PLAB 2 Mock test feedback:: Paediatrics Symptomatic Differentials: 8 Weeks Vaccination

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Mock Date: 11/08/2025
Case 1:
Topic: Paediatrics Symptomatic Differentials
Case Name: 8 Weeks Vaccination; CaseUID: Vaccination1
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. Emma Smith, a 30-year-old mother, has brought her 5-week-old son for a non-urgent appointment because she has concerns about the upcoming vaccinations of her baby.
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 patient's full name and age: Emma Smith, 30 years old along with the baby’s name and age	0:08–0:25	Partial	You confirmed Emma’s name and the baby’s name and age, but you did not ask Emma’s age (30 years old). In PLAB stations, always ensure you cover both patient’s and child’s details as written in the task. Next time, after confirming the baby’s details, you could naturally add “And Emma, may I also confirm your age please?” to complete the data gathering.
Data Gathering	Clarify the reason for attendance by asking the mother to elaborate on her concerns regarding the upcoming vaccinations.	0:33–0:56	Yes	You did well by asking what was concerning her about the vaccinations. This was clear and allowed Emma to open up. Keep this structure going, it shows you are listening and tailoring your questions.
Data Gathering	Explore Emma’s knowledge and beliefs about vaccines, including what she knows about how they work.	1:19–1:48	Yes	You asked about online reading and what she knows about immunity. This was well done, as it gauged her baseline understanding.
Data Gathering	Ask specifically about her concerns regarding side effects, such as fever, pain, or long-term effects like autism.	0:56, 4:25	Partial	You explored autism but did not directly ask about common side effects like fever, swelling, or pain at the injection site. Next time, structure your questions: “Some parents worry about things like fever, swelling, or even myths like autism — are any of these worrying you?” That way you cover all areas systematically.
Data Gathering	Inquire about baby's feeding, drinking, and sleeping patterns. Ask if the baby has had any health issues recently, such as fever, infections, or hospital admissions, which might delay vaccination.	1:52–2:18	Partial	You asked about feeding and illness, but not about sleeping patterns or hospital admissions. A quick addition like “How is Lester sleeping at the moment? Any hospital stays so far?” would have completed this point.
Data Gathering	Check for any family history of adverse vaccine reactions or immunodeficiency to identify potential contraindications.	–	No	You missed asking about family history. This is key in vaccine consultations. You could have slotted this in after asking about allergies: “Has anyone in the family had problems with vaccines or immune system issues?”
Data Gathering	Ask about any medical problems, medications, or allergies	2:20–2:51	Yes	You asked about pregnancy/delivery complications and allergies, which was appropriate.
Data Gathering	Gather pediatric history including development, milestones and diaper output	–	No	You did not ask about development or diaper output. These are quick but important questions to ensure overall well-being before vaccination. A simple “Is Lester meeting his milestones so far, like smiling or head control? How about his wet nappies?” would have covered this.
Data Gathering	Use ICE (Ideas, Concerns, Expectations) to thoroughly understand what Emma believes about vaccines, her specific fears, and what she is hoping for.	0:49–6:02	Partial	You explored her concerns (sickness, autism, number of vaccines), but not her expectations — e.g., what she was hoping to get from the consultation. Asking “What would you like from today’s discussion — more information, reassurance, or to delay?” would have made this complete.
Data Gathering	Address specific concerns about vaccine side effects and administration method	3:34–7:25	Yes	You explained well about the single injection, side effects like fever and irritability, and reassured about paracetamol. This was good.
Management	Educate about the 6-in-1 vaccine: The 6-in-1 vaccine protects babies against six serious diseases—diphtheria, hepatitis B, Hib, polio, tetanus, and whooping cough—by helping their immune system build strong, lasting protection early in life.	6:33–6:57	Yes	You explained the six infections clearly. Nicely done.
