Role Play Flashcards
tips & small things to remember for introductions
always introduce yourself - first and last name – introduce your role e.g. GP or nurse – whatever role they gave you outside the station
Ask their name again and also ask if it’s okay to be called by that
Make sure to use their name throughout the conversation – makes it personal and develop rapport
Ask the person/patient what their current understanding of why they are there / what they already
Breaking big news e.g. overnight stay/shocks – asks if patient wants to know the information now or rather wait for relative to be with them / friend. Shows empathy/ communication up to the next level.
Remember that the interview can’t hear or see what you’re thinking
small things to remember - agitated or difficult patients
Agitated/ worried – verbalise it in the role-play stations – “you look really frustrated is everything okay?” always acknowledge the cues – find opportunity to show that you are being empathetic and you can read the room.
Reluctant people who don’t want scan- always explore the reasons why – don’t just be persuasive – keep asking why and formulate a plan
Offer help – toward end of role play just say – “is there anything else I can do to make this better for you/to help/easier” most likely told you’re a medical student or junior doctor
KNOW UR LIMITS AS A MEDICAL STUDENT – NO FALSE PROMISES / HELP – never say “I’m sure you’ll be fine”
Try to avoid saying “ I understand” say “I can’t imagine or can only imagine” – they’ll say you don’t understand
GMC – good medical practice – skim through and get general gist
breaking bad news - SPIKES
S- setting the scene – introduce yourself, explain your position/role, and confirm patient’s name – ask if they have any loved ones with them
P – perception – ask “what’s your understanding of why we are meeting today” – minimize any shock
I – invitation – explain there is bad news coming and ask permission to proceed – allows time to prepare “ I am afraid I do have some bad news – is this an appropriate time to discuss this with you?”
K- knowledge – explain exactly what has happened – avoid jargon and allow them to process
E – emotion – listen to the actor and let them process – don’t try to regain the control of situation – ask open questions “ what are your thoughts?” – show active listening skills – apologise
Summary – reiterate the info you’ve been given briefly and maybe future plan - end with “I’m sorry this news has made you feel upset - is there anything I can do to help”
Any further questions/ next appointment and then thank them for their time.
You are a Summer Camp Advisor and you notice that one of your campers seems down. You approach your camper, and he admits that he feels isolated and lonely, having trouble making friends. Your camper admits that he takes illicit substances, but he asks you not to tell any authority figure about this. How would you approach this situation?
Ensure a Safe, Non-Judgmental Environment:
Listen actively: Create a supportive, confidential space where the camper feels comfortable expressing their feelings and concerns without fear of judgment.
Show empathy: Acknowledge the camper’s emotions (e.g., isolation, loneliness) and let them know that their feelings are valid and important.
2. Encourage Open Communication:
Validate their experience: Reassure the camper that it’s okay to feel lonely and that making friends can sometimes be challenging, especially in a new environment like camp.
Discuss their substance use: Gently ask more about their use of illicit substances—what substances, how often, and whether they feel it is affecting their health or well-being.
3. Set Boundaries and Responsibilities:
Clarify your role: Explain that while you’re there to support them, there are limits to confidentiality, especially when it comes to matters of health and safety.
Discuss the importance of professional support: Let them know that substance use can have serious effects on their mental and physical health and that talking to an adult can help them find the right support.
4. Encourage Seeking Help:
Provide options for support: Offer to help them talk to a trusted adult, counselor, or camp director who can provide more professional support. Emphasize that seeking help is a positive step for their well-being.
Offer resources: Direct the camper to mental health resources at camp (e.g., camp counselor, camp doctor, or a therapist), explaining that these professionals are trained to support them without judgment.
5. Address the Substance Use:
Express concern for their health: While respecting their confidentiality, explain that their safety is a priority and that substance use can have long-term consequences, especially if they are struggling with feelings of isolation.
Discuss camp policies: Explain the camp’s rules around substance use and that they must follow these to ensure a safe environment for everyone.
