PLAB 2 Mock test feedback:: Medical Ethics-Underage Contraception Request at GP Clinic :: 1st Attempt

Mock Date: 24/07/2025
Case 1:
Topic: MedicalEthics CaseUID: SensitiveContraception1
Case Name: Underage Contraception Request at GP Clinic
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 a FY2 doctor in a GP practice. Your patient is Samantha Collins, a 14-year-old girl who has had unprotected sexual intercourse with her boyfriend and is worried about getting pregnant. She is requesting emergency contraception.
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	Greet the patient and confirm her name and age.	0:03	Yes	You introduced yourself and confirmed her name and age clearly right at the start. Good start.
Data Gathering	Ensure privacy and confidentiality by explicitly stating: "Everything we discuss stays between us unless I feel you're at risk."	–	No	You did not explicitly mention confidentiality. In cases involving minors and sensitive topics, it is essential to reassure the patient while stating exceptions (e.g., safeguarding).
Data Gathering	Ask directly, 'What brings you in today?'	0:19	Yes	You asked "How can I help you today?" which is acceptable and open-ended.
Data Gathering	Confirm the primary reason for the visit (request for emergency contraception). Clarify timing and context of unprotected intercourse.	0:24	Partial	You confirmed the reason and timing (“last night”), but you did not ask if the intercourse was consensual. This is a key safeguarding point.
Data Gathering	Ask about the sexual history, previous sexual partners, and history of STI testing. Clarify details about the unprotected sexual intercourse and if any contraception is usually used.	1:12	Partial	You asked about when she became sexually active and relationship duration, but you missed STI testing history and contraception usage.
Data Gathering	Ask about the age of her partner and whether the relationship is consensual and free from pressure. Assess for safeguarding concerns like coercion, grooming, or abuse.	1:12	Partial	You asked her partner's age and school background, but you did not ask directly if the relationship was consensual and free from pressure, nor did you explore for grooming/coercion.
Data Gathering	Explore the patient's understanding of contraception and sexual health. Assess her understanding of emergency contraception: ask how she thinks it works, when it should be taken, and side effects.	–	No	This was completely missed. You should have explored what she knows about emergency contraception and general contraceptive methods.
Data Gathering	Explore menstrual history in detail: cycle length, last menstrual period, any irregularities.	3:10	Partial	You asked if periods were regular and about bleeding, but did not ask about cycle length or date of last period.
Data Gathering	Ask if she understands the advice, would continue sex with or without contraception, and her willingness to involve a parent.	5:20	Yes	You explored her willingness to involve her parents and whether she would continue unprotected sex. Well done.
Data Gathering	Ask about past medical history, STIs, allergies, current medications (use PMAFTOSA for structure).	3:25	Yes	You asked about medical history, medications, allergies, discharge, and lifestyle—good structure using PMAFTOSA.
Data Gathering	Check understanding throughout the consultation by using teach-back: “Can you tell me what you’ve understood so far?”	–	No	Teach-back technique was not used. It's a vital tool to check whether she has understood the advice. Consider adding this near the end.
Management	Explain that she’s at risk of pregnancy and within the window for emergency contraception; offer the pill by saying, “Since you’ve understood how it works and we’ve had a good discussion, I can offer you the emergency contraceptive pill today, if you’re comfortable with that.”	–	No	You offered the pill but didn’t explain risk or confirm her understanding first. This phrase is important for informed decision-making.
Management	Offer emergency contraception (e.g., Levonorgestrel pill): Emphasize urgency – most effective within 24 hours.	4:27	Partial	You offered the pill and mentioned taking it now, but did not explain urgency or timing window for effectiveness.
Management	Discuss side effects: nausea, vomiting, spotting, menstrual changes, and what to do if vomiting occurs within 2 hours.	–	No	Side effects were not discussed. You missed a critical opportunity to safety-net this treatment.
Management	Discuss the limitations of emergency contraception and the necessity for long-term solutions. Explain emergency contraception is not a regular method.	7:39	Partial	You briefly said the pill is not 100% effective and mentioned condoms, but did not clearly explain this is not a regular method.
Management	Offer long-term contraception options (COCP, POP, implant, IUD) and discuss suitability and benefits.	–	No	This was not discussed. Please ensure to talk about long-term options tailored to the patient’s context.
Management	Discuss STI risks and offer STI screening, explain that emergency contraception does not protect from infections.	7:54	Partial	You mentioned STIs but did not offer screening or emphasize the need for testing.
Management	Advise consistent condom use and educate on dual protection for pregnancy and STIs.	7:50	Yes	You advised condom use and explained it doesn’t prevent STIs, which is good.
Management	Encourage follow-up in one month to review contraception needs and emotional wellbeing.	–	No	You did not mention follow-up. This is a missed opportunity for continuity of care.
Management	Provide written information: emergency contraception leaflet, local sexual health clinic contact, STI screening pamphlets.	–	No	There was no mention of written info. Always important for young patients to refer back later.
Management	Document Fraser competence assessment, discussions of safeguarding, contraception advice, and management plan.	–	No	Fraser competency and safeguarding documentation not mentioned. Always state explicitly in consultation even in role play.
Management	Safety net the condition and possible complications/differentials: Warn that the next period may be early or late, and that a pregnancy test should be done if it is more than 7 days late.	–	No	You didn’t safety net regarding menstrual changes or advice on doing a pregnancy test if period is delayed. Critical part of emergency contraception counselling.
Interpersonal Skills	Validate the patient's feelings and concerns about her relationship and parental reactions.	2:31	Yes	You empathised with her concerns about her parents' views and cultural beliefs—this was sensitively handled.
Interpersonal Skills	Use open body language and active listening to build trust.	0:32	Yes	You used verbal affirmations and empathetic tone throughout, indicating good listening and presence.
Interpersonal Skills	Reassure the patient of your support and confidentiality.	1:36	Partial	You reassured her emotionally, but missed explicitly reassuring confidentiality, especially crucial with adolescents.
Interpersonal Skills	Provide clear, non-judgmental information on emergency contraception and its use.	–	No	You did not explain how the pill works or its usage properly. Missed opportunity for education.
Interpersonal Skills	Educate on the need for regular contraception and safe sexual practices.	–	Partial	You mentioned condom use briefly but didn’t educate on regular contraception properly.
Interpersonal Skills	Address any of the patient's misconceptions or fears.	–	No	You did not actively explore or correct any misconceptions, for instance, about emergency contraception effectiveness.
Interpersonal Skills	Be sensitive to the cultural background and the mother’s religious beliefs.	2:55	Yes	You acknowledged her concerns and handled it with appropriate sensitivity.
Interpersonal Skills	Respect patient's autonomy while guiding her.	5:58	Yes	You respected her choices, did not force decisions, and offered options. Well balanced.
Interpersonal Skills	Reassure confidentiality until there is no danger to anyone involved and offer support while gently encouraging involvement of a trusted adult.	5:04	Yes	You encouraged her to involve someone without being forceful—nicely done.

