PLAB 2 Mock test feedback:: Pediatrics: Epipen Teaching

Mock Date: 04/08/2025
Case 1:
Topic: Teaching; Case UID: TeachingProcedures4
Case Name: Epipen
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 the Emergency Department. Your patient is Priya Wilson, a 30-year-old mother who brought her 5-year-old daughter, Hannah, to the hospital following an anaphylactic reaction. Hannah has had two previous episodes of anaphylaxis due to a peanut allergy. Hannah has been successfully treated and is ready for discharge. Mrs. Wilson has several concerns regarding the use of the EpiPen and the management of Hannah's allergy.
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	Response	Remarks
Data Gathering	Greet Mrs. Wilson and introduce yourself as FY2 doctor	Yes	You introduced yourself clearly as Dr. Khan and confirmed your role early on. Well done on setting a professional tone.
Data Gathering	Patient identifiers: 'full' name, relation with Hannah and her age	Yes	You confirmed the mother’s relation, child’s full name and age, covering all aspects efficiently.
Data Gathering	Confirm the reason for the visit and current symptoms	Yes	You clearly established that the mother was there to learn about the EpiPen and followed up on symptoms.
Data Gathering	Gather event details: 'Could you please describe what happened today?'	Yes	You asked about what happened, and the mother described today’s episode in detail.
Data Gathering	Previous episodes and management: 'Can you tell me about the previous episodes?'	Partial	You only asked generally if it happened before without exploring details of the previous management. You could have said: “Has she been prescribed the EpiPen before? What happened then?”
Data Gathering	Confirm whether EpiPen was used previously and today; explore barriers if not used	No	You didn’t ask if the EpiPen was used either today or in the past. You missed a key safety assessment opportunity.
Data Gathering	Identify current concerns with EpiPen usage	Yes	You explored the mother’s concern that she didn’t remember how to use the EpiPen and wanted to avoid mistakes.
Data Gathering	Ask about other medical conditions or regular medications	No	You didn’t ask about Hannah’s general health background. A quick, “Is she on any regular medications?” would have sufficed.
Data Gathering	Inquire about other known allergies	No	You confirmed the peanut allergy but did not check for any other allergies.
Data Gathering	Ask about Hannah’s daily activities (e.g. school, caregivers)	No	You didn’t explore school or caregiver settings. Asking about who else might need training would be valuable.
Data Gathering	General health: immunization status, development, bowel/bladder habits	No	General health wasn’t explored. Even a brief question like, “Otherwise, is she doing well developmentally?” would have helped.
Management	Explain signs of anaphylaxis (e.g., breathing difficulty, swelling, hoarseness, faintness)	Yes	You listed all the major signs of anaphylaxis very clearly. Good use of patient’s past symptoms to reinforce this.
Management	EpiPen Instruction Demonstrate correct use of EpiPen: Remove blue safety cap, Blue to the sky, orange to the thigh	Yes	You provided clear and memorable instructions using mnemonics like “blue to sky.” This was very well done.
Management	Jab orange tip into thigh, click sound, hold for 3 seconds	Partial	You said “hold for 10 seconds,” which is technically acceptable, but missed specifying “click sound” clearly as a cue to start holding.
Management	Advise second dose if symptoms persist after 5–10 minutes	No	You did not mention the need for a second dose if symptoms persist. This is critical safety advice.
Management	Further management: 'Always carry two EpiPens and an antihistamine.'	Partial	You mentioned carrying two pens and a tablet (though you mistakenly said “chloroform” instead of “chlorphenamine”), but didn’t emphasize always having antihistamines on hand.
Management	Post-EpiPen procedure: 'After using the EpiPen, always call 999 and inform them it’s an "anaphylactic reaction."'	Yes	You clearly stated to call 999 and use the word “anaphylaxis.” This was well executed.
Management	Long-term Management	—	No
Management	Clarify EpiPen safety even in non-anaphylactic reaction	Yes	You reassured the mother well that EpiPen is safe even if given mistakenly.
Management	Explain checking expiry and clarity of EpiPen fluid monthly	Yes	You gave very good advice on setting reminders and checking expiry dates.
Management	Prevention & Follow-up	—	No
Management	Recommend allergy bracelet	Yes	You advised use of the allergy bracelet clearly.
Management	Offer reading materials and Arrange GP follow-up in 1–2 weeks	Partial	You offered a leaflet but didn’t mention GP follow-up. Always plan a formal follow-up to reinforce learning.
Interpersonal Skills	Empathy and reassurance: 'I can see this is very stressful for you, and it’s normal to feel this way.'	Partial	You did say “I’m glad you’re here” and showed warmth, but didn’t directly acknowledge her distress or worries with empathy words. Try: “I can imagine how scary this must be.”
Interpersonal Skills	Active listening and encouragement: 'Do you have any other concerns or questions about what we discussed today?'	Yes	You invited her to ask more at the end, which was supportive and encouraging.
Interpersonal Skills	Paraphrasing and summarizing: 'To summarize, you will use the EpiPen if Hannah shows severe symptoms.'	No	You did not paraphrase or summarize the key learning points. A simple recap would help cement understanding.
Interpersonal Skills	Checking understanding: 'Can you repeat back to me the key points about using the EpiPen?'	No	You didn’t verify her understanding. Asking her to explain back or demonstrate would’ve been ideal.
Interpersonal Skills	Follow-up plan: 'We will also schedule a follow-up appointment to review Hannah’s allergy management plan.'	No	No formal follow-up was discussed. This is important for safety and GP coordination.
Interpersonal Skills	Safety Netting	Yes	Highlight red flags and reiterate when to seek emergency help

	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
1	2	2