PLAB 2 Mock test feedback:: Medical Ethics: Elderly Multiple Bruises

Practice this case with the AI patient 🤖

Mock Date: 09/08/2025
Case 1:
Topic: Medical Ethics; Case UID: ElderlyAbuse1
Case Name: Elderly Multiple Bruises
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:
An elderly patient, Mrs. Green, is brought in after a fall, with concerns about possible elder abuse due to unexplained bruises. The doctor confirms identities, gathers a detailed history, and sensitively screens for abuse. Management involves pain relief, comprehensive assessment, referral to social services, and senior colleague involvement, while offering caregiver support and ensuring safeguarding in line with GMC guidelines.
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. Clarify the relationship of the daughter to the patient.	0:17, 0:55, 1:04	Yes	You confirmed the mother’s name, age, and relationship early on, which set a clear context for the rest of the history-taking.
Data Gathering	Explore the incident of fall: Ask the daughter to describe what exactly happened when the fall occurred and who was present.	1:18–1:36	Yes	You let the daughter explain what she heard and saw. This was a good open question to get the narrative of events.
Data Gathering	Ask detailed questions about the fall: time, how it happened, consciousness, witnesses, previous falls.	2:00–2:35	Partial	You asked about what happened, presence of injury, and consciousness. You did not ask about the exact time of fall, whether she has had previous falls, or any witnesses apart from the daughter. This would have helped to assess risk and possible causes more fully.
Data Gathering	Inquire about the patient's mobility, cognitive status, and use of aids. Check fall history: Ask if the mother has had any previous falls, balance issues, or history of fractures.	1:36	Partial	You noted she uses a zimmer frame but didn’t explore cognitive status, prior falls, balance issues, or fracture history. This could have been linked when discussing her mobility and daily activities.
Data Gathering	Explore the daughter's caregiving responsibilities, work situation, and family dynamics.	3:15–4:23	Yes	You asked about her being the sole carer, her responsibilities, and financial/work situation, which was important to understand the context of care.
Data Gathering	Explore medical history: Ask for known diagnoses such as dementia, stroke, hypertension, or osteoporosis.	4:32–4:41	Partial	You elicited arthritis and hypertension but did not ask about dementia, stroke, or osteoporosis specifically. These could be relevant to falls and injury risk.
Data Gathering	Assess care dynamics and support system: Explore who lives with the patient, the frequency of caregiver presence, and availability of additional support (e.g., relatives, community care).	5:03–5:29	Yes	You asked who else lives at home, who looks after the mother when the daughter is away, and explored options for extra help.
Data Gathering	Review current medications: Ask for a list of medications and specifically confirm usage of amlodipine and paracetamol.	4:46–5:00	Yes	You obtained an accurate list and confirmed regular use.
Data Gathering	Screen for elderly abuse: gently inquire about the source of bruises and care when the daughter is away.	5:38–6:27	Yes	You addressed the bruising directly and sensitively, giving the opportunity for disclosure.
Management	Explain diagnosis and situation: Explain that the fall needs careful evaluation to rule out injury and understand any underlying causes.	—	No	You mentioned concern about bruises but did not clearly explain that the fall itself needs evaluation and the aim is to rule out injury and underlying causes. This could have helped the daughter understand the medical reasoning.
Management	Order relevant investigations: Recommend chest x-ray, head CT if any signs of head trauma, and routine blood work if indicated.	5:38–5:42	Partial	You mentioned a chest x-ray was done but did not suggest any head imaging or blood work, despite unclear consciousness and potential head trauma.
Management	Provide appropriate pain relief and care for injuries.	—	No	No mention of offering pain relief for her chest pain. A quick offer could have demonstrated proactive symptom management.
Management	Explain the necessity of referring to social services for suspected elder abuse.	—	No	You discussed support services generally but did not clearly state that social services referral is necessary due to suspected abuse. This is important for safeguarding.
Management	Normalize referral process: Reassure the daughter that referral to social services is routine and meant to support both patient and caregiver.	—	No	Missed the opportunity to frame referral in a supportive, non-threatening way, which could reduce defensiveness.
Management	Discuss options for in-home care support to reduce caregiving burden.	7:36–8:00	Yes	You suggested community and social services that can help at home.
Management	Involve seniors	—	No	You didn’t mention escalating or involving senior colleagues despite a safeguarding concern, which is expected.
Management	Explore long-term solutions like carer visits or considering a nursing home.	4:24–4:31	Partial	You touched on being open to carers visiting home but didn’t explore nursing home as an option in depth.
Management	Arrange a follow-up appointment if further action is needed.	—	No	No plan for follow-up was made explicit, which is key to ensuring continuity of care.
Management	Provide written information: Give leaflets about elder care support, local carer organizations, and respite services.	—	No	You did not offer any written resources, which could reinforce verbal advice and give her something to revisit later.
Interpersonal Skills	Acknowledge and validate the daughter's emotions: 'I understand this situation is very stressful for you, and I’m here to help.'	3:33	Yes	You acknowledged that her situation is hard and validated her effort, which was good rapport building.
Interpersonal Skills	Show empathy continuously toward both the patient and her daughter.	—	Partial	You showed some empathy, but at times the conversation felt more factual than supportive, especially when discussing abuse. More warmth throughout could help.
Interpersonal Skills	Approach the topic of potential abuse with great sensitivity.	5:38–6:27	Yes	You brought it up gently, explained your concerns, and allowed space for her to respond.
Interpersonal Skills	Use clear, non-judgmental language when discussing the patient's condition and care options.	5:38–8:00	Yes	You avoided judgmental tone and kept your language factual, even after disclosure of rough handling.
Interpersonal Skills	Provide continuous reassurance and support to the daughter.	—	Partial	While you did offer some reassurance, it was not sustained across the consultation, especially after she admitted rough handling. A closing supportive statement could have helped.
Interpersonal Skills	Document all findings accurately for further reference and ensure communication with the multidisciplinary team.	—	No	You did not mention documentation or MDT handover; in real life, this is essential for safeguarding and continuity.
Interpersonal Skills	Maintain professionalism and respect patient's choices and beliefs	Throughout	Yes	You remained respectful, non-judgmental, and calm throughout the consultation. This is excellent and reflects well on your professional demeanor.

	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	1	2