OET Speaking Cards

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OET Online OET Preparation Material
ALZHEIMER’S/DEMENTIA
Setting Rural Community Health Clinic
Patient
You are a 79 year old woman who lives on her own. You have one son who lives in
the city who helps you when he can. Recently he has paid for a gardener and a
cleaning lady to visit you regularly. He has also arranged for a neighbour to do your
shopping. You have come to see your GP at the Community Health Clinic. He
knows you and your son well. You want his advice because you are having a real
problem with all these helpers but you don’t want to complain to your son. You are
finding life very difficult because the cleaning lady is obviously hiding and taking
things and putting others in the wrong place. Your neighbour claims to have bought
groceries that you can never find. When you complain she says that you have
forgotten where you put them. The gardener is obviously stealing lots of your tools
and claims to have come when you know he hasn’t.
.
Task
• Explain to the doctor that you are finding it more and more difficult to cope
because these people are taking advantage of you
• Say you have got to a point where you don’t like to go out yourself because
nothing seems the same and sometimes you get lost
• Admit that you are a bit forgetful but insist that the real problem is the people
who are supposed to be helping you
• Answer the doctor’s questions as best you can
• Finally agree to his suggestion to contact your son
_____________________________________________________________________
Setting Rural Community Health Clinic
Doctor
A 79 year old woman who lives in your community has come to see you. You have
known her and her son for several years and are concerned by how she appears to
have aged recently and seems very agitated. You also know that the people her son
arranged to help her are completely trustworthy. You want her to agree to let you
contact her son as soon as possible to explain her situation to him.
Task
• Be sympathetic and understanding of her problems
• Ask if there are any others things that are making her life difficult – does she
think her memory is not as good as it used to be
• Ask if she is eating well and cooking for herself without difficulty
• Stress that you know her son cares for her and would want to be informed of
her present situation
• Ask her permission to phone him so that he can help with finding a solution to
make her life easier.
This resource was developed by OET Online
Website: http://oetonline.com.au Email: oetonline@gmail.com
ANAPHYLACTIC SHOCK
Setting: Children’s Hospital
Patient
You are the concerned father of a 5 year girl who is being discharged today. She
collapsed yesterday shortly after eating some peanuts while attending a friend’s
birthday party. The ambulance was called and she was admitted to hospital where she
was treated for anaphylactic shock. You are very worried.
Task
• Find out about your daughter’s current condition and whether she has
completely recovered.
• Be difficult to reassure that your daughter is well enough to come home today.
• Request more details about the condition and its causes.
• What can you do to prevent further attacks.
• Enquire about possible treatments.
Setting: Children’s Hospital
Doctor
You are talking to the concerned father of a 5 year old girl who was admitted
yesterday by ambulance after collapsing at a friend’s birthday party shortly after
eating peanuts. Your examination indicated that the girl suffered an anaphylactic
shock. Test results show an allergy to peanuts. The girl is now fine and ready for
discharge. There is no permanent damage.
Task
• Reassure the father that the girl is now completely recovered
• Explain the causes of anaphylactic shock including food allergy or an insect
bite such as bee sting. In his daughter’s case test results show she is allergic to
nuts.
• Explain the importance of informing school, teachers, relatives and friends in
order to reduce the possibility of it happening again
• Explain that there is no vaccine currently, but trials are underway and that in
the future it may be treatable

ANOREXIA NERVOSA
Setting: Suburban General Practice
Patient
You are an 18 year old woman about to be married shortly. You try to avoid looking
at the doctor. You want to look good in your wedding dress so you have been dieting
to lose weigh. Your parents are constantly over reacting about your dieting. and
always trying to make you eat more. You want to reach your ideal weight of 40 kg
(currently 45kg). Deny you are vomiting and using laxatives. There is much fighting
at home about your eating habits .but you feel well and can’t see what all the fuss is
about. You just are not hungry.
Task
• Respond to the doctor’s questions
• Deny vomiting.
• Admit some laxative use
• Keep focusing on your need to reach your goal weight
_____________________________________________________________________
Doctor
An 18 year old woman has presented alone for a scheduled follow up visit for the
third time in 3 months. During this period her weight has dropped from 52 kg to 45kg.
You suspect self induced vomiting & laxative use. On previous visits you have
spoken to her mother who is very concerned about her daughter. Relationship
between mother and daughter is tense. Examination today reveals:
Weight: 45kg
BP 100/60 Lying and standing
Abdo: and urinalysis unremarkable
Appearance: Pale, thin.
Task
• Ask about current health/eating habits/emotions/ family relationships
• Question patient about the possibility of self induced vomiting & laxative use
• Discuss your assessment with patient and explain the risk factors associated
with anorexia nervosa
• Recommend referral to a psychiatrist due to your assessment that indicates
anorexia nervosa

Doctor Speaking Tasks
BLOOD PRESSURE
Setting: Family General Practice
Patient
Two months ago, you had cardio-thoracic surgery to repair an aortic aneurysm and
you now have a mechanical heart valve in place. Your surgeon has referred you to
your local GP for follow-up care. You have been seeing your GP each week to check
your blood pressure
Task
• Ask your doctor how is your blood pressure
• Remind him that you are on several medications for blood pressure
• Ask if you need to remain on so many
• Tell him you have reduced salt in your diet
• Tell him you have lost some weight but need to lose more
• Tell him you are walking gently every day but are afraid to do more exercise
___________________________________________________________
Doctor
You are a GP in a General Practice. This patient has been referred to you from a
cardio-thoracic surgeon for follow-up care. Two months ago, he had a repair of a
Type A dissection and aortic root replacement with mechanical valve. He has his
blood pressure checked every week as it needs to remain stable following his surgery.
Respond to his questions and give him advice on keeping his blood pressure low.
Task
• Reassure him that his blood pressure is very good – 110/70
• Tell him that the plan is to start weaning him off some of the blood pressure
medications, one at a time
• Advise him on other things that affect blood pressure (salt, weight, exercise)
• Ask him what exercise he is doing
• Reassure him that he can return to doing any exercise he wants, except for
lifting very heavy weights.
• Ask if he would like to be referred to a cardiac exercise program
This resource was developed by OET Online and is subject to copyright ©

Website: http://oetonline.com.au Email: steve@oetonline.com.au
BREAKING BAD NEWS
Setting: Hospital Ward
Patient
You are Connie Matthews aged 66, married with three adult children. You have had
recurring abdominal pain, loss of appetite and tiredness for several months. Recently
you visited your GP when the pain became more intense and you were losing weight.
She referred you to a surgeon who performed a colonoscopy and CT scan yesterday.
You are waiting to hear the results. You have been preparing yourself for bad news
as you think you have cancer.
Task
• Confirm that you would like your husband to be present (he has just arrived)
• Ask the surgeon what he has found
• Ask what this means and what treatment you can have
• Say you want to know about your life expectancy
• Express your wish to return home
• Ask what help will be available for your husband if he decides to care for you
at home
_____________________________________________________________________
Surgeon
Your patient is Connie Matthews aged 66, married with three adult children. She was
referred by her GP because of recurring abdominal pain and weight loss. She had a
colonoscopy with biopsy and CT scan yesterday. She has a malignant colon tumour
with widespread metastases in the liver and lungs (TNM Stage 4). You do not
consider that cure is possible and you can only offer palliative treatment (palliative
surgery to remove the tumour, followed by chemotherapy and maybe radiation
therapy to reduce pain). You consider that she has a life expectancy of 3-6 months.
Task
• Explain that you want to discuss the results of the surgery
• Ask if there she would like a family member to be present
• Explain the results of the tests as gently as possible
• Explain treatment options
• Respond to her questions about prognosis and life expectancy
• Suggest she considers her options and offer to refer her to an oncologist for a
second opinion
• Suggest arranging a visit by the hospital’s palliative care coordinator to
provide full information about home care options and other support services.

