TI Communication Scenarios

These scenarios can be practiced as simulated role play after which the facilitator can provide feedback
as well as generate discussion for the students.

Scenario 1
You are the surgical intern on-call. You are reviewing a post-operative patient after a below knee
amputation surgery. The nurse has called you because the patients dressing is soaked in blood.

You assess the patient and these are the findings. He appears pale but is conscious and alert. His surgical
dressing is soaked in blood and the nurse has applied some more dressing over it.

His vital signs are as followers:

HR 120 b/min
BP 105/88mmHg
Temp 36.5 degrees Celsius
CBG 7.8mmol/L

You try and open the dressing to assess the problem further and give 500mls of IV fluid to the patient.
His tachycardia gets a little better, but there is a bleeder in the patients wound that you can’t see or
access.

You decide to call your Surgical Registrar to discuss the patient’s status. Make a brief summary with your
recommendations for the registrar and make a call.

The role of the registrar will be played by the facilitator.

Scenario 2
You have been rostered to work in the GOPD area of a Health Centre. You finish seeing a patient when a
patient rushes into the consultation room and angrily shouts that they have been waiting for last 2 hours
and they haven’t been called in to be seen. You ask his name and find out that his name was called 30
minutes earlier but the patient did not come and his folder was put aside into the “Did not turn up” box.

The patient continues to be angry and speaks loudly.

Describe and play out how you will deal with this situation. The role of the angry patient will be played
by the facilitator.

Scenario 3
You are rostered to work in the ED. It is a busy day and one of the registrars asks you to cannulate one of
his patients who is sitting on a bench. You cannulate the patient and continue with your work.

20 minutes later the registrar ask you again why haven’t you cannulated the patient. You realize that
you actually cannulated the wrong patient. Both patients however have come to no harm because of
this error.

How will you communicate this information to the registrar and the patient whom you have cannulated
by mistake?

The facilitator will play the role of the registrar and then the patient.

Scenario 4
You are the medical intern on shift and a patient who is admitted to the ward is supposed to receive a
unit of blood transfusion. You are to take an informed consent from the patient for the procedure.

The facilitator will act as the patient.

Scenario 5
You are the intern in ED and are about to discharge a patient after assessing him for vomiting and
diarrhea. The patient has been assessed as a viral gastroenteritis although there is a typhoid outbreak in
the area. His vomiting has lessened and he is starting to tolerate food orally. He is being prescribed some
ORS as well as some anti-emetics.

Communicate with the patient his discharge plan and any other relevant information you deem
necessary.

The facilitator will act as the patient.