PLAB 2 Mock Test Feedback :: 27/03/25 :: PaduhwanUID32

Mock Date: 27/03/2025

Case 1:

Failed CBT : Psychiatry (Attempt 1)

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. Ralph Carter, a 41-year-old patient, has come for a follow-up. He was diagnosed with mild depression two months ago and started on cognitive behavioral therapy (CBT). Ralph feels that CBT is not working and is experiencing worsening symptoms. He is seeking an alternative treatment plan.

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	Patient identifiers: Confirm full name and age	00:12	Yes	You confirmed both the patient’s name and age early on—great start to build rapport and confirm identity.
Data Gathering	Explore symptoms of depression: low mood, anhedonia, fatigue, sleep disturbances, changes in appetite	01:28	Partial	You explored low mood, anhedonia (low libido), sleep, and appetite. However, fatigue was not specifically asked about. A quick “Do you feel more tired than usual?” would’ve completed this.
Data Gathering	Assess duration and impact of symptoms on daily life	02:00	Yes	You asked when it started and explored work, social life, and coping, which clearly captured both duration and functional impact.
Data Gathering	Investigate any previous episodes of depression or mental health issues	—	No	You didn’t ask if Ralph had any similar episodes in the past or previous mental health diagnoses. This could’ve been added naturally after asking about the current symptoms.
Data Gathering	Identify risk factors: family history, recent stressors, substance use	02:02, 03:03	Partial	You addressed recent stressors (divorce) and substance use (alcohol), but missed asking about family history of mental health conditions.
Data Gathering	Review current medications and any recent changes	04:47	Yes	You asked if the patient was taking any medications. Clear and concise.
Data Gathering	Gather psychosocial history: support systems, significant life events	04:09	Partial	You asked about support systems and uncovered estranged relationships. More could have been done to explore current living situation, occupation, and hobbies.
Data Gathering	Perform a mental state examination: appearance, behavior, speech, mood, affect, thought process, thought content, perception, cognition, insight, judgment	01:39–04:30	Partial	You explored mood and thought content, but missed appearance, speech, affect, perception, cognition, and insight. You could have commented on or gently explored these areas in between your questions.
Management	Assess suicide risk and create a safety plan if necessary	05:01	Partial	You asked directly about self-harm and got a negative response. However, no clear safety plan or further risk exploration (intent, planning, protective factors) was discussed.
Management	Consider starting antidepressant medication (e.g., Reboxetine) based on severity and patient preference	06:18	Yes	You offered antidepressants considering the patient’s preferences and previous therapy attempt. Good shared decision making.
Management	Advise to continue medication for 6 months even if effects don’t show immediately	—	No	You mentioned it would take time to work, but did not mention the 6-month continuation recommendation. This is a NICE guideline-based point and would have strengthened the plan.
Management	Offer high-intensity or individual CBT if not previously tried	—	No	Patient said he had been to CBD (likely meant CBT), but you did not clarify whether it was high-intensity or individual CBT. A clarification here would be helpful, especially as he found it unhelpful.
Management	Advise on lifestyle interventions: reduce alcohol intake, regular physical activity, healthy sleep hygiene	06:10	Partial	You discussed alcohol and asked about physical activity, but no advice or suggestions were given. Also, sleep hygiene was not covered at all.
Management	Schedule regular follow-up appointments to monitor progress and medication side effects	08:01	Partial	You planned a follow-up in 2 weeks, but did not mention monitoring for side effects specifically. You could’ve said something like “We’ll check how you're doing with the medication, especially in case of side effects.”
Management	Provide patient education on depression and treatment options	06:18	Partial	You explained that medication takes time and mentioned therapy, but did not explain what depression is or why certain treatments help. A brief explanation would show patient-centeredness.
Management	Refer to support groups and community resources	—	No	You missed an opportunity to offer external help like support groups or helplines, which is particularly helpful given his isolation.
Management	Encourage maintaining a healthy lifestyle and engaging in enjoyable activities	06:05	Partial	You did ask about activities, but didn’t encourage or suggest any hobbies or alternatives, especially since football was no longer enjoyable for him.
Management	Safety netting: Advise Ralph to seek immediate help if experiencing worsening mood, suicidal thoughts, or new distressing symptoms	07:42	Yes	Excellent safety netting here—well done. You emphasized seeking help if his mood worsens or he experiences harmful thoughts.
Management	Provide emergency contacts: crisis resolution and home treatment team, 24-hour mental health support	—	No	You did not mention specific emergency contacts or services, which is important for safety netting in mental health consultations.
Management	Encourage Ralph to inform a trusted family member or friend about his condition	—	No	You asked about support but didn’t encourage him to inform someone about his situation. This could increase his safety and support.
Management	Arrange first follow-up appointment in 1 week if starting medication, otherwise in 2–4 weeks	08:01	Partial	You offered a 2-week follow-up but did not explain why or mention 1 week if starting meds. A little more precision here would’ve aligned with best practice.
Management	Schedule subsequent follow-ups every 2–4 weeks to monitor progress and side effects	—	No	Follow-ups beyond the initial one were not discussed. It would’ve been better to mention the need for ongoing reviews every few weeks.
Management	Continue follow-ups for at least 6 months after improvement to reduce relapse risk	—	No	You didn’t mention the long-term follow-up needed. This would’ve reassured the patient and shown you’re thinking about sustained care.
Interpersonal Skills	Show empathy, listen actively, and validate the patient's feelings	01:52, 04:33	Yes	You consistently acknowledged Ralph’s distress and validated his feelings. Great tone and presence throughout.
Interpersonal Skills	Maintain a non-judgmental and supportive demeanor	03:10, 04:30	Yes	You remained calm and supportive, even when alcohol and sexual dysfunction were discussed.
Interpersonal Skills	Provide clear explanations about diagnosis and treatment	06:18	Partial	While you explained antidepressants and their side effects, you didn’t explain what depression is, or why certain therapies work, which could’ve helped engagement.
Interpersonal Skills	Encourage patient involvement in treatment decisions	06:18	Yes	You acknowledged his concerns about side effects and worked around his preferences—well done.
Interpersonal Skills	Involve the patient in decision-making, respecting their preferences	06:05	Yes	You adapted the plan to his reluctance to reduce alcohol and concerns about medication—good shared decision making.
Interpersonal Skills	Be sensitive to cultural and personal factors influencing their experience and treatment	04:19	Yes	You respected his personal situation and didn’t push when he rejected family support—well judged.