Doctors Speaking Tasks
BREAST CANCER PATIENT
Patient
You are Margery Hill, aged 34 and the mother of two children aged 4 and 7. You
had a surgical biopsy, which resulted in a diagnosis of stage 1 breast cancer. The
biopsy was followed by a lumpectomy to remove a small malignant tumour. The
surgeon told you that an oncologist would visit you today to discuss treatment options
such a chemotherapy and radiation. You are quite shocked and fearful. The
surgeon’s registrar has come to see you how you are.
Task
• Tell the registrar your concerns:
o There is no history of breast cancer in your family – why you?
o What will happen to your children if you don’t survive?
o How will your husband cope with this situation?
o What will be the side effects of your treatments
Surgical Registrar
You are a surgical registrar in a Breast Cancer Ward. Margery Hill, aged 34, mother
of two children, has been diagnosed with Stage 1 breast cancer. A lumpectomy was
performed yesterday to remove the tumour and the surgeon has called in an oncologist
to advise on a course of chemotherapy and/or radiation. The oncologist will be
visiting later today. The patient is upset and very apprehensive
Task
• Listen to Mrs Hill’s concerns
• Be sympathetic and as reassuring as possible
• Point out that her cancer has been found at an early stage
• Assure the patient that the oncologist will fully explain any recommended
treatment, the success rates and side effects
• Recommend contact with by a breast cancer support group

CHILD – BROKEN LEG
Patient
You are Henry Murray. Your 9 year old daughter Emma has had a bad fall at school
while doing gymnastics. The school called you immediately and you have brought
her to your local GP who has taken an X-ray, that shows a spiral fracture of the right
tibia.
Task
• Suggest taking her straight to an emergency hospital
• Ask what a spiral fracture is
• Seek advice on:
pain management
restriction of activities
care of back slab
what to watch for
need for crutches
• Ask about what the Fracture Clinic will do at your first appointment and how
long her activities are likely to be restricted.
___________________________________________________________
Doctor
You are a GP at a Family Clinic. Henry Murray who is a regular patient has carried
in his 9 year old daughter Emma. She is pale and upset and has obviously injured her
lower right leg. It is badly swollen. X-ray confirms a spiral fracture of the tibia but
no displacement. You have contacted the Fracture Clinic at the Children’s Hospital
for advice. They recommend applying a back slab and bandage as a fiberglass cast
cannot be applied successfully until the swelling subsides. An appointment has been
made for her to attend the fracture clinic in five days.
Task
• Explain the X-ray results and the Fracture Clinic recommendations
• Respond to any questions
• Advise on immediate care
• Explain what will happen at the Fracture Clinic ie further X-ray, assessment,
fiberglass cast applied
• Be reassuring about long term recovery
This resource was developed by OET Online and is subject to copyright © 1

CHICKENPOX
Setting: General Practice Family Clinic
Patient
Your local primary school phoned to ask you to come to the school and pick up your
daughter Alice aged 6 as she was feeling unwell. You are surprised as although she
has a few spots on her face which you think are insect bites, she ate all her breakfast
and was eager to go to school this morning. She is now running a slight fever and has
a few more spots on her face. You decide to take her to your GP to be on safe side.
You hope it is nothing infectious as you work four days a week at the local
supermarket and arranging child minding will be difficult.
Task:
• Be anxious that the spots do not indicate anything infectious
• Explain you are working and it will be difficult to keep her home, particularly
if she feels well enough to go to school.
• If the doctor diagnoses an infectious disease, ask how long it will be before
she can return to school
• Ask if antibiotics will speed her recovery
• Ask what treatment she needs and if there are any complications that you
should look out for.
_____________________________________________________________________
Setting: General Practice Family Clinic
Doctor
A regular patient has brought her six year old daughter Alice to see you. Alice was
sent home from school this morning by her teacher because she had spots on her face
and was feeling unwell. After examining Alice you diagnose chickenpox. You know
there has been a recent outbreak at the local school.
Task
• Explain why you have diagnosed chickenpox
• Emphasise that this condition is contagious and that Alice must be kept at
home until no spots can be seen and the last blister has completely dried.
• Advise that it can take up to two to three weeks to fully recover from
chickenpox and that it is important to check for fever and report any unusual
symptoms.
• Point out that chickenpox is a viral infection and therefore antibiotics will not
be effective
• Suggest that the mother asks the local pharmacist for advice on something to
relieve any itchiness.
• Recommend plenty of fluids and paracetamol as required.

COMPLAINT AGAINST HOSPITAL STAFF
Setting: Private Hospital
Patient
You are Sonia Afleck, a young married woman who had an emergency
appendectomy last night. Twice during the night you pressed the nurses call bell for
assistance. On the first occasion you needed pain relief and it took at least 20 minutes
before anyone answered the call. On the second occasion you needed assistance to go
to the toilet. You rang the call bell but because of the delay in response you were
forced to struggle to the toilet yourself. When the nurse finally arrived she
reprimanded you for getting out of bed unassisted. You are upset and angry and want
to be discharged today. You ask to see the surgical registrar on duty.
Task
• Express anger at the poor response to you calls for assistance and at the
attitude of the nurse who reprimanded you.
• Claim you would be better off at home where you mother and husband would
look after you.
• Agree that there are occasions there may be problems with fully staffing a
busy surgical ward but that does not excuse nurse reprimanding you.
• Admit you still require regular pain relief and help in walking.
_____________________________________________________________________
Setting: Private Hospital
Doctor
You are the surgical registrar at a busy private hospital. There were four emergency
operations last night. You know that due to a flu epidemic the nursing night shift was
understaffed so less experienced on-call nursing staff filled in. On your morning
round you check on Sonia Afleck who had an emergency appendectomy last night.
She is upset and angry about the poor nursing care she has received. She wants to be
discharged today.
Task
• Ask about what happened to upset her
• Explain the ward’s staffing situation last night.
• Address her anger at nurses
• Discuss her present condition and usual hospital recovery time
• Explain why it would not be in her interests to be discharged today, especially
without consultation with her surgeon.

DIABETES MELLITIS
Setting: Hospital Outpatients
Patient
You are a 59 year old woman with Type 2 diabetes who is mildly obese. Your
husband passed away 1 year ago and you live alone and you also have been feeling
tired over the past 3 weeks. You have been told that you need to begin insulin
therapy. You feel that self injections will be difficult for you to manage and are afraid
to administer the medication by yourself. You are worried that you will have to make
big changes to your lifestyle.
Task
• Ask why it necessary to begin insulin therapy
• Ask what you will have to do to administer the insulin
• Demonstrate lack of confidence on ability to do self injections
• Continue to express your anxiety, despite the doctor’s reassurances
• Request advice about suitable diet and exercise regime
_________________________________________________________________
Setting: Hospital Outpatient
Doctor
Patient is a 59 year old woman who was diagnosed with Type 2 Diabetes, three years
ago. She was initially treated with diet and exercise and then with oral medication.
However this has not been sufficient and recently her blood sugar levels have
increased. She now needs to begin insulin therapy. Patient’s husband passed away 1
year ago and she lives alone. She appears calm but you sense some anxiety. Patient is
also concerned about her recent feeling of tiredness & weight gain. She is also
worried about administering insulin to herself.
Task
• Inquire about the patient’s general health
• Find out if she has any underlying concerns
• Explain why insulin therapy is necessary
• Explain how she must monitor her blood sugar levels and how to
administer insulin injections
• Explain the importance of eating a balanced diet and doing regular
exercise
• Respond to patient questions and provide reassurance

