gathering	Confirm any allergies, medications, past medical history, and the last meal Ryan had	8:42, 8:46, 8:50	Partial	You asked about allergies, medications, and past hospital admissions, but you missed asking about the last meal Ryan had. It is important to ask about this before surgery as it affects anesthesia safety.
Management	Explain the need for surgery and the process involved	3:12	Yes	You clearly explained why surgery was needed and the process. Good job on making it simple and understandable.
Management	Discuss potential complications and reassure them about the expertise of the surgical team	5:12	Yes	You mentioned blood loss, infection, and scarring, and reassured the parent. This was well done.
Management	Obtain consent for the surgery and any necessary procedures, including blood transfusions if required	4:08, 5:33	Yes	You explained the need for consent and included the possibility of blood transfusion, which is essential.
Management	Offer leaflets and additional resources about the procedure	-	No	You did not offer any written resources or leaflets. Providing these can help reassure parents and give them something to refer back to later.
Management	Provide safety netting and follow-up information, assuring them that they will be kept informed throughout the process	7:25, 7:52	Partial	You reassured the mother about seeing Ryan after surgery but did not provide clear follow-up information on post-op care or when they will get updates. This would help set expectations and ease parental anxiety.
Interpersonal Skills	Introduce yourself and state your role clearly	1:43	Yes	You introduced yourself and your role well at the beginning, which helps build trust.
Interpersonal Skills	Use sensitive and empathetic language	2:43, 3:55	Partial	You expressed empathy but some phrases sounded rehearsed, e.g., "I know the way you feel, and many people will feel the way you feel too." Try to make empathy sound more natural and personal.
Interpersonal Skills	Signpost throughout the conversation to ensure clarity	-	No	There was little signposting to guide the conversation. Using phrases like "First, let's discuss what happened, then we'll talk about treatment" would improve clarity.
Interpersonal Skills	Allow the parents to express their feelings and concerns	3:36, 5:13	Yes	You gave space for the parent to express guilt and concerns, which was good.
Interpersonal Skills	Provide reassurance and empathy, acknowledging their guilt and anxiety	3:55, 5:16	Yes	You reassured the mother well when she expressed guilt and worry about Ryan's safety.
Interpersonal Skills	Offer continuous support and reassurance to the parents	5:50, 7:52	Partial	You reassured her during the conversation, but continuous support could have been reinforced by explicitly telling her she can ask further questions or who she can contact for more information.

Feedback Statement Checklist:

	Feedback Statements:	Needs Improvement
Consultation	Disorganised / unstructured consultation – Due to lack of signposting, the conversation felt somewhat unstructured.	✔️
Diagnosis
Examination
Findings
Issues
Management	Does not offer sufficient follow-up/safety netting – More clarity was needed on follow-up steps post-surgery.	✔️
Rapport	Does not appear to develop rapport or show sensitivity for the patient’s feelings and concerns, including use of stock phrases – Some responses felt rehearsed rather than natural.	✔️
Listening
Language
Time