Feedback Statement Checklist

	Feedback Statements:	Needs Improvement
Consultation
Diagnosis
Examination
Findings
Issues
Management	Many key management components were missed.	✔️
Rapport
Listening
Language	Does not use language or explanations understandable to the patient ✅ (Partial – could’ve explained depression better)	✔️
Time	Shows poor time management (spent too long on certain areas, less time on referrals/safety planning)	✔️

Case 2:

Failed CBT : Psychiatry (Attempt 2)

Mock Date: 27/03/2025

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. Ralph Carter, a 41-year-old patient, has come for a follow-up. He was diagnosed with mild depression two months ago and started on cognitive behavioral therapy (CBT). Ralph feels that CBT is not working and is experiencing worsening symptoms. He is seeking an alternative treatment plan.

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	Patient identifiers: Confirm full name and age	00:07	No	You confirmed the patient's name but didn’t ask for or confirm their age. Always verify both name and age at the start to avoid any medico-legal issues.
Data Gathering	Explore symptoms of depression: low mood, anhedonia, fatigue, sleep disturbances, changes in appetite	00:36–00:48	Partial	You covered low mood, anhedonia, and fatigue. However, you missed asking about sleep disturbances and appetite changes, which are essential symptoms to evaluate in depression. Try asking, “How has your sleep and appetite been lately?”
Data Gathering	Assess duration and impact of symptoms on daily life	01:21, 04:00	Yes	Well done here. You explored how long he has been feeling this way and its effect on his daily functioning including work and intimacy.
Data Gathering	Investigate any previous episodes of depression or mental health issues	03:21	Yes	You asked if he had experienced this before and clarified this was the first episode.
Data Gathering	Identify risk factors: family history, recent stressors, substance use	01:21, 02:03	Partial	You asked about the divorce and alcohol use. However, family history of mental illness wasn’t explored, which is crucial in psychiatric assessments.
Data Gathering	Review current medications and any recent changes	03:38	No	You asked about any medications he’s taken, but not clearly about current medications or recent changes. Always clarify what the patient is currently on, even if it’s just over-the-counter meds.
Data Gathering	Gather psychosocial history: support systems, significant life events	02:28–02:43	Yes	You asked about support systems and his living situation. This was explored sufficiently.
Data Gathering	Perform a mental state examination: appearance, behavior, speech, mood, affect, thought process, thought content, perception, cognition, insight, judgment	Throughout	Partial	You did ask about mood, perception (hallucinations), and suicidal ideation. However, other components like speech, appearance, affect, cognition, and insight weren’t explicitly explored or commented on. You could have added phrases like “You seem a bit withdrawn today” or “Would you say you’re thinking clearly?” to help cover these.
Management	Assess suicide risk and create a safety plan if necessary	02:47, 05:34	Partial	You asked about suicidal thoughts but didn’t create a clear safety plan. Although you mentioned crisis support, you could have been more explicit, like “Let’s make a plan together for what to do if things get worse.”
Management	Consider starting antidepressant medication (e.g., Reboxetine) based on severity and patient preference	04:40–05:00	Yes	You discussed medication as per the patient’s preference and acknowledged the severity. Well done!
Management	Advise to continue medication for 6 months even if effects don’t show immediately	–	No	This wasn’t mentioned. It’s important to set the right expectations about duration of treatment to encourage adherence.