DISCHARGE OF AGED PATIENT
Patient
You are an 83 year old woman and are being discharged today from hospital after
having a large lesion successfully removed three days ago. You suffer from arthritis
for which you take Glucosamine & Chondroitin Supplement as recommended by your
GP. You take Panadol to relieve the pain. You are concerned about how to manage at
home as your husband is unable to offer much assistance. You are unsure of how to
care for the wound and how to have showers as your balance is not good. You feel it
will be hard to cope with shopping, cooking & cleaning. You do not have any family
to help and most of your friends are in aged care themselves. You have just been
visited by ward doctor. Express your concerns to the doctor.
Task:
Ask the following questions:
• How can you care for the wound?
• Is there any service available to help at home?
• Express concern about your balance and arthritis in hands.
_____________________________________________________________________
Doctor – Medical Resident on Ward
The patient is an 83 year old woman who is being discharged today from hospital
after having a large lesion successfully removed three days ago. The sutures are to be
removed in 7 days time at the Hospital Outpatients. The patient is also suffering from
arthritis for which she is taking Glucosamine & Chondroitin Supplement
recommended by her GP and the pain is being relieved with 2 Panadol 3 times daily.
The patient is concerned about how to manage at home as her husband is also frail
and therefore unable to offer much assistance.
Task:
• Find out what the patient’s main concerns are.
• Explain basic management of sutures over the next week.
• Find out if patient has friends or relatives who can provide assistance
• Advise the patient that a hospital Social Worker will see her before discharge and
provide information about home care options such as Community Home Nursing
Services and other Community Home Help Services which can also provide
assistance with shopping and house cleaning.
• Remind patient about when/where sutures are to be removed

DIVERTICULAR DISEASE
Setting: General Practice Surgery
Patient
You are a single 45 year old woman. You have been a patient at this surgery for five
years. You rarely visit the doctor because he is always telling you that you need to
reduce your weight. He does not seem to understand that after working hard in a
factory 8 hours a day all you want is an easy take away meal and to relax by watching
TV. Recently you have had abdominal cramps and are very concerned it may be
bowel cancer as your father was diagnosed with this disease 2 years ago. You are at
the surgery to hear the results of a recent colonoscopy examination.
Task
• Express relief that it is not bowel cancer.
• Ask if you can have an operation to cure diverticular disease
• Ask what will happen if you do nothing
• Continue to express your reluctance to change your diet.
_____________________________________________________________________
Doctor
Your patient is Joan Thompson aged 45. She is unmarried and lives on her own. She
has been your patient for 5 years and you have repeatedly asked her to consider
changing her dietary habits as she relies heavily on take away foods with a high fat
content and now weights over 90 kilos. Joan works full time as a factory hand and
says she is too tired to bother cooking at night. You have asked her to come to your
surgery to discuss the results of a recent colonoscopy examination. There is no
evidence of bowel cancer which she was concerned about as her father was diagnosed
with bowel cancer two years ago. However there is evidence of diverticular disease.
Task
• Reassure her that there was no evidence of bowel cancer.
• Explain what diverticular disease is
• Discuss complications that can occur and treatment planned
• Endeavour to convince her of the importance of a low residue diet
and of regular exercise. Point out consequences of taking no action.

EPILEPSY
Patient
Your 12 year old niece, Jean, who suffers from epilepsy, is coming to stay with you
while her mother is having a hysterectomy. She will be staying for a month. She
suffers from tonic-clonic (Grand Mal) seizures. She has had 3 – 4 fits in the last
couple of years and is on medication. You have little knowledge or experience of this
condition. The child’s mother is going to discuss the situation with you, but you want
professional advice.
Task
• Ask the doctor for information and advice. What should you expect?
• What will happen before during and after a fit?
• What should you do?
• Be prepared to interrupt and seek clarification or further details on points the
doctor makes. You are a little over anxious.
_____________________________________________________________________
Doctor
A patient of yours has come to see you. The patient has a 12 year old niece, Jean, who
suffers from epilepsy with tonic-clonic (Grand Mal) seizures and is on medication;
Jean has had 3-4 fits in the last couple of years. The niece is coming to stay with your
patient for a month while her mother has a hysterectomy.
Task
Give the patient information and advice on the condition. You may like to include
some of the following points:
• Know about and supervise child’s medication.

• If a fit develops remain calm, lie the girl on her side, move any obstacles out
of her way
• Fits generally begin with a sudden loss of consciousness followed by jerking
movements,
• Most seizures last less than 3 minutes
• Sometimes there is a loss of bladder and bowel control and tongue biting can
occur
• The fit may be followed by a period of confusion or a need for sleep
• Try not to be overprotective of the child

FAINTING ATTACK
Setting: Hospital Emergency
Doctor
Patient is a 69 year old man who was brought to the emergency department after
apparently fainting while shopping at the local supermarket. Ambulance attendant
says that he appeared to have had some kind of fit although the patient states he only
fainted because of the heat. He has had these attacks several times in recent months
and says he is always OK afterwards if he rests. He is a widower and lives on his
own. You would like to arrange for an EEG and CT scan and refer him to a
neurologist to fully investigate these fainting attacks.
Task
• Inquire about the patient’s general health
• Explain why you would like to him to be seen by neurologist
• Explain that to you would like him to have an EEG and CT scan
• Discuss what this involves
_________________________________________________________________
Setting: Hospital Emergency
Patient
You are a 69 year old man who has been brought to the emergency department by
ambulance after fainting in the supermarket. The ambulance attendant believes you
had some kind of fit but you don’t want to accept that and are sure you only fainted
because it was hot. This has happened a few times in recent months and you
generally feel OK after a rest. You don’t like hospitals and want to go home. You
believe you are in good health although you haven’t visited your local GP for a few
years.
Task
• Ask how soon you can be discharged
• Although you a little worried you don’t want to have any tests
• You don’t like unnecessary fuss so don’t want to see another doctor
• Ask how long the tests will take
• Continue to express your desire to go home.

SURGERY FEARS
Setting: Hospital Surgical Ward
Patient
You are Ann Sayers aged 23. You have never been to hospital before but you are
being admitted to have a plate inserted in your ankle which you broke while skiing.
You are very worried about developing a DVT because you have heard this can
happen after surgery. You recently read about a young woman who died in
circumstances similar to yours. A doctor has come to examine you prior to surgery
Task
• Tell the doctor that you are scared about the operation.
• When the doctor asks you what scares you explain about your fear of
developing a deep bone thrombosis.
• Despite reassurances continue to express your fears
______________________________________________________________
Setting: Hospital Surgical Ward
Doctor - On duty Surgical Resident
You are examining Ann Sayers a 23 year old who is scheduled for surgery on her
broken ankle. She appears very tense and anxious
Task
• Ask how she broke her ankle
• Encourage her to tell you why she is so anxious
• Be understanding and try to reassure her about the operation and the care she
will receive post surgery.

HEAD LICE
Setting: Suburban GP Family Clinic
Patient
You are the mother of three children aged 3, 4, 6. You have just discovered your 6
year old daughter has head lice. You are upset and embarrassed as you always wash
the children’s hair regularly. You have never encountered this problem before.
Task
• Respond to the doctor’s questions.
• Ask about any natural remedies you can use as you don’t like chemicals
• Ask about whether your other children will be infected also.
__________________________________________________________________
Setting: Suburban GP Family Clinic
Doctor
A young woman, the mother of three children aged 3, 4, and 6 has come to the clinic
and tells you she has just discovered her eldest daughter has head lice. She is upset
and embarrassed and assures you she always washes the children hair regularly. She
has no experience in dealing with the situation as it has never happened before.
Task
• Reassure the mother and explain that head lice are contagious and anyone no
matter how regularly they wash their hair can get head lice.
• Suggest the mother contact any school or kindergarten her children attend as it
quite probable other children are also affected.
• Recommend and explain the use of a head lice comb
• Suggest the mother visit the local pharmacy to obtain a herbal product with
natural (non chemical) pyrethrins.
• Say that because head lice spread when people play, cuddle or work together,
it is important to check the whole family.
• Offer to provide the client with a detailed leaflet on treating and controlling
head lice.

