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

Mock Date: 24/07/2025
Case 2:
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.

Data Gathering	Greet the patient and confirm her name and age.	0:05	Yes	You greeted the patient and confirmed her name and age effectively. This was done clearly and early in the consultation. Good start.
Data Gathering	Ensure privacy and confidentiality by explicitly stating: "Everything we discuss stays between us unless I feel you're at risk."	0:32	Partial	You said the discussion would stay between you two, but you didn’t include the important caveat “unless I feel you're at risk.” This is vital when dealing with underage patients. Always include the exception to avoid misleading the patient.
Data Gathering	Ask directly, 'What brings you in today?'	0:17	Yes	You asked this directly and created a comfortable environment for the patient to express herself. Well done.
Data Gathering	Confirm the primary reason for the visit (request for emergency contraception). Clarify timing and context of unprotected intercourse: "When did it happen?" and "Was it consensual?"	0:43, 3:00, 2:29	Yes	You explored the reason, clarified when the intercourse occurred and whether it was consensual. Good thoroughness here.
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	1:04–1:39	Yes	You explored contraception use, history of STIs, and sexual activity appropriately.
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.	2:12–2:47	Yes	You explored the partner’s age and directly asked about coercion and pressure. Good safeguarding awareness.
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.	3:08, 3:22, 6:00	Yes	You explored her understanding well and followed up with education. You also asked her to repeat what she understood — good use of teach-back.
Data Gathering	Explore menstrual history in detail: cycle length, last menstrual period, any irregularities.	5:04–5:21	Yes	You explored menstrual history adequately. Covered LMP and regularity. Well done.
Data Gathering	Ask if she understands the advice, would continue sex with or without contraception, and her willingness to involve a parent.	4:04, 4:42, 3:33	Partial	You asked about continuation of sex and explored parental awareness, but you did not explore whether she would be willing to involve a parent or trusted adult. You could ask, “Would you feel comfortable involving a trusted adult to support you with your decisions?”
Data Gathering	Ask about past medical history, STIs, allergies, current medications (use PMAFTOSA for structure).	5:23–5:39	Yes	You followed a structured approach, covering PMH, medications, and allergies. Well structured.
Data Gathering	Check understanding throughout the consultation by using teach-back: “Can you tell me what you’ve understood so far?”	7:16	Yes	You asked her to repeat what she understood, which is a strong example of teach-back. Nicely done.
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…”	7:31	Partial	You did offer the pill and explained how it works, but you didn’t say clearly “Since you’ve understood... I can offer it to you if you’re comfortable.” That line ensures consent and confidence in shared decision making.
Management	Offer emergency contraception (e.g., Levonorgestrel pill): Emphasize urgency – most effective within 24 hours.	7:35	Partial	You offered the pill and mentioned taking it immediately, but didn’t explicitly mention the 24-hour efficacy window. Saying this helps reinforce urgency and helps the patient understand why timing matters.
Management	Discuss side effects: nausea, vomiting, spotting, menstrual changes, and what to do if vomiting occurs within 2 hours.	6:44–7:41	Yes	You covered side effects comprehensively and gave safety-netting advice for vomiting. This was well handled.
Management	Discuss the limitations of emergency contraception and the necessity for long-term solutions. Explain emergency contraception is not a regular method.	6:26–6:40	Yes	You explained well that emergency contraception is not a regular solution. Good work.
Management	Offer long-term contraception options (COCP, POP, implant, IUD) and discuss suitability and benefits.	—	No	You did not offer any long-term contraception options. This is an essential part of management and expected in these consultations. You could say, “Would you like me to talk you through some regular methods to help you avoid needing emergency contraception in the future?”
Management	Discuss STI risks and offer STI screening, explain that emergency contraception does not protect from infections.	7:51	Partial	You briefly said emergency contraception doesn't protect from STIs and suggested condoms, but you didn’t offer STI screening. You should mention and offer testing services: “Would you consider getting tested for STIs? We can arrange it confidentially.”
Management	Advise consistent condom use and educate on dual protection for pregnancy and STIs.	7:55	Yes	You advised condom use explicitly. Well done here.
Management	Encourage follow-up in one month to review contraception needs and emotional wellbeing.	—	No	You didn’t mention follow-up. This is important, especially for young patients. You can say, “Let’s arrange a follow-up in a few weeks to check how things are going and talk more about your options.”
Management	Provide written information: emergency contraception leaflet, local sexual health clinic contact, STI screening pamphlets.	—	No	No written resources were offered. Consider ending the station by saying, “I'll give you a leaflet with all this information, and contacts for nearby sexual health clinics you can access if you need more support.”
Management	Document Fraser competence assessment, discussions of safeguarding, contraception advice, and management plan.	—	No	You did not mention or demonstrate Fraser competency assessment, which is critical when prescribing contraception to under 16s. You could include, “Based on what you’ve told me, you understand the implications and are mature enough to make this decision without your parents.”
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 missed this. It's important to mention, “Your period might come earlier or later than usual. If it’s more than 7 days late, do a pregnancy test and come back to us.”
Interpersonal Skills	Validate the patient's feelings and concerns about her relationship and parental reactions.	3:44–4:00	Yes	You acknowledged her parental concerns and validated her feelings. This was done in a kind and supportive tone. Great empathy.
Interpersonal Skills	Use open body language and active listening to build trust.	—	Yes	You used supportive verbal cues and gave the patient space to speak. This came across naturally in the dialogue.
Interpersonal Skills	Reassure the patient of your support and confidentiality.	0:32	Partial	While you reassured her of confidentiality, you didn’t clarify that this may change if she is at risk. Always add that exception with minors.
Interpersonal Skills	Provide clear, non-judgmental information on emergency contraception and its use.	6:00–7:15	Yes	You did well in explaining the function and limitations of the morning after pill without judgement. Keep this up.
Interpersonal Skills	Educate on the need for regular contraception and safe sexual practices.	6:26–7:00	Partial	You advised it’s not for regular use and mentioned condoms but didn’t explore or offer long-term methods like pills or implants. This left a gap in education.
Interpersonal Skills	Address any of the patient's misconceptions or fears.	3:13–3:28	Yes	You explored what she thought the pill would do and corrected gaps in understanding kindly. Good.
Interpersonal Skills	Be sensitive to the cultural background and the mother’s religious beliefs.	3:50	Yes	You acknowledged and responded sensitively to the strict Roman Catholic background of her parents. Nicely done.
Interpersonal Skills	Respect patient's autonomy while guiding her.	4:00–4:42	Yes	You showed understanding and allowed her to express her wishes about the relationship and decision-making. Good patient-centred approach.
Interpersonal Skills	Reassure confidentiality until there is no danger to anyone involved and offer support while gently encouraging involvement of a trusted adult.	—	No	You missed the opportunity to gently encourage her to involve a trusted adult. This is expected as part of safeguarding in minors and supports autonomy while encouraging safety.

	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	3