Management	Offer high-intensity or individual CBT if not previously tried	05:00	Partial	You suggested intensive CBT but didn’t clarify that it was different from what he previously received or explain what it entails. Try adding, “This might be a different, more focused version of the talking therapy you’ve tried before.”
Management	Advise on lifestyle interventions: reduce alcohol intake, regular physical activity, healthy sleep hygiene	06:51	Partial	You gave excellent advice on alcohol but didn’t mention physical activity or sleep hygiene. These are often overlooked but make a big difference in mental health.
Management	Schedule regular follow-up appointments to monitor progress and medication side effects	–	No	Follow-up appointments weren’t discussed. You should always mention when you’ll review them again to monitor treatment response.
Management	Provide patient education on depression and treatment options	04:42	Partial	You explained a bit about moderate depression and side effects but didn’t go into more about the nature of depression or how different treatments work.
Management	Refer to support groups and community resources	06:15	Yes	You did well arranging support groups and helpline contact.
Management	Encourage maintaining a healthy lifestyle and engaging in enjoyable activities	–	No	You didn’t encourage engaging in pleasurable activities or a healthy routine, which is an important part of managing depression.
Management	Safety netting: Advise Ralph to seek immediate help if experiencing worsening mood, suicidal thoughts, or new distressing symptoms	05:34	Yes	You gave appropriate safety netting instructions including helpline and coming back to the clinic.
Management	Provide emergency contacts: crisis resolution and home treatment team, 24-hour mental health support	06:33	Yes	You gave him a 24/7 helpline. Excellent!
Management	Encourage Ralph to inform a trusted family member or friend about his condition	–	No	You didn’t encourage him to share his condition with someone. Since he is isolated, this would have been crucial to explore.
Management	Arrange first follow-up appointment in 1 week if starting medication, otherwise in 2-4 weeks	–	No	You didn’t mention the timeline for a follow-up, which is essential when initiating treatment.
Management	Schedule subsequent follow-ups every 2-4 weeks to monitor progress and side effects	–	No	No follow-up frequency was mentioned. This is a key part of managing chronic conditions.
Management	Continue follow-ups for at least 6 months after improvement to reduce relapse risk	–	No	Continuity of care was not discussed. Reinforce long-term follow-up for chronic conditions like depression.
Interpersonal Skills	Show empathy, listen actively, and validate the patient's feelings	00:26, 00:56	Yes	You validated his frustration and sadness nicely. Your tone was calm and your responses were caring. Great job!
Interpersonal Skills	Maintain a non-judgmental and supportive demeanor	Throughout	Yes	You remained supportive and non-judgmental throughout, especially when discussing alcohol and intimacy concerns.
Interpersonal Skills	Provide clear explanations about diagnosis and treatment	04:42–05:18	Partial	You explained the diagnosis and treatment briefly, but didn’t explore other options or explain the nature of depression in a simplified way.
Interpersonal Skills	Encourage patient involvement in treatment decisions	04:20, 05:09	Yes	You involved him in the decision and explored his preferences. Excellent collaborative approach.
Interpersonal Skills	Involve the patient in decision-making, respecting their preferences	04:24	Yes	You respected his choice to move away from CBT and towards medication. Well done!
Interpersonal Skills	Be sensitive to cultural and personal factors influencing their experience and treatment	–	Partial	While you were generally empathetic, you didn’t specifically acknowledge or explore any personal or cultural influences that may affect his coping or views on treatment.