HEART MURMUR - CHILD

Patient
Your family has recently moved to a new city and you are visiting a GP for the first
time. Your previous doctor said that Sandra, your 5 year old daughter, has a heart
murmur and should be reviewed from time to time. No other family members have
this condition and there is no family history of heart disease. Your child had dental
check up 3 months ago.
Task
• Ask what the diagnosis is
• Demonstrate concern and ask what effects is has on your child’s health
• Why does she need special antibiotics when she goes for dental procedures?
• Request early referral to a cardiologist for surgery.
• How frequently does she need cardiologist follow up?
_____________________________________________________________________
Doctor
You have just seen a healthy 5-year-old girl in a general practice. Her family recently
moved to your area, and her previous doctor said that she had a heart murmur and
should be reviewed from time to time. She is an active child, who has had occasional
sore throats (about once a year). Her parents and 3-year-old brother are in good health
and there is no family history of heart disease. Examination was normal
Task
• Explain likely diagnosis (Ventricular septal defect)
• Reassure the patient that it will probably heal spontaneously with time. Rarely
needs surgery to correct it if it does not heal spontaneously.
• Advise the patient to inform her condition to the dentist when child wants
dental procedures eg: need prophylaxis antibiotics.
• Need six monthly follow up by a cardiologist.

HEPATITIS A
Setting: Suburban Clinic
Patient
You are visiting your local GP today surgery because you have been feeling unwell
for a few days. Symptoms include mild fever, tiredness, nausea & recent vomiting. In
addition you have noticed that your eyes have a yellowish tinge and your urine is
dark. You have recently returned from a business trip in Nuigini and you wonder if
this could be the cause of your condition. Although while you were in Nuigini, you
stayed in first class hotels and took precautions such as drinking bottled water only
and avoiding local food.
Task
• Describe your symptoms to the doctor
• Express concern at the diagnosis as you are a frequent traveller and are always
careful
• Ask about treatment options & recovery time.
• Explain that you need to go overseas on another business trip next week. Will
that be okay?
Setting: Suburban Clinic
Doctor
A regular patient is presenting in your surgery today with symptoms suspicious of

hepatitis A including mild fever, tiredness, nausea, vomiting and jaundice.
Task
• Ask the patient about the symptoms
• Explain that you are suspicious of hepatitis A and that you need to do some
blood tests including Liver Function Test (LFTs) to confirm the diagnosis.
• Explain that hepatitis A is a virus and that it can spread through contaminated
food & water, eating utensils, poor hygiene practices. It is more common in
developing countries than Australia.
• People with hepatitis A are considered infectious for a week after the onset of
jaundice.
• Explain the usual duration of the illness (about 1 month to fully recover)
• Advise rest and avoidance of overseas travel for the next 2 weeks

INGUINAL HERNIA
Setting Suburban General Practice
Patient
You are a 45 year old man and have recently noticed a small swelling in your groin.
It is causing pain and has been increasing in size. You have stopped exercising
because of the pain and it is beginning to bother you at work. You are not sure what
caused the swelling but suspect that it may have been due to recent heavy lifting
during house renovations.
Task
• Enquire about the cause of the pain
• Express fear of surgery and be initially reluctant to accept it as a treatment
• Ask if there are alternative treatments
• Ask if there will be future restrictions
____________________________________________________________________
Setting Suburban General Practice
Doctor
Your patient is a 45 year old man. He has recently noticed a small swelling in his
groin. The patient states that it is beginning to cause pain and has been increasing in
size. After examining him you have diagnosed an inguinal hernia.
Task
• Explain your diagnosis to him
• Respond to the patient’s questions
• Inquire about recent events which may have led to the condition i.e. heavy
lifting
• Explain why surgery is necessary
• Reassure the patient that after surgery he will have no restrictions regarding
exercise and lifestyle

LESION ON LIP
Patient
You are a 33 year old woman and are visiting the doctor because you have recently
noticed a small spot on your lower lip which has changed in size and colour recently.
The doctor has examined you and you are now discussing the diagnosis.
Task
• Express concern at doctor’s diagnosis
• Request more details about the types of skin cancer
• Be alarmed at the possibility of a melanoma (your father died of this
condition)
• Ask for advice about skin protection and how to reduce the risk of you
suffering from skin cancer
-------------------------------------------------------------------------------------------------------
Doctor
This 33 year old woman has come to see you regarding a small lesion on her lower lip
which has changed in colour and size recently. It is suspicious and you are concerned
about its appearance. Due to its location you can’t use cryotherapy (freezing) and
would like a second opinion so are referring the patient to a specialist, Dr Jenkins for
a skin biopsy
You suspect basil cell carcinoma which is the least dangerous form of skin cancer.
Nevertheless explain to the patient that treatment is necessary just in case it is a
squamous cell carcinoma or melanoma, which although quite uncommon are much
more dangerous forms of skin cancer.
Task
Inform the patient of your treatment plan
• Explain why referral is necessary
• Describe the 3 kinds of skin cancer BCC; SCC; Melanoma
• Inquire about patient’s lifestyle and how much sun exposure they receive
• Provide general advice about the importance of protection: sun screen, hat,
adequate clothing etc
• State the importance of regular checks to reduce the risk

MYOCARDIAL INFARCTION
Patient
You are a 42 year old male who arrived at the hospital via ambulance 10 days ago
after suffering from acute substernal chest pain radiating to left arm. You have been
diagnosed with myocardial infarction. You are a businessman, married with 5
children. Your condition has now stabilized however you are restless and worried that
you will have to make big changes to your lifestyle. Seek reassurance from the doctor.
Task
• Express nervousness about future health.
• Ask if all the medications are necessary.
• Will you be able to work soon?
• Express concern that it will be hard to make changes to your lifestyle.
• Request advice about suitable diet/exercise routine
_________________________________________________________________
Doctor
Patient is a 42 year old male who arrived at the hospital via ambulance 10 days ago
after suffering from acute substernal chest pain radiating to left arm. Patient has been
diagnosed with myocardial infarction. Patient is a businessman, married with 5
children. His condition has now stabilized however he appears restless and worried
about his condition. He is overweight and is a smoker. He has high blood pressure.
Task
• Provide comfort and stress the importance of a gradual transition back to
normal life
• Reassure the patient that he can expect a full recovery if he follows your
advice
• Discuss the importance of taking medications regularly
• Discuss the importance of giving up smoking
• Provide advice on what assistance is available to help quit smoking
• Provide advice on suitable diet and exercise
• Discuss importance of regular rest periods between activities

NUTRITION
Parent
You are Leanne Wilson, a sole parent with three children - Ronnie aged 8, Dexter
aged 12 and Marie aged 14. Ronnie’s teacher asked you to come up the school to see
her yesterday morning because she is concerned about Ronnie’s health. She says he
frequently complains of headaches and tiredness and on several occasions has said he
hasn’t eaten any breakfast. You work Monday – Friday, 7am – 2.30pm at a local
factory. Because you leave for work so early you rely on Marie to get herself and her
brothers ready for school. Often they don’t have time for breakfast.
Although you are a bit worried about Ronnie, you are angry because the teacher
doesn’t seem to have any understanding of your situation. A neighbour has told you
about a Family Clinic that could give you some advise at no charge.
Task
• Explain to the doctor why you have come
• Tell him about your family situation and your work demands.
• Explain that you work hard and go to bed early. The kids go when they are
tired. Generally they watch a bit of TV.
• Say that Ronnie seems OK to you. He always has a bowl of coco pops and
some soft drink when he gets home in the afternoon.
• Point out you leave for work at 6.30am so can’t be responsible for getting
breakfast for the family.
___________________________________________________________
Doctor
You are a GP at a Family Clinic. There are a number of sole parents who visit your
clinic because you have a policy of bulk billing (that is only charging a fee that is
covered by a government health card) Your services include advice and education on
a range of parenting issues including behavioral problems and nutrition. Ms Leanne
Wilson, a sole parent of three children has come for advice about her son youngest
son Ronnie
Task
• Listen to Ms Wilson’s concern
• Ask about the family – ages of children – work situation
• Ask about Ronnie’s general health
• Ask about family routines in relation to meals and bed times.
• Discuss importance of a proper diet including a nourishing breakfast and
suggest how this might be achieved
• Make an appointment for a follow-up visit to see Ronnie.

