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

Practice a case with the AI patient 🤖

Summary:

This case simulates a teaching session where a doctor instructs a junior medical student on how to safely and effectively administer a subcutaneous injection. It assesses the candidate’s ability to communicate, teach practical skills, correct misunderstandings, and ensure patient safety.

Key Points:

Teaching & Education

• Establishing Baseline Knowledge:

  • Ask the learner about their prior experience with subcutaneous injections.

  • Understand the learner’s motivation and how it aligns with their current goals.

• Setting a Learning Agenda:

  • Clearly outline what will be covered in the session (e.g., preparation, technique, safety precautions).

  • Mention follow-up opportunities or additional resources if the session doesn’t cover everything.

• Checking Understanding:

  • Ask the learner to summarize key points intermittently.

  • Actively identify misunderstandings and gently correct them using paraphrasing and explanations.

  • Ask open-ended questions to assess depth of understanding.

Subcutaneous Injection Technique

• Equipment Preparation:

  • Gather all necessary items including gloves, alcohol swab, syringe, medication, gauze, and sharps bin.

• Pre-Procedure Checks:

  • Confirm patient identity and check for allergies.

  • Verify medication (name, dose, expiry date) preferably with a witness.

  • Choose an appropriate site (e.g., abdomen, upper arm, thigh), avoiding areas with infection, inflammation, or lesions.

• Injection Technique:

  • Clean the area, pinch the skin, inject at a 45°–90° angle.

  • Withdraw needle, apply gentle pressure with gauze, discard sharps properly.

• Post-Injection Steps:

  • Observe for adverse reactions.

  • Explain the importance of site rotation to avoid lipodystrophy.

Important Considerations:

• Avoid technical jargon unless explained (e.g., lipodystrophy).

• Do not administer in inflamed, infected, or scarred areas.

• Rotate injection sites to prevent fat tissue damage.

• Offer reassurance and encourage questions throughout.

Diagnostic Approach:

• Not applicable in this station as it is a procedural/teaching case rather than diagnostic.

Management:

• Provide a structured teaching plan:

  • Introduction → Preparation → Technique → Complications → Follow-up resources

• Encourage repeat practice with feedback.

• Offer materials (leaflets, websites) for further study.

Communication Skills:

• Use clear, layman’s terms.

• Engage the learner with questions and summaries.

• Provide encouragement and correct mistakes without discouragement.

• Avoid overuse of rehearsed phrases; maintain natural conversation.

Ethical Considerations:

• Uphold professional standards in teaching.

• Foster a supportive learning environment.

• Provide honest feedback in a constructive manner.

Additional Resources:

• GMC Good Medical Practice Guidelines

• Examiner Top Tips for PLAB 2

• Understanding Your Results (PLAB 2 feedback criteria)