Feedback Statement Checklist

	Feedback Statements:	Needs Improvement
Consultation
Diagnosis
Examination
Findings
Issues
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	✔️
Listening
Language	Does not use language or explanations that are relevant and understandable to the patient, including not checking understanding	✔️
Time

Case 3:

Gender Dysphoria : Medical Ethics (Attempt 1)

Mock Date: 27/03/2025

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 at a GP surgery, you have a consultation with Emily Thompson, a 16-year-old patient who presents with concerns regarding gender identity. Emily expresses her desire to transition from female to male. She is seeking information and support on how to proceed with her transition.

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 patient details: Confirm Emily Thompson’s identity, ask if she has a preferred name and pronouns.	00:11	Partial	You confirmed Emily's full name and age at the start, which was great. But you didn’t ask her about her preferred name or pronouns—this is crucial in gender identity consultations to ensure the patient feels respected and seen. You could have said, “Do you have a name or pronouns you prefer I use today?” right after getting her name.
Data Gathering	Establish the main concern: Explore the primary reason for visiting.	00:19	Yes	You gently asked how you could help and allowed the patient to open up at her pace. Good use of open-ended questions.
Data Gathering	Explore gender identity: Duration of feeling this way about gender, present living gender, steps taken toward the preferred gender, disclosure to anyone regarding gender identity, support received so far, feelings about the body and any associated dysphoria.	01:37–05:06	Partial	You covered duration, current gender feelings, and body dysphoria well. However, you didn’t ask about steps taken toward transition or whether she's begun presenting as her preferred gender. You also missed asking about experiences with discrimination or public facilities. Asking about support systems was partially addressed. Try to break this down naturally across the consultation.
Data Gathering	Self-perception: Biologically female, currently living as female, has not begun living as the preferred gender, has not disclosed to anyone, including her family, assess feelings towards body parts causing dysphoria, identify any ongoing support or friends aware of the situation, assess fears and worries about the transition.	02:57–05:06	Partial	You did clarify her current biological and living gender status and touched on her body dysphoria. But there was no direct questioning about specific fears regarding transitioning or worries about disclosure to others beyond the vague mention of “maybe” telling someone. You could have asked, “Are there particular aspects of your body that make you uncomfortable?” or “Are you worried about how others might react?”
Data Gathering	History of gender change: Considering transitioning to male, has not started any transition processes yet, no consultations with gender identity clinic or related doctors, no prior medications or treatments related to gender transition.	06:12	Yes	You clarified she hasn’t started transitioning or seen any professionals before, and you discussed referral options. Good job here.
Data Gathering	Sexual life: Assess if sexually active and if so, whether partners are male or female.	—	No	This was completely missed. It would’ve been appropriate to ask gently: “Can I ask you a bit about your relationships or if you’re sexually active? This helps me understand how you’re feeling overall.”
Data Gathering	Mental health: Assess current stress, anxiety, or depression, coping mechanisms and support systems, discrimination faced, if any, problems with using appropriate public facilities.	03:30–04:27	Partial	You explored mood, stress, and coping (e.g., likes being alone), which was good. However, you didn’t ask about discrimination, suicidal ideation, or problems with public facilities. These are vital areas to ensure patient safety.
