EXAMPLE SCENARIOS FROM SELECTION CENTRE EXERCISES


The Simulation exercise:
A previous simulation exercise included the following Candidate instruction.
This exercise will never be used again.

Recent medical history:

Has experienced indigestion for years on and off. Put down to busy lifestyle, working long days and eating whilst on the go or in a rush. In the past has received treatment with Omeprazole but not working well now. Slight weight loss over past months but patient put this down to working harder.

Was referred by your colleague 6 months ago for routine endoscopy and biopsy – the usual waiting time for this procedure is between 3 and 4 months. Patient mentioned at this time the long wait for referrals and investigations, but appeared to be unworried and fairly convinced they only had indigestion or maybe the start of an ulcer like their father as nothing else was troubling them.

The endoscopy was carried out a week ago and the result has been faxed to you: On endoscopy the Dr saw a suspicious ulcer. The biopsy result states that a firm opinion cannot be given due to insufficient material. A fresh gastroscopy and biopsy is required.
Reason for consultation

today:

 Patient is coming in to discuss the results of the endoscopy. You will be telling them the results of the gastroscopy and biopsy and informing them of the next step which will be referral for a further gastroscopy.


The Written exercise:
A previous written exercise included the following Candidate instruction.
This exercise will never be used again.

Your Task (30 minutes):

The various issues listed below are presented to you on arrival and need to be prioritised for action. This should involve three stages :
    1. Ranking each issue in the order in which you intend to deal with it.
    2. Justifying your decisions.
    3. Commenting on interesting and/or difficult challenges posed by the exercise.
  • All rankings, justifications and comments should be entered and completed within the appropriate boxes (see answer sheet).

  • For the first 5 minutes you should not write, but should study the challenge posed. You will be advised when you may start writing.

  • For the next 20 minutes you should complete the first two stages of the task listed above (ranking the issues and justifying your decisions).

  • For the final 5 minutes you should complete the third stage of the task (reflecting on the exercise).

You will not be reminded about the time you have left.

Issues to be ranked:

  • The ward sister reminds you that there is a very confused patient, who has been on the ward for 2 hours, and has not yet been assessed by a doctor.
     
  • The ward clerk tells you that your life partner has just phoned sounding very upset and asking that you contact her/him urgently.
     
  • The security guard phones you to say that your car is blocking access to the mortuary and must be moved immediately.
  • A GP surgery phones you requesting the discharge summary on a patient whom you discharged a week ago. The patient’s neighbour has phoned the surgery for an urgent GP house call, saying that the patient has collapsed.

  • The ward clerk tells you that the family of a patient (who was given the wrong medication during the night and has since felt dizzy) want to speak to you urgently.


The Group exercise:
 A previous group exercise included the following Candidate instruction.
This exercise will never be used again.

The Challenge :
  • Imagine you are working together as junior doctors in a small city hospital.
  • Over recent months, specific concerns have emerged about four of the hospital’s doctors. You know none of them well, but are aware of a combination of facts and rumours regarding each (over the page). No progress appears to have been made in dealing with these concerns. As a result, you have decided to meet today – informally – to discuss the situation and decide how you might best respond.
  • To start the discussion, each of you has chosen to summarise the background to one of the doctors, making clear your initial thoughts on this doctor’s situation.
  • The person you are going to comment on is CLAIRE BROWN
  • As a group, you are responsible for ensuring that all four parties are properly considered within the time allowed, and agreement reached on specific issues.

You have access to no further information about these people, beyond what is printed on the back of this sheet.

Claire Brown age (28)

She has made two recent errors of judgment (one diagnostic, one choice of treatment)

Neither patient complained or suffered adverse effects

She has recently stopped treatment for depression

She is a very caring doctor and well respected within the profession