OSTEOARTHRITIS
Patient
You are an overweight, 55-year-old man who is returning to the doctor to get x-ray
results regarding recent back pain which has been getting progressively worse. You
are concerned about the results and what they might mean and have many questions
for the doctor. One of your hobbies is cycling and you are worried about whether you
can continue this from of exercise.
Task
• What is osteoarthritis?
• Why has it developed?
• What are the treatment options?
• Will it get worse?
• Can you still do exercise?
_______________________________________________________
Doctor
The patient, a 55 year old overweight man, who is a regular patient of yours. He
appeared at your surgery complaining of back pain last week. As a result, you ordered
an x-ray. Today is the second visit and x-ray results confirm osteoarthritis.
Task
• Explain factors which can lead to the condition i.e. genetic
• Explain treatment options including medication such as parecetemol and
NSAIDS
• Explain the possibility of physiotherapy for relief
• Inform the patient of the benefits of mild exercise such as walking and
swimming
• Discuss the importance of weight loss
• Advise against hard exercise such as running or cycling

PAIN MANAGEMENT
Patient
You have recently been discharged from hospital following a open-chest surgery to
repair an aortic aneurysm and you now have a mechanical heart valve in place. Your
surgeon has referred you to your local GP for follow-up care. You have had a lot of
pain since being discharged and you are concerned about it.
Task
• Tell the doctor that you have not had much pain from the wound but you have
had a lot of back pain and are not sleeping well
• Describe how the pain is mostly in the upper back, near the shoulders
• Ask him if this is serious and if you should go to the hospital when you have it
• Ask him if you can take more Endone as this is the only medication that works
for you.
___________________________________________________________
Doctor
You are a GP in a General Practice. This patient has been referred to you from a
cardio-thoracic surgeon for follow-up care. He has recently been discharged from
hospital following open chest surgery for repair of a Type A dissection and aortic root
replacement with mechanical valve. During this visit, he is complaining of a lot of
pain. Respond to his questions and give him advice on how to manage the pain.
Task
• Ask him to describe where the pain is
• Reassure him that upper back pain is normal following open-chest surgery
• Explain the surgery to him and how the muscles in the back will be affected.
• Explain what type of pain is serious and what to do when he gets it
• Explain that he should not take Endone more than the prescribed dose
• Explain that it is important to take regular Paracetamol first and if this is not
enough, then take the Endone
• Explain that Endone is a Schedule 8 drug and what this means
• Explain for how long he might need Endone after surgery. Explain that he
should not take Endone for too long as it can be addictive
• Reassure that the pain will gradually reduce
• Suggest gentle walking to help with the pain and for relaxation

PALLIATIVE CARE
Setting: Home Visit by family GP
Patient/Carer
You are John Reeve aged 36. Your wife Jill, aged 34, has terminal ovarian cancer.
You have 2 sons aged 10 and 7. You have taken time off work to care for your wife
at home. A Community Care Nurse comes five days a week to shower your wife.
Your family GP visits weekly to monitor Jill’s pain medication. You are finding it
increasingly difficult to manage at weekends when the nurse doesn’t come. You feel
you can’t make Jill comfortable and are worried that the pain medication often takes a
long time to work. Your whole time is taken up trying to keep the household
functioning so you have no time to just sit with Jill. You get little sleep at night. The
children are complaining that you never play with them and that they always have to
be quiet. You have no family nearby to call on and are worried that you may not be
able to keep your promise to your wife to let her die at home. You ask the family GP
for advice
Task
• Tell the doctor that you are not managing well. You need more help,
especially at weekends when the children are home from school and wanting
your attention.
• Emphasize that you want to keep caring for your wife at home but you are
feeling physically and emotionally exhausted and starting to wonder if you are
doing the right thing by her and the children.
_____________________________________________________________________
Setting: Home Visit by family GP
Doctor
Your patient, John Reeve has taken time off work to be a full time carer for his wife
Jill who has terminal ovarian cancer. They have two sons aged 10 and 7. You visit
Jill at home once a week and have observed a rapid deterioration. The level of
medication to provide adequate pain relief has been increased but she still experiences
break through pain A Community Care Nurse comes five days a week to shower Jill.
John looks exhausted but is still determined to keep Jill at home. You consider it is
time to admit Jill to a palliative care hospital.
Task
• Ask John if Jill has had a comfortable and pain free weekend.
• Ask how the children are coping and whether John has access to any family
help.
• Ask John how he is coping physically and emotionally
• Recommend admission to a nearby palliative care hospital for benefit of all
family.

POST SURGERY ACTIVITY
Patient
You are Harry Jones aged 78. You are a bachelor who lives on his own. You were
admitted to hospital to have a large lesion removed from your back. You know you’ll
be discharged in the next few days but meantime you want to make the most of the
rest and the hospital food. You want the nursing staff to leave you in peace but a
nurse says its time to get up and have a shower. You are feeling quite cranky. You
have refused to get up until you have seen the doctor
Task
• Point out that you will be home in a few days and there will be plenty of time
to shower then
• Say that at your age you need rest not exercise
• Argue that a shower will only wet the dressing on your shoulder
_____________________________________________________________________
Doctor
You are a hospital resident in a busy surgical ward. A nurse has asked you to talk to
Harry Jones aged 78, who had surgery two days ago to remove a large lesion from his
back. He has recovered well and will be discharged within the next two days.
Meanwhile he needs to become mobile and can have a shower. He has refused to
move until he has spoken to a doctor.
Task
• Confirm that he has progressed very well and will be ready for discharge
within the next two days.
• Encourage him to have a shower, wash his hair and generally get cleaned up
• Explain that a waterproof dressing can be placed over the lesion area.
• Be understanding but stress the importance of exercise and good hygiene in
ensuring a speedy recovery.

SEPTICAEMIA MENINGITIS
Setting: Rural Area General Practice
Patient
You are a mother of 5 year old boy, Brett, who suddenly became severely ill. Now
your son is lethargic with fever. He refused to eat and you noticed he has a rash over
the trunk and legs.
Task
• Ask what the diagnosis is.
• If doctor suggested IV antibiotic, ask why it is necessary.
• Show your resistance to the doctor’s suggestion of transferring your child
immediately to the Tertiary unit because you have other 4 other kids aged 2
and 12.
_____________________________________________________________________
Setting: Rural Area General Practice
Doctor
You are a general practitioner in rural area (300km) from a Tertiary Hospital. Your
patient is a severely ill 5 year old boy. He suddenly became severely ill. Your
probable diagnosis is Septicaemia-meningitis.
Task
• Take relevant history
• Explain diagnosis to the mother
• Do immediate management e.g. give an IV one dose of Penicillin
• Immediately transfer (via air ambulance) to the nearest Tertiary hospital.
• Arrange care of other kids, such as contact social worker to help other kids.

WARFARIN THERAPY
Patient
You have recently been discharged from hospital following a repair of an aortic
aneurysm and you now have a mechanical heart valve in place. Your surgeon has
referred you to your local GP for follow-up care. You have been started on a
medication to keep the blood thin so that you do not develop blood clots and you want
to know more about it.
Task
• Tell the doctor that you are on several new medications including one to keep
the blood thin.
• Ask how long you will need to be on that medication (Warfarin)
• Ask why you must have blood tests
• Ask how often you must have the blood tests
• Ask what are the side effects of Warfarin
• Ask who to call if you have questions or concerns
___________________________________________________________
Doctor
You are a GP at a Family Clinic. This patient has been referred to you from a cardio-
thoracic surgeon for follow-up care. He has recently been discharged from hospital
following a repair of a Type A dissection and aortic root replacement with mechanical
valve. He is on a few new medications including an anticoagulant, Warfarin. His
surgeon recommends maintaining the INR between 2.5 and 3.5
Task
• Confirm why he needs to be on an anticoagulant
• Explain that it will be necessary to be on Warfarin for life
• Explain why the blood tests are necessary
• Explain what is INR and the recommended level
• Explain what things may affect his INR levels (change in brand, time of day
taken, diet, medication, exercise, alcohol use)
• Explain how often he will need blood tests
• Explain the side effects of Warfarin
• Tell him that the QML Pathology will monitor his INR and change his
Warfarin dose if needed.
• Explain that QML have a Warfarin support service and their staff are able to
answer questions.