6. Monitor the Situation:
Check in regularly: Continue to offer emotional support throughout the camp experience, ensuring they have someone to talk to if they feel lonely or troubled.
Look for signs of worsening issues: Keep an eye out for any changes in their behavior or emotional state, and be prepared to act if the situation escalates.
7. Protecting the Camper’s Well-Being:
Involve appropriate authorities: If the camper’s well-being or safety is at risk (due to substance use or mental health concerns), it may be necessary to inform relevant authorities (e.g., camp director, parents, or medical staff) to ensure they receive the help they need.
Your best friend calls you and tells you that his girlfriend broke up with him. He is extremely “depressed,” and states that he wants to end his life. How would you approach this situation?
Stay Calm and Listen:
Stay composed: It’s important to remain calm, as your friend may be in a highly emotional state. Speak slowly and reassuringly.
Listen actively: Let your friend express their feelings fully without interrupting. Show that you are genuinely listening and that you care.
2. Acknowledge His Feelings:
Validate his emotions: Acknowledge how painful and overwhelming the breakup must be for him, and that it’s okay to feel devastated.
Avoid minimizing: Don’t dismiss his feelings as “just a breakup” or tell him to “snap out of it.” Instead, validate that what he’s experiencing is real and serious.
3. Express Concern for His Safety:
Express your concern: Gently but firmly tell him that you’re really concerned about his statement regarding ending his life. Let him know that his safety is your priority.
Encourage him to talk: Ask him more about how he’s feeling and if he has any plans or thoughts about how he might act on these feelings.
4. Encourage Professional Help:
Suggest seeking help: Encourage him to speak to a professional—such as a therapist, counselor, or doctor—who can help him process his feelings in a safe, supportive environment.
Offer to help: Offer to help him make the first step—whether it’s finding a therapist or accompanying him to see a professional.
5. Don’t Keep It a Secret:
Discuss the importance of reaching out for help: Emphasize that it’s important to talk to someone who can help him right now, even if he’s reluctant to do so.
Involve others if necessary: If you believe he is in immediate danger, you should consider involving someone close to him, like a family member, or calling a helpline or emergency services.
6. Provide Support:
Offer emotional support: Let him know that you are there for him, and that his feelings matter to you. Offer to spend time together, and check in with him regularly.
Encourage healthy coping: Help him focus on activities that might bring him some comfort, such as exercise, spending time with others, or creative outlets.
7. Follow Up:
Stay involved: Continue to check in with him regularly to see how he’s doing and to make sure he’s seeking the support he needs.
Monitor for any warning signs: Keep an eye out for any signs that his mental state is worsening, and be ready to intervene if necessary.
You are a doctor who leads several clinical trials, including a stage IV breast cancer therapy trial. You see your patient, Mrs. Jordan, whose metastatic breast cancer is unfortunately continuing to spread. After looking at the eligibility criteria, you confirm that Mrs. Jordan is eligible for this clinical trial. You know that Mrs Jordan can potentially benefit significantly if she is in the “treatment” arm of this clinical trial. You ask the patient if she wants to enrol in the study, but she is extremely hesitant. How do you approach this situation?
Acknowledge Her Concerns:
Listen attentively: Start by acknowledging her hesitation and asking her what specific concerns or fears she has about the trial.
Provide reassurance: Validate her feelings, letting her know that it’s normal to feel uncertain when faced with complex decisions about treatment.
2. Provide Clear, Comprehensive Information:
Explain the trial in simple terms: Clearly describe the trial process, the treatment options, and what being in the trial would involve (e.g., monitoring, potential side effects).
Discuss the potential benefits: Outline the potential benefits of the trial, emphasizing that she is eligible for the treatment arm that could offer significant improvement, given her current condition.
Address risks: Honestly discuss any risks, including possible side effects or the fact that the trial may not provide any benefit at all. Explain that being in a clinical trial means she is also being closely monitored, which can provide additional care and support.
