MSRA-PD: Empathy and Sensitivity

Scenario:

You are an FY2 on a surgical ward. A patient in their late seventies has just died unexpectedly from a postoperative pulmonary embolism. The consultant has gone to theatre and asked you to telephone the next-of-kin daughter to inform her. As you introduce yourself she interrupts to say she is driving and asks you to get to the bottom line straight away. You can hear road noise and a child in the back of the car. You have never broken bad news by phone before and feel exposed without your registrar.

Task:

Rank the following five possible actions in order from most appropriate (1) to least appropriate (5).

Scenario:

You are an FY2 on a busy medical ward. The angry adult son of an elderly patient walks directly to the nurses station and confronts you loudly about a four-hour delay in his mother getting pain relief overnight. Other patients and staff can hear the conversation clearly. The mother has dementia and is now settled. The son is not raising a fist but his voice is escalating and he repeatedly says he will be making a complaint about the ward.

Task:

Rank the following five possible actions in order from most appropriate (1) to least appropriate (5).

Scenario:

You are an FY2 in a respiratory outpatient clinic. A 26-year-old man has come back for what he expected to be reassuring results after a chronic headache. The MRI report on the system flags a likely glioma that needs urgent neuro-oncology referral. The consultant has just texted that he is held up in theatre and asks you to start the conversation. The patient is alone in the room, clearly nervous, and asks straight away whether his scan is normal.

Task:

Choose the three most appropriate actions from the eight options below.

Scenario:

You are the FY2 on a geriatric ward. An 86-year-old patient with advanced dementia died peacefully on the ward overnight after a documented end-of-life decision was agreed with the family three days ago. Her daughter, who arrived to collect belongings this morning, is now in the corridor crying and shouting that nobody told her things had moved so fast and that she should have been called overnight. The night team did call the next-of-kin number on the system but it rang unanswered. The bay is open and other patients can hear. The nurse in charge has asked you to come.

Task:

Choose the three most appropriate actions from the eight options below.

Scenario:

You are an FY2 in a GP surgery during a community placement. A 15-year-old girl has come in for a routine repeat prescription for asthma. Her mother is in the waiting room. Towards the end of the consultation, while you are reviewing her inhaler technique, the girl quietly pulls back her sleeve and shows you several recent cuts on her forearm. She says she has not told anyone and that her mother would be devastated. She asks you not to put anything in the notes that her mother could see. The next patient is already waiting.

Task:

Rank the following five possible actions in order from most appropriate (1) to least appropriate (5).