Location: You are an foundation year doctor in sexual health
Patient: 21 year old female patient has attended the drop in sexual health clinic
Task: – Take a focused sexual history from the patient – Answer any questions that the patient may have – After 6 minutes you will be asked a series of questions by the examiner
Note to actor: Try to restrain yourself from volunteering too 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 21 year old female. You start the consultation by admitting to the doctor that you feel embarrassed as you have never been to a sexual health clinic before.
You are not to sure how the system works but you have come for a check up, you have no symptoms.
You have a regular long-term partner of 3 years who you do not use condoms with. You use the combined oral contraceptive pill.
Only give information if prompted – you have recently got back from holiday and you had a casual encounter. You did not use protection, you had oral and vaginal sex. At the time you had a lot to drink and you cannot remember all the details.
You are worried you have got an STI and you might pass it onto your regular partner. You are worried he will find out and leave you. So far you have not had sex with your regular partner.
You have never had an STI screen or HIV test before. You have had not been vaccinated against hepatitis A or B.
You drink heavily once a week. You have tried recreational drugs once but you have no intention of doing this again.
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.