Data Gathering	Social impact: Any discrimination experienced due to gender identity, issues with public restroom usage.	—	No	This was not covered. A gentle way to explore it could have been, “Have you ever had any difficult experiences because of how you feel about your gender? In school or in public spaces?”
Management	Immediate support: Acknowledge feelings and concerns empathetically, reassure about confidentiality.	00:38	Yes	You showed warmth and reassurance. Your calm tone and reassurance that the consultation is confidential helped create a safe space.
Management	Support exploration of gender identity, including emotional reflection and access to counseling/community groups	06:12	Partial	You did offer referral to a gender identity clinic and acknowledged her emotional conflict, but you didn’t mention any counseling services or emotional reflection support like CAMHS or specific community mental health options.
Management	Referral: Refer to Child and Adolescent Mental Health Services (CAMHS), refer to a Gender Dysphoria Clinic (Gender Identity Development Service).	06:31	Partial	You mentioned referral to a gender identity clinic which is great, but CAMHS was not mentioned. Since she is 16, referral to CAMHS should’ve been explicitly offered.
Management	Support and education: Provide information on support groups and educational resources, discuss potential treatments and their explanations, including hormone treatments like testosterone, offer educational leaflets about gender identity and support groups.	—	No	This was completely missed. You could have added: “There are leaflets and online resources I can give you about gender identity, and if you want, we can also discuss what treatment options might look like in the future.”
Management	Additional Points: Emphasize the importance of regular follow-up to monitor progress, provide crisis helpline information for immediate mental health support, liaise with school counselors to provide a supportive environment if required, encourage connection with LGTBQ+ support groups to foster community.	07:35	Partial	You did well to mention follow-up and invited her to return if her mood drops. However, no mention of crisis helplines, school counselor involvement, or encouragement to join LGBTQ+ groups apart from her already attending one. Next time, you could say, “Would you like me to contact the school to make sure they’re offering support?” or “Here’s a helpline you can call anytime you’re struggling.”
Interpersonal Skills	Rapport: Open body language, maintain eye contact, show empathy.	Throughout	Yes	You maintained a calm, soft, and supportive tone. You clearly built trust. Just be mindful to avoid sounding too repetitive or rehearsed.
Interpersonal Skills	Communication: Use simple language, avoid jargon, summarize key points, encourage and allow questions, answer patience-centeredly understanding.	—	Partial	You mostly used simple language and allowed the patient to speak. However, you didn’t summarize the discussion clearly or ask if she had any questions. A simple wrap-up like, “So just to summarize what we’ve discussed today…” would help.
Interpersonal Skills	Ensure confidentiality: Emphasize the private nature of the consultation.	00:41	Yes	You reassured her early on that it’s a safe space and confidential. This was well done.
Interpersonal Skills	Be Non-judgmental: Acceptance and understanding regardless of personal beliefs.	Throughout	Yes	Your tone was kind, open, and accepting. No judgment shown at any point. Great job here.
Interpersonal Skills	Document details: Accurately record all details discussed including patient’s preferred name and pronouns.	—	No	There was no discussion or clarification of preferred name or pronouns, so this could not be documented. Next time, include this early in the consultation.
Interpersonal Skills	Respect and dignity: Treat the patient with dignity and respect.	Throughout	Yes	You treated Emily with warmth, maintained dignity, and respected her struggles. Very good.

