PLAB 2 Mock test feedback:: Dermatology: Psoriasis

Practice this case with the AI patient 🤖

Mock Date: 11/08/2025
Case 1:
Topic: Dermatology; Case UID: Rash4
Case Name: Psoriasis
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 a GP surgery. Your patient, Darlene Litterman, is a 35-year-old woman presenting with a rash on her Shin and forearm. 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:
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	Response	Remarks
Data Gathering	Confirm the patient's full name and age.	0:24:00	Yes	You confirmed the full name but not the exact age or date of birth (she only said she was 35 years old and “not a Mrs yet”). You could have politely re-asked for her date of birth to complete demographic details.
Data Gathering	Ask about the onset, duration, and progression of the rash. Any similar lesions on any other part of the body.	1:15:00	Yes	You covered onset (six weeks), duration, progression, and confirmed presence on both arms and legs. Nicely done.
Data Gathering	Inquire about previous episodes, site, and appearance changes. Ask about exact location, size, shape, and distribution of lesions.	1:24:00	Partial	You covered site, shape, colour, and distribution, but didn’t ask about previous episodes. In future, just add, “Have you ever had anything like this before?” to complete the picture.
Data Gathering	Screen for triggers — stress, infections, medications, new skincare products.	4:01:00	Partial	You asked about infections and medications but not new skincare products or clear stress link until later. Linking stress early in the history can help spot triggers sooner.
Data Gathering	Assess associated symptoms (local and systemic).— pain, itching, scaling, bleeding, eye symptoms, nail changes and joint pain, stiffness, swelling	2:38:00	Partial	You covered pain, itching, scaling, bleeding, and some systemic symptoms, but missed eye symptoms, nail changes, and joint pain/swelling. Just a quick screen for these would tick the box fully.
Data Gathering	Explore aggravating/precipitating factors. Discuss the treatments tried.	2:24:00	Yes	You discussed progression and creams used from pharmacy — well done.
Data Gathering	Check past medical, medication, allergic history, and family history.	4:18:00	Yes	You covered PMH, DH, allergies, and family history well.
Data Gathering	Take smoking history and assess alcohol intake.	—	No	These were not asked at all. Even if unrelated, this is an important baseline part of a complete history.
Data Gathering	Explore impact psychosocial and physical — stress due to joblessness, mood changes, effect on daily life.	5:38:00	Partial	You elicited stress from unemployment but didn’t explore mood changes or daily functioning. Asking, “How is this affecting your daily activities or mood?” would complete it.
Data Gathering	Understand patient's ideas, concerns, and expectations (ICE).	2:33:00	Partial	You partially covered concerns (“don’t know what it is”), but didn’t clearly ask expectations. Try “What were you hoping we could do today?” to finish ICE.
Data Gathering	Perform general physical examination including vitals.	5:56:00	Yes	You planned to take vitals, which satisfies this.
Data Gathering	Examine skin lesions. Examine nails, joints, and eyes for signs of complications.	6:24:00	Partial	You examined skin but didn’t check nails, joints, or eyes. This would be important in psoriasis.
Management	Explain diagnosis of psoriasis in clear, non-technical language.	6:50:00	Yes	You explained clearly in lay terms.
Management	Reassure patient that psoriasis is not contagious.	7:42:00	Yes	You did this clearly.
Management	Discuss risk factors: Genetics, immune system disorders, infections, stress, obesity, smoking, alcohol, vitamin D deficiency, medications, weather, hormonal changes.	—	No	Risk factors were not discussed. Even a brief outline of a few main ones would help patient understanding.
Management	Offer symptomatic treatments: Emollients, potent topical corticosteroids, vitamin D preparations, topical salicylic acid.	7:05:00	Partial	You mentioned emollients and steroid creams but not vitamin D or salicylic acid.
Management	Advise vitamin D analogues — correct timing to avoid chemical inactivation.	—	No	Not mentioned.
Management	Advice on application: Emollients before other treatments, steroid and vitamin D preparations once daily at different times.	—	No	No specific application advice beyond frequency.
Management	Provide lifestyle advice: Quit smoking, limit alcohol, manage weight, reduce stress.	—	No	Missed entirely — could have been linked to her stress from unemployment.
Management	Arrange follow-up in 4 weeks to assess treatment response.	—	No	No follow-up arrangement mentioned.
Management	Safety Netting: Contact GP if experiencing joint pain or swelling, inform about signs of severe psoriasis complications such as eye symptoms, infection signs, nail changes.	—	No	Safety-netting advice not given.
Management	Provide written information and resources about psoriasis (Psoriasis Association, British Association of Dermatologists, NHS patient leaflet).	7:56:00	Partial	You mentioned a leaflet but not specific resources.
Interpersonal Skills	Use open-ended questions and actively listen to the patient's concerns.	0:47:00	Yes	You used open-ended questions and let her speak.
Interpersonal Skills	Provide clear and empathetic explanations about the condition and its management.	6:50:00	Yes	Clear and kind explanation.
Interpersonal Skills	Involve the patient in decision-making, ensuring they understand the treatment plan.	7:33:00	Partial	You asked how she felt about the plan but didn’t check her understanding or invite her to choose between options.
Interpersonal Skills	Offer psychological support, acknowledging the stress related to joblessness.	5:47:00	Partial	You acknowledged stress but didn’t explore coping strategies or offer support options.
Interpersonal Skills	Encourage lifestyle changes positively, providing resources and support where needed.	—	No	Not covered.
Interpersonal Skills	Schedule a follow-up appointment to reassess the condition and treatment efficacy.	—	No	Missed — this is important for chronic skin conditions.

	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
3	2	2