WORKPLACE HEALTH
Setting: General Practice Clinic
Patient
You are a truck driver with a large Interstate Road Transport Company. In the
interest of workplace health the company has arranged for all their truck drivers over
the age of 40 to have the option of a medical checkup by a local GP. This service is
free and confidential. You are aged 45 and have not seen a doctor for at least 15
years. Your father died of a stroke at age 55 so you want to get your blood pressure
checked. You don’t smoke, are a bit overweight, don’t exercise much and like a few
beers after work and at the weekend. Eat mainly take away foods on job – hamburgers
and chips.
Task
• Answer the doctor’s s questions
• Request a blood pressure check
• Admit you could be fitter
• Ask for advice on how to avoid a stroke
_____________________________________________________________________
Setting: General Practice Clinic
Doctor
A large interstate road transport company is encouraging all their truck drivers over
40 who have not seen a doctor over the past year to have a fitness checkup at a
General Practice Clinic which is near the Company. The company will pay the cost
of this service and has assured staff that the results will remain confidential. A truck
driver, aged 45, has come to see you. Weight 82 kg Ht 178 BP check 150 /90
Task
• Ask about his health concerns
• Ask about his lifestyle i.e diet, exercise smoking/drinking habits
• Check when he last visited a GP
• Advise BP indicates borderline hypertension and should be checked regularly
• Stress importance of commencing regular check- ups with GP
• Recommend
o reducing weight by healthy eating habits – less fat and less salt
o reducing alcohol intake
o 30 minutes exercise 4-5 times a week.

ALCOHOL DEPENDENCE
Setting: Rural Medical Centre
Patient:
You are a 26 year old single father of an 8 year old girl. You are employed as a truck driver.
Your wife died 2 years ago and you have custody of your child. After that you started to drink
heavily at the weekends. Day time your daughter is at school and the after-school centre. At
weekends sometimes you leave your daughter at home alone. You have had a couple of car
accidents in the past year.
Task:
 Answer appropriately the doctor’s questions.
 Ask for some help for your daughter.
 If doctor advises you to stop drinking explain that you have tried before but it is very
difficult to do.
____________________________________________________________________
Setting: Rural Medical Centre
Doctor:
You are working in a general practice. This patient is well known to you. He is a 26 year old
single parent of an 8 year old daughter. Mother died 2 years ago and he has sole custody of the
child. Patient is a truck driver. He regularly drinks heavily at weekends and has had 2 car
accidents. You are aware that he sometimes leaves his daughter by herself for a few hours on
weekends.
Task:
 Ask the patient to describe his drinking pattern e.g. how much alcohol and how often?
 Point out the harmful consequences of his alcoholic consumption and recommend
immediately cutting it down to a safer level.
 Describe the risks of alcoholism and the support services available.
 Ask about the care of his daughter at weekends when he is drinking heavily.
 Discuss an arrangement of community support services for his daughter or social
worker’s help
CHOLESTEROL
Patient
You are a 47 year old male and are visiting your local GP to check on your blood test results. You
are nervous about the results as you fear your cholesterol may have increased. Your father had heart
surgery when he was 60 so you are worried that you are at risk also. You don’t really smoke (only
on rare social occasions) and drink moderately.
Task
 Begin with some ‘small talk’ such as the weather etc.
 Express concern at diagnosis.
 Request more details about the treatment.
 Ask if you can delay treatment for 6 months while you try to reduce risk factors and improve
your diet.
_____________________________________________________________________
Doctor
This 47 year old male is a regular patient of yours and has come to receive his blood test results.
You take patient’s BP and it is normal at 120/80. The blood test results are:
Random Fasting
Total Cholesterol 6.6 7.9 mmol/L
Triglycerides 1.6 0.9 mmol/L
Measured fractions
HDL 1.54 1.24 mmol/L
LDL 4.65 5.52 mmol/L
This is a sharp rise from the previous test completed 1 year ago and moves the patient into a higher
risk category. Therefore you recommend medication to control cholesterol and reduce the risk of a
future heart event.
Task
 Ask the patient if there have been any changes in his lifestyle which could have led to the
change: i.e diet/work or family stress.
 Enquire about other risk factors: family history/ smoking /drinking.
 Recommend that patient should start on a medication such as Lipitor or Crestor.
 Explain the benefits of this approach and the potential risks of not taking medication.
Consent of Surgery
Setting: Private Practice
Patient
Your GP has referred you to a consultant surgeon to get your ultrasound results after suffering from
abdominal discomfort for 2 months. You are waiting for the ultrasound results. You are talking to
the surgical registrar.
Task
 Ask for details about the diagnosis.
 Are the stones big or small?
 How many are there?
 Ask doctor to explain surgical options in detail
 Ask about consequences if no surgery is done
 Ask about risk factors of surgery and why consent is necessary
 Ask about recovery time
 Check for other alternatives to surgery
 Is there a medication which can dissolve the stones?
 Can surgery be delayed?
___________________________________________________________
Setting: Private Practice
Doctor
You are a consultant surgeon in a private practice. This patient has been referred to you by his GP
after suffering from abdominal discomfort for 2 months. You have received ultrasound report that
indicate that your patient has gall bladder stones. There are 3 stones of varying size, one of which is
causing obstruction and associated pain. He requires surgery.
Task
 Ask about current condition
 Explain diagnosis
 Offer him laprascopic cholecystectomy as operation of choice
 Inform on some occasions open cholecystectomy is necessary due to anatomical variation
 Explain that consent is required for this procedure
 Respond to patient’s concerns
 Explain necessity for surgery especially if he will be traveling
DIABETES TYPE 1
Patient
You are the mother of Tom, 10 years, who has recently been diagnosed by an endocrinologist as
having type 1 diabetes. You are visiting your local GP today seeking more details regarding the
condition and what effects it will have on your son’s daily life.
Task
 Listen to the doctor’s explanation of the disease and if you have queries, ask and clarify that
query.
 Ask about medications.
 Ask what would happen if you forgot to give insulin.
 Ask if Tom can participate in school camping and sleepovers.
_____________________________________________________________________
Doctor
You are a GP at a general practice. Your patient is Tom, a 10 year old boy who has come with
mother. He was diagnosed with type 1 diabetes by an endocrinologist.
Task
 Explain the diagnosis to the mother.
 Explain about hypoglycaemic and hyperglycaemic attacks.
 Suggest what the mother should do in these situations including glucagon injection, oral jelly
beans, seeking urgent medical advice.
 Discuss importance of insulin intake two times daily.
 Talk about school camps and sleepovers.
ECZEMA

Patient
You have a five year old son who has red scaly patches on his hands, the back of his knees and on
his tummy. They are very itchy and he keeps scratching them which makes them worse. The rash on
his hands has become cracked and weepy. You have tried to ease the itch with various cosmetic
creams but they don’t work. You have brought him to the doctor to see what can be done to improve
his skin.
Task
 Ask the doctor about the condition
 Request details about the treatment options. How can the itchiness be stopped?
 What about the future, will he grow out of it?
 What about your other children, are they likely to suffer from the same condition?
____________________________________________________________

Doctor
Your patient is a young boy of five who has patches of red scaly rash on his hands, the back of his
knees and on his stomach. The rashes are very itchy and he keeps scratching them which make them
worse. The patches on his hands have become cracked and weepy. His mother has tried to ease the
itch with various cosmetic creams but they don’t work. You diagnose eczema.
Task
 Inform the patient of your diagnosis
 Respond to the parent’s questions regarding the condition
 Explain how to manage the condition including:
o Avoid things which may irritate the skin such as soaps, woolen clothes/ dust/pets
o Encourage parent to monitor the diet of the child to determine what may be triggering
the condition. i.e eggs, milk, wheat
o Reduction of scratching
o Keeping the skin moist
Immunization
Doctor
A young father visits you with his 6 weeks old baby daughter. His wife wants to begin the
recommended immunization program immediately because she has to return to work in 6 months
and feels it will be necessary protection for her daughter. She also thinks that the child care agency
will not accept her daughter without evidence of vaccination. The father is worried about the
possibility of serious complications due to immunization.
Task
 Explain why vaccination is recommended
 Reassure the father that side effects (if any) will be minimal
 Explain the potential risks if the child is not vaccinated
____________________________________________________________
Patient
You have decided to visit your doctor with your 6 weeks old daughter. You know that your wife
wants the baby to start on the recommended immunization program immediately. She is due to
return to work in 6 months and will need to place the baby in a childcare agency. She says the baby
needs protection and that the child care agency probably won’t accept a child who has not had the
recommended vaccinations. You are concerned as your brother has an autistic boy aged seven. Your
brother and his wife believe it was a reaction to the vaccinations that brought on the autism.
Task
 Express your concerns regarding vaccination
 Explain what happened to your brother’s child
 Be difficult to reassure that the risks are minimal
 Enquire about possible alternatives
SLEEPING TABLETS
Patient
You are a 40 year old family man and have been suffering from lack of sleep. This is primarily due
to your new job as a shift worker at an oil refinery. You work on a rotating shift and have to work
12 hour night shifts twice a week. After work you have not been able to sleep well. As a
consequence it has been hard to remain alert during your shift. You have been drinking a lot of
coffee to stay awake. You have visited the doctor in order to receive a prescription for sleeping
tablets. You regular doctor refused them. You are desperate so are visiting a different medical clinic
for the first time.
Task
 Explain your situation and request sleeping tablets.

 Do not accept other solutions as you need a quick solution as you feel your job might be at
risk.
 Be prepared to argue strongly for the tablets
____________________________________________________________
Doctor
A 40 year old family man who has been suffering from sleep deprivation since starting a new job as
a shift worker at an oil refinery is requesting that you provide a prescription for sleeping tablets. The
patient states that he has already visited another doctor who refused to provide a prescription. It is
your first time to see this patient.
Task
 Ask about working hours and eating/drinking habits at work.

 Decline to provide sleeping tablets due to risk of becoming dependent, possible side effects
and the short term nature of this solution.
 Enquire about home environment. Suggest creating a quite, cool, dark place which will aid in
sleeping.
 Recommend relaxation techniques and herbal teas as a healthier alternative.
SWOLLEN ANKLE
Patient
You are a 22 year old man who fell and badly hurt your ankle during a game of tennis. You think it
might be broken as it is badly bruised and swollen. The doctor sent you for an X-ray and you have
returned with the results. You are worried because you are about to start a new job as a clerk with a
legal firm next week. This is a job you really want and you are afraid you will create a bad
impression if you ask for time off at the outset.
Task
 Stress how worried you are about your ankle. It seems badly swollen to you.
 Be surprised that it is not broken considering the swelling.
 Tell the doctor about your new job.
 Remain doubtful that you will be able to manage at work.
_____________________________________________________________________
Doctor
Your patient is an anxious 22 year old man. He has a moderately bruised and swollen ankle as a
result of a fall while playing tennis. You do not consider the injury to be serious but you sent him
for an X-ray. He has returned with the results which show there is no fracture. You expect the ankle
to recover within a few days.
Task
 Advise the patient that the X-ray shows there is no fracture.

 Reassure him that there is no serious injury and that the ankle should mend quite quickly.
 Suggest rest and elevation of the ankle until the swelling subsides and the use of ice packs
and Panadol for pain relief if necessary.
 Ask about the type of work the patient does.
 Be sympathetic to his concerns about needing time off work, but emphasise that it is not a
serious injury and that he can continue working provided he keeps his ankle elevated
TUBERCULOSIS
Patient
You are woman aged 35 who has been working in Freetown, the capital of Sierra Leone with an
international care agency for two years. Your work was mainly assisting with the distribution of
medical goods and other aids to refugee camps which you visited from time to time. You often
talked with the people in the camp about their needs. Since you returned to Australia 6 months ago
you have lost about 8 kilos in weight, feel tired most of the time don’t feel like eating and recently
you have had a low fever in the afternoon or at night. You notice that you sweat heavily at night and
have developed a persistent cough. Lately you have been coughing up yellowish mucous. You
wonder if you have picked up some bacterial infection while you were in Africa.
Task
 Respond to the doctor’s questions.
 Request more details about the treatment.
 Ask if you are contagious.
_____________________________________________________________________
Doctor
Your patient is a woman of 35 who has been working in Sierra Leone with a refugee support
organization for two years. Since her return to Australia 6 months ago she has noticed that she has
lost weight, feels tired most of the time, and recently she has noticed she consistently has a low
fever in the afternoon or at night. She has also developed a persistent cough. She thinks she may
have picked up some bacterial infection during her work in Sierra Leone but you suspect that it
could be tuberculosis.
Task
 Take a recent history.
 Recommend a course of antibiotics (6-12 months on rifampicin and isoniazid during
which time no alcohol should be consumed).
 Explain infectious nature of the condition.
 Request regular visits to monitor condition.
Hypertension
SETTING: General practice
DOCTOR: Your patient is 48 years old and suffers from poorly controlled hypertension. The
patient smokes and is overweight. You suspect that the patient is not taking his/her medication
regularly. Examination today has shown that the patient’s BP is still too high.
TASK:
 Tell the patient the results of your examination.
 Discuss with the patient the benefits of losing weight, giving up cigarettes and adopting a
healthier lifestyle.
 Mention the possible dangers of uncontrolled hypertension (increased risk of a heart attack or
stroke)
 Try to convince the patient that it is important to take the medication even if he or she is
feeling well.
--------------------------------------------------------------------------------------------------------------
SETTING: General practice
PATIENT: You are 48 years old. You are a smoker. You are overweight. For the past three years
you’ve had mildly raised blood pressure. The doctor has given you tablets to take but you don’t
usually bother with them if you are feeling OK. You are visiting the doctor for your annual check-
up (a waste of time in your opinion but your husband / wife insists you attend).
TASK:
 Ask about the results of your blood pressure check. Ask if losing weight would help to lower
it.
 Find out why you have to take tablets when you feel fine.
 When the doctor mentions the health problems associated with high blood pressure, you
think he or she is exaggerating. How can it be such a big problem when you feel fine?
 You certainly don’t want to give up smoking. You’ve tried before and failed completely.
You were so bad tempered that after a week your family begged you to start again!
JAUNDICE BABY
Setting: Maternity Hospital
Patient
You are an 18 year old mother who delivered a baby boy 3 days ago without complication. It is your
first baby. He is slightly underweight at 2.7kg. He is breast feeding but during the last 24 hours, he
has not been feeding well. He is sleepy and becoming jaundiced. You were supposed to be
discharged home today but the doctor recommends you stay. You want to return home as soon as
possible as you don’t like hospitals and you have not been sleeping well. You had a friend whose
baby was jaundiced and she did not need to stay in hospital for treatment.
Task
 Ask the doctor if it is possible to go home today.
 Explain that you really prefer to be at home instead of hospital.
 Ask for information about jaundice. What causes it?
 Be anxious about side effects of the treatment for jaundice.
_____________________________________________________________________
Setting: Maternity Hospital
Doctor
Your patient is an 18 year old girl who has just delivered a baby boy 3 days ago. The baby is
healthy but a little underweight at 2.7 kg and has become jaundiced. He is breast feeding but for the
last 24 hours, he has not been feeding well. Your patient would like to be discharged today as was
originally planned but you recommend that she stays until a blood test is taken and the results are
known, in case her baby needs treatment for the jaundice.
Task
Give the patient information and advice on the condition. You may like to include some of the
following points:
 That the patient and baby must stay in hospital longer.