Feedback Statement Checklist

Feedback Statements:	Needs Improvement
Consultation	Disorganised / unstructured consultation	✔️
Diagnosis
Examination
Findings
Issues	Does not recognise the issues or priorities in the consultation	✔️
Management	Does not develop a management plan reflecting current best practice, including follow up and safety netting	✔️
Rapport
Listening
Language
Time	Shows poor time management	✔️

Case 4:

Gender Dysphoria : Medical Ethics (Attempt 2)

Mock Date: 27/03/2025

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 at a GP surgery, you have a consultation with Emily Thompson, a 16-year-old patient who presents with concerns regarding gender identity. Emily expresses her desire to transition from female to male. She is seeking information and support on how to proceed with her transition.

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 patient details: Confirm Emily Thompson’s identity, ask if she has a preferred name and pronouns.	00:07 – 01:00	Yes	You confirmed Emily’s name and age, and also asked about preferred name and pronouns early in the consultation, which is great.
Data Gathering	Establish the main concern: Explore the primary reason for visiting.	00:18 – 01:00	Yes	You explored the reason for visit empathetically and supported Emily when she hesitated to open up.
Data Gathering	Explore gender identity: Duration of feeling this way about gender, present living gender, steps taken toward the preferred gender, disclosure to anyone regarding gender identity, support received so far, feelings about the body and any associated dysphoria.	01:18 – 02:26	Partial	You explored the duration, steps taken (LGBT group), and dysphoria. However, you didn’t clarify her present living gender, and didn’t ask how she identifies herself currently, which are key details.
Data Gathering	Self-perception: Biologically female, currently living as female, has not begun living as the preferred gender, has not disclosed to anyone, including her family, assess feelings towards body parts causing dysphoria, identify any ongoing support or friends aware of the situation, assess fears and worries about the transition.	01:25 – 02:20	Partial	You covered dysphoria and her not disclosing to family, but didn’t explore feelings about specific body parts, and didn’t ask about friends or specific fears about the transition.
Data Gathering	History of gender change: Considering transitioning to male, has not started any transition processes yet, no consultations with gender identity clinic or related doctors, no prior medications or treatments related to gender transition.	04:01 – 04:32	Yes	This was clearly established when Emily asked about starting and you clarified her background and lack of previous medical steps.
Data Gathering	Sexual life: Assess if sexually active and if so, whether partners are male or female.	03:14 – 03:34	Yes	This was appropriately asked and Emily shared she was not sexually active and unsure of preferences.
Data Gathering	Mental health: Assess current stress, anxiety, or depression, coping mechanisms and support systems, discrimination faced, if any, problems with using appropriate public facilities.	03:01 – 03:10	Partial	You asked about mood and school performance, but did not ask about discrimination, coping mechanisms, or issues using facilities, which are vital areas in gender dysphoria consults.
Data Gathering	Social impact: Any discrimination experienced due to gender identity, issues with public restroom usage.	–	No	This was missed entirely. You could have asked something like, “Have you ever felt treated differently or faced issues in public spaces like school or restrooms?” to bring this out.
Management	Immediate support: Acknowledge feelings and concerns empathetically, reassure about confidentiality.	00:29 – 01:00, 07:39	Yes	You acknowledged Emily's embarrassment and reassured her, particularly around not having to tell her parents unless she chooses.
Management	Support exploration of gender identity, including emotional reflection and access to counseling/community groups	04:27 – 06:26	Yes	You offered referral to Gender Identity Clinic and psychiatrist, and mentioned support groups—well done.
Management	Referral: Refer to Child and Adolescent Mental Health Services (CAMHS), refer to a Gender Dysphoria Clinic (Gender Identity Development Service).	04:27 – 05:05	Partial	You referred to the Gender Identity Clinic and psychiatrist, but did not mention CAMHS which is an essential part of the pathway for a 16-year-old.
Management	Support and education: Provide information on support groups and educational resources, discuss potential treatments and their explanations, including hormone treatments like testosterone, offer educational leaflets about gender identity and support groups.	05:10 – 05:43	Yes	You discussed testosterone, mentioned medical supervision, support groups, and leaflets—great job here.
Management	Additional Points: Emphasize the importance of regular follow-up to monitor progress, provide crisis helpline information for immediate mental health support, liaise with school counselors to provide a supportive environment if required, encourage connection with LGTBQ+ support groups to foster community.	05:36	Partial	You encouraged LGBTQ+ group interaction, but missed follow-up plan, crisis support, and liaising with school counselors which would be important in this case.
Interpersonal Skills	Rapport: Open body language, maintain eye contact, show empathy.	Throughout	Yes	You were warm, gentle, and built rapport well. You supported her emotionally, especially at points of vulnerability.
Interpersonal Skills	Communication: Use simple language, avoid jargon, summarize key points, encourage and allow questions, answer patience-centeredly understanding.	05:10 – 06:26	Partial	You communicated well with simple language and gave time for questions. However, you did not summarize key points or safety net properly, which could have helped clarify everything.
Interpersonal Skills	Ensure confidentiality: Emphasize the private nature of the consultation.	07:39	Partial	You reassured her she doesn’t have to tell her parents, but you didn’t explicitly state this is a confidential consultation. Even a gentle, “This is a safe space” could help.
Interpersonal Skills	Be Non-judgmental: Acceptance and understanding regardless of personal beliefs.	Throughout	Yes	You were very respectful and non-judgmental throughout the consultation.
Interpersonal Skills	Document details: Accurately record all details discussed including patient’s preferred name and pronouns.	–	No	This wasn’t verbalised or suggested. You could say, “I’ll make sure we note down your preferences properly in your record.”
Interpersonal Skills	Respect and dignity: Treat the patient with dignity and respect.	Throughout	Yes	You respected Emily's identity and handled the conversation with dignity.

Feedback Statement Checklist

Feedback Statements:	Needs Improvement
Consultation	Your structure was a little loose. A clearer flow (intro – concern – impact – management – summary) would help.	✔️
Diagnosis
Examination
Findings
Issues
Management	Missed CAMHS and crisis planning.	✔️
Rapport
Listening
Language	Mostly good, but summarising and checking understanding at the end would enhance clarity.	✔️
Time