Location: FY1 doctor on the Surgical Assessment Unit (SAU)
Patient: 25 year old female patient has an acute history of lower abdominal pain
Note to actor: Try to restrain yourself from volunteering to much information – you may do so when prompted (that is, by a specific question, not a general one). If a student is on the wrong line of clinical reasoning do not fuel this line of thinking, state no to the question as being ambiguous may prompt further questioning and does not allow the student to be appropriately tested. The aim of the exercise is to take a focused history; short answers are required.
You are a 25 year old male. You went out for dinner last night and just didn’t feel quite right and had some general low level abdominal pain. You woke up at 2am with intense abdominal pain and vomited once only. You had severe abdominal pain much worse over the right hand side. You called 111 who sent out an ambulance and they have rushed you into hospital and you don’t know what is going on. You have lost your appetite, have not had anything to eat and drink since yesterday evening.
PMH = asthma
DH = salbutmaol when you need it. You have no drug allergies
SH = drink socially on the weekends, non-smoker
ICE = you are worried about the pain as it does not seem to be getting any better.
If the candidate appears to have finished early remind them how long is left at the station and enquire if there is anything else they would like to ask, or whether they have finished. If they have finished, please remain silent and allow the candidate that time for reflection.