	Feedback Statements:	Needs Improvement
Consultation	Disorganised / unstructured consultation. Includes illogical and disordered approach to questioning. You did not demonstrate sufficiently the ability to follow a logical structure in your consultation. For example, your history taking may have appeared disjointed, with your line of questioning erratic and not following reasoned thinking. You may have undertaken practical tasks or examination in an illogical order that suggested you did not have a full grasp of the reason for completing them or a plan for the consultation.	✔️
Diagnosis	Does not make the correct working diagnosis or identify an appropriate range of differential possibilities.
Examination	Does not undertake physical examination competently, or use instruments proficiently.
Findings	Does not identify abnormal findings or results or fails to recognise their implications. You did not identify or recognise significant findings in the history, examination or data interpretation.
Issues	Does not recognise the issues or priorities in the consultation (for example, the patient’s key problem or the immediate management of an acutely ill patient). You did not recognise the key element of importance in the station. For example, giving health and lifestyle advice to an acutely ill patient.	✔️
Management	Does not develop a management plan reflecting current best practice, including follow up and safety netting.	✔️
Rapport	Does not appear to develop rapport or show sensitivity for the patient’s feelings and concerns, including use of stock phrases. You did not demonstrate sufficiently the ability to conduct a patient centred consultation. Perhaps you did not show appropriate empathy or sympathy, or understanding of the patient’s concerns. You may have used stock phrases that show that you were not sensitive to the patient as an individual, or failed to seek agreement to your management plan.	✔️
Listening	Does not make adequate use of verbal & non-verbal cues. Poor active listening skills. You did not demonstrate sufficiently that you were paying full attention to the patient’s agenda, beliefs and preferences. For example, you may have asked a series of questions but not listened to the answers and acted on them.
Language	Does not use language or explanations that are relevant and understandable to the patient, including not checking understanding. The examiner may have felt, for example, that you used medical jargon, or spoke too quickly for the patient to take in what you were saying.
Time	Shows poor time management. You showed poor time management, probably taking too long over some elements of the encounter at the expense of other, perhaps more important areas.	✔️

Data_gathering	Management	IPS
2	1	2