Management	Clarify the vaccine schedule, particularly the 8, 12, and 16-week intervals, and mention the updated fourth dose for babies born after July 2024. Explain that each dose is administered as an injection into the thigh muscle (intramuscular route).	6:05–6:17	Partial	You mentioned the 8-week dose but not the 12 and 16-week schedule, nor the new 4th dose after July 2024, and you did not mention intramuscular administration. Next time, add: “This is given into the thigh muscle at 8, 12, and 16 weeks, and babies born after July 2024 will also get a fourth dose.”
Management	Explain the concept of herd immunity, emphasizing protection of the whole community, especially those who cannot be vaccinated. Address consequences of not vaccinating and associated risks (e.g., disease resurgence).	4:52–5:06	Yes	You mentioned community protection — good. Keep reinforcing this idea as it’s often a mark-scoring point.
Management	Describe common side effects such as mild fever, local swelling or redness, and irritability, and reassure these are normal and self-limiting.	7:25–7:44	Yes	You explained fever, pain, irritability, and paracetamol. Good reassurance.
Management	Vaccinations are usually given at your GP surgery or local health centre, following the NHS schedule by trained professionals.	–	No	You didn’t mention where the vaccinations are administered. You could have briefly said, “These are given at your GP surgery by trained nurses.”
Management	Address Emma’s concern about autism, clearly stating there is no scientific evidence linking vaccines to autism or neurodevelopmental harm.	5:21–5:43	Yes	You explained autism well and clarified no link with vaccines. Clear explanation.
Management	State absolute contraindications (e.g., anaphylaxis to a previous dose, encephalopathy within 7 days of previous vaccination).	–	No	You didn’t mention absolute contraindications. Even a brief, “The only reasons not to vaccinate are if a child had a severe reaction to a previous dose or certain brain problems within 7 days” would have scored.
Management	While UK vaccinations aren't legally mandatory, they are strongly recommended and follow a structured NHS immunisation schedule	7:49–7:55	Partial	You started to answer when asked if it’s mandatory, but you didn’t complete with “not legally mandatory but strongly recommended.” Be clear on this point.
Management	Explain that separate vaccines are not available and that combining them means the child only needs one injection instead of multiple injections.	6:23–6:28	Yes	You explained this clearly.
Management	Provide leaflet about immunization schedule	6:59–7:05	Yes	You offered a leaflet, which was excellent.
Management	Safety Netting: Advise Emma to monitor for severe reactions (persistent crying, high fever, seizures, anaphylaxis signs) and seek medical attention if needed.	–	No	You reassured about mild effects but missed safety-netting for severe symptoms. A short “If he gets a very high fever, persistent crying, or seizures, seek help immediately” would have scored.
Management	Offer follow-up appointments to discuss ongoing concerns	–	No	You didn’t offer follow-up. At the end, saying, “We can book a review if you’re still unsure before the next vaccine” would show patient-centred care.
Management	Document all details including concerns raised, information provided, vaccines discussed, and any decisions or deferrals made.	–	No	You didn’t mention documentation. Even one line, “I will document our discussion” is expected.
Interpersonal Skills	Acknowledge mother's concerns and normalize anxiety about vaccinations	1:09, 3:34	Yes	You acknowledged and validated her worries. Good empathy.
Interpersonal Skills	Use empathetic phrases: 'I understand your concerns,' 'It’s normal to be worried about vaccinations'	1:09, 3:34	Yes	You used empathetic phrases well.
Interpersonal Skills	Summarize discussion to ensure understanding	–	No	You didn’t summarise at the end. A quick “So today we discussed your concerns about sickness, autism, and multiple vaccines, and I’ve explained side effects, benefits, and safety — does that sound right?” would have closed strongly.
Interpersonal Skills	Use simple language and avoid medical jargon	3:46–7:25	Yes	You mostly kept explanations simple, though avoid phrases like “clinical disorder” as this may sound technical.
Interpersonal Skills	Encourage questions and provide clear, concise answers	0:49–7:51	Yes	You encouraged questions and responded well.
Interpersonal Skills	Show patience and understanding	Throughout	Yes	You remained calm and patient, even when she repeated concerns.
Interpersonal Skills	Create supportive environment to make mother feel heard and respected	Throughout	Yes	You did well here, giving her space and validating her.

	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	2	3