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Subcutaneous Injections:: Attempt 1:: A PLAB 2 Mock

Summary:

This PLAB 2 station involves teaching a junior colleague or medical student how to perform a subcutaneous injection. The candidate must demonstrate not only technical knowledge but also effective teaching, communication, and feedback strategies while ensuring the session is interactive and supportive.



Key Points:


Teaching Technique

  • Ensure the session is interactive: frequently ask, “Are you with me?”, “Do you understand?”, and “Any questions?”

  • Check understanding multiple times—ideally three times throughout the session.

  • Use quizzing techniques: ask the student to repeat or summarize what was taught.

  • Reframe explanations if the student gives an incorrect response, to correct misconceptions.

  • Always summarize key learning points at intervals.

Introduction & Engagement

  • Begin with informal rapport building: ask how their rotation is going and what they’re interested in.

  • Identify the student’s current knowledge and learning goals.

  • Ask: “What do you know about subcutaneous injections?”, “Why do you want to learn this?”, “Have you seen or performed one before?”

Planning the Session

  • Provide a clear learning agenda: e.g., “Today we’ll cover the definition, preparation, procedure, and aftercare of subcutaneous injections.”

  • Tailor content to the student's goals and existing knowledge.

  • Prepare for partial completion by stating upfront the scope of the teaching session.


Important Considerations:

  • Always verify if the student understood each segment before moving on.

  • Correct errors immediately with patience and clarity.

  • Maintain aseptic technique and explain clinical rationales.

  • Use simple, clear language and avoid excessive jargon.

  • Be encouraging and normalize anxiety around learning procedures.

  • Provide follow-up plans, contact info, and educational resources (e.g., NHS leaflets).


Diagnostic Approach:

Not applicable (teaching station, not diagnostic).



Management:


Procedure Steps

  • Pre-Procedure:

    • Verify patient identity and allergies.

    • Select appropriate site: abdomen, upper arm, thigh, buttocks.

    • Explain rationale: these areas have more subcutaneous fat for slow, consistent absorption.

  • Procedure:

    • Gather necessary equipment (syringe, needle, alcohol swab, gauze, sharps bin).

    • Clean area, pinch skin, inject at 45–90 degrees.

    • Withdraw needle, apply gauze gently, discard in sharps bin.

  • Post-Procedure:

    • Explain aftercare.

    • Mention site rotation to avoid lipodystrophy, hypertrophy, or sclerosis.


Follow-Up & Safety Netting

  • Offer to schedule another session if needed.

  • Provide contact details for further queries.

  • Suggest credible online resources or NHS leaflets.


Communication Skills:

  • Use open-ended questions to assess understanding.

  • Avoid rehearsed phrases; be natural and supportive.

  • Explain all terms and steps clearly.

  • Invite the student to ask questions at any point.

  • Praise effort and provide constructive feedback.


Ethical Considerations:

  • Maintain professionalism and avoid patronizing language.

  • Respect the student's pace and learning style.

  • Share accurate, evidence-based information.

  • Avoid unnecessary referrals to online sources during the exam (as per GMC guidance).


Additional Resources:

  • GMC Good Medical Practice (Teaching and Supervision)

  • NHS guidance on injection techniques

  • GMC guidance on confidentiality, communication, and professional behaviour

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