Location: You are a junior doctor in general practice
Patient: A 19 year old female patient has come in with headaches
– Take a focused history from the patient
– After 6 minutes you will be asked a series of questions by the examiner.
– Answer any questions that the patient may have
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 19 year old university student who is now in the third year of study. You have come into see your doctor because you have been experiencing headaches about 6 months ago but they have no been more frequent and more severe.
You only give information if prompted:
You have noticed before the headaches start you have some strange zig-zag lines at the corner of your vision about 20 mins before the headaches start.
You are really stressed about the headaches as you have not been able to attend lectures and you are worried you will not be able to pass the year with your attendance. You are scared about leaving the house if these headaches come on.
PMH No ongoing medical issues
No previous operations
No known drug allergies
You stopped smoking about 4 months ago
You drink about 20 units per week
You live with 3 of your friends, they are very supportive
University is stressful at the moment as it is your final year and you have a lot of exams and assignments
No recreational drug use
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.