 Why a blood test is necessary.
 What causes jaundice in new born babies.
 How common is it and how serious.
 What treatment will be needed if the blood results are higher than normal.
 Any long term effects of jaundice and the treatment.
MEDICATION CHANGE
Setting: GP Surgery
Patient
You are a man aged 75 who has had osteoarthritis since your early fifties. You took Drug X for
several years and it worked well. However Drug X has recently been withdrawn from sale because
it has been discovered to cause an increase in strokes and heart attacks. You have stopped taking
Drug X. Despite the fact that you have considerable joint pains which give you sleepless nights you
are too worried to try any other drugs in case they have the same effect. You would like the doctor
to give you some ideas of more natural ways to relieve your pain.
Task
 Explain your problem to the doctor.
 Respond to his/her questions.
 Stress your fear about the side effect of prescription medication.
 Ask if there is a more natural alternative.
_____________________________________________________________________
Setting: GP Surgery
Doctor
Your patient is a man aged 75 who has had osteoarthritis since his early fifties. He took Drug X for
several years and it worked well. However, Drug X has been withdrawn from sale because it has
been discovered to cause an increase in strokes and heart attacks. He wants you to suggest more
natural ways to relieve his pain.
Task
 Ask about the degree of pain he is currently suffering.

 Reassure him that there are effective prescription drugs that are not related to an increase
in strokes and heart attacks.
 Recommend natural approaches he might try to relieve his discomfort.
 Suggest a review of the situation in one month.
Lung Mass
PATIENT:
You are experiencing discomfort due to shortness of breath and regular coughing. You have
returned to the doctor’s practice to talk about your chest radiograph results.
Task:
 Respond with shock when the doctor gives you the news.
 Demand to know what your chances are, what the treatment will be, and how long you have
to live.
 Ask the doctor to promise you that you’ll be OK.
_____________________________________________________________________
DOCTOR:
Mr. Langer is a 45-year-old factory worker who originally presented complaining of blood stained
spit and shortness of breath. Chest radiograph results show a golf ball sized mass in his left lung.
Task:
 Explain the results of the radiograph.
 Explain that a biopsy will be necessary to determine what kind of cancer he has.
 Respond to Mr. Langer’s questions by explaining the uncertainty of the degree of spread and
the varying treatment needs for each type. Explain possible treatment options.
Lifestyle Change
PATIENT:
You are a 55-year-old retired insurance broker recovering from a serious heart attack. You have
been out of hospital for two months and are happy to return to your normal lifestyle. You have an
optimistic attitude, and think that your recovery is due to your own strong health.
Task:
 Respond with indifference to your weight and BP readings and say that it’s to be expected
that you are not totally healthy after having a heart attack.
 Report that you attempted the exercise regime you were given but quit after one month
because it was too difficult. You are still smoking 15-20 cigarettes per day, drinking and
continuing your diet of fried meat and potatoes.
 Refuse to modify your lifestyle.
_____________________________________________________________________
DOCTOR:
Mr. Croft is a 55-year-old retired insurance broker who has been in cardiac rehabilitation for the
past two months following a severe heart attack. At his regular check-up, his systolic BP has not
improved (155/98) and he is still dangerously overweight (BMI 29.5), 90kg.
Task:
 Explain the risk associated with his current blood pressure and weight.
 Ask him about his progress with his exercise regime and whether he has quit or reduced his
cigarette and alcohol consumption and modified his diet.
 Warn him of the risks if he refuses to modify his lifestyle. Suggest he visits the hospital’s
dietician.
Pregnancy
SETTING: GP Clinic
DOCTOR
A twenty one year old has tested positive on a self-administered urinary pregnancy test. She is
single with minimal social supports available and tries to pressure you into making a decision about
her pregnancy for her.
TASK
 Assess the patient’s recent symptoms, self-diagnosis technique, and ask about her obstetric
related medical history.
 Explore with the patient how she feels about the pregnancy and what options she has
considered to cope with it so far.
 When she asks about the options of termination versus proceeding with the pregnancy,
provide her with a brief explanation of terminations/abortions and inform her of support
services available for single mothers.
 Sensitively re-direct her to make her own decisions when she expects you to make them for
her.
_____________________________________________________________________
SETTING: GP clinic
PATIENT
You are a twenty one year old who has just found out you are pregnant using a self administered
urinary pregnancy test. You are single and have very few social supports in your city as your family
are mostly overseas working. You already have had one child who is in the care of your ex partner
because you previously struggled with heroin addiction. Your first pregnancy was uncomplicated
but you did have an emergency caesarean section for the delivery. This time, you are ambivalent
about proceeding with the pregnancy and want more information on having a termination/abortion
though. After information is provided, you try to pressure the doctor to make a decision for you as
to whether you have the baby or a termination.
TASK
 Answer the doctor’s questions about your recent pregnancy symptoms, urine test and
pregnancy/ childbirth related history.
 Answer the doctor’s questions about how you feel about the pregnancy and tell him/her you
are extremely ambivalent about proceeding with the pregnancy because you don’t know how
you will cope and that you have already ‘failed’ with your first child.
 Ask the doctor to explain the termination option to you but also about what support is
available if you proceed with the pregnancy.
 Pressure the doctor to make a decision for you about whether you should proceed with the
pregnancy or have a termination. Emphasize that it’s all too stressful for you to deal with.
Psychological Disease
SETTING: Emergency department
DOCTOR
The mother of a 21 year old male patient who has been brought in by police in a highly psychotic
and aggressive state is very angry with you because he is currently being manually restrained and
given an intramuscular medication to sedate him. There are clear clinical grounds for sedating the
patient as he has tried to violently strike several nurses and was pointing knives at people randomly
in the street just before his admission. It is his first psychiatric presentation at a hospital and his
mother has little understanding of mental health. She feels that you, as the doctor in charge of his
care, are just being cruel and barbaric towards him.
TASK:
 Sympathise with the mother’s concerns but explain his recent behaviour and the need for
manual restraint and sedative medications for his and other’s safety.
 Reassure her that the medications given (e.g. midazolam & droperidol) rarely have any long
term side effects when given in the short term and that they will help him to become less
paranoid and agitated.
 Explain that the patient needs to be soon transferred to the mental health unit for safety and
assessment reasons, and that he will be given the help he needs there.
 When she becomes hostile about him going to a mental health unit, reassure her that staff in
mental health facilities are highly trained and accountable health professionals and that
patients and their families have many legal rights.
_____________________________________________________________________
SETTING: Emergency department
PATIENT
You are the mother of a 21 year old man brought into emergency by the police as he was highly
paranoid and aggressive. You don’t know the exact details about his recent behaviour yet as you
haven’t seen him for one week. You are outraged when you arrive as he is being held down by male
staff members and being given an injection in his buttocks against his will. You know little about
mental health and just feel all this must be a mistake as your son has always been mentally healthy
up until now. You approach the doctor enraged about the way he is treating your son.
Task:
 Angrily demand to know why your son is being restrained and given injections against his
will. Eventually – but not too easily - accept the doctor’s rationale for this treatment.
 Express shock, especially because your son has never had any mental problems before and
was fine when you last saw him one week ago.
 Voice concerns about the side effects of what might be strong psychiatric drugs.
 Become hostile and defensive again when told that your son will be soon transferred to the
hospital’s mental health unit. Insist that your son isn’t ‘one of those crazy people’.
Croup
Setting: Suburban clinic, 11 pm
Doctor
This parent has brought in his/her four-year-old child, Tom, who has been well, except for one day
of mild rhinorrhoea. This evening he developed a cough that sounded ‘like a dog barking’. You
diagnose mild croup.
Task
 Explain the illness and that there is no treatment.
 Reassure the parent that it is