3. Emphasize Patient Autonomy:
Respect her decision-making: Make it clear that enrolling in the trial is her decision, and she has the right to refuse or accept the opportunity.
Offer time for reflection: Let her know that she can take some time to think it over and that you are available to answer any further questions.
4. Highlight Support and Informed Consent:
Offer emotional and informational support: Explain that she will receive ongoing support throughout the trial, both from you and from the research team.
Informed consent: Reassure her that she will receive a thorough informed consent process, where all details of the trial are explained and she can ask any questions before agreeing.
5. Involve Family or Trusted Advisors:
Encourage discussion with loved ones: Suggest that she talk to her family or close friends who may offer additional support and help her process the information.
Offer support from a counselor: If necessary, suggest speaking with a clinical trial nurse or counselor to discuss any emotional or psychological concerns she may have about participating in the trial.
6. Follow-Up and Ongoing Dialogue:
Keep communication open: Reaffirm that this is an ongoing conversation, and she can come back at any time with more questions or concerns.
Respect her timeline: Let her know there’s no rush to make a decision, and that you will be there to support her no matter what she chooses.
You are playing football in the back garden when you accidentally kick a ball over the fence and hear a smash. You find that it has destroyed your elderly neighbour’s garden gnome, which you know holds great sentimental value to them. How would you break the news?
Take Responsibility:
Be honest and direct: Approach your neighbour and calmly explain what happened. Acknowledge that it was an accident and take full responsibility for breaking the gnome.
Express genuine regret: Let them know you feel genuinely sorry for the damage caused, especially given the sentimental value of the gnome.
2. Show Empathy:
Acknowledge their feelings: Recognize that the loss of the gnome may be upsetting for them. Use a compassionate tone to show that you understand how much it meant to them.
Offer sincere apologies: Say something like, “I know how important this gnome was to you, and I’m really sorry for the mistake.”
3. Offer a Solution:
Offer to repair or replace: Let them know you are willing to replace or repair the gnome, if possible. If replacement is not an option, offer to help find a meaningful substitute.
Suggest making it right: Say, “I’d like to make it up to you in any way I can, whether that’s fixing it or helping you find something special to replace it.”
4. Be Ready for Their Reaction:
Allow them to express their feelings: Give them space to process the situation, whether they feel upset, disappointed, or understanding.
Remain patient and supportive: Be prepared to listen if they need to talk about it further, and stay calm if their initial reaction is frustration or anger.
5. Follow Through:
Act on your offer: If they accept your offer to replace or repair the gnome, make sure to follow through quickly and effectively.
Maintain open communication: Let them know you’re available to discuss any further concerns and will keep them updated on the steps you’re taking to resolve the issue.
You are working in an ICU and have 1 donated kidney available, but 3 patients need it. One is a 60 year old teacher with 5 days to liver if he doesn’t receive the transplant. Another is a drug addict in his 30s who has kidney failure due to drug usage and will die within 2 weeks without the transplant. Lastly there is an 8 month pregnant woman with cancer in her kidneys, whose baby will survive but she won’t live much past its birth without the transplant. What do you do?
2 ways to think about it:
1. Look at three patients
2. Look at medical ethics pillars:
Beneficence – want to do well by all patients – not always possible especially
Justice– who is eligible – think in the fairest way possible:
Think about the time frames given, they’re quite similar – differentiated by days – can’t place that factor too high up
60-year-old – no other info on his condition or lifestyle – difficult to clinically say how long the transplant would last – age is the only factor – others may benefit more – more years of life to be gained
Drug addict – lifestyle habits – 30 years old – would they gain many years? Yes provided they change the lifestyle factors, if not, they’ll need another transplant + transplant could be rejected + immunosuppression – not the most appropriate person
8 month pregnant lady – 20-30s – many years of life to be gained, bearing a child – can provide care to child who will be born – utilitarianism – more people that are affected are happy
3. Personal opinion: give the transplant to the pregnant patient – the majority of people will benefit from the pregnant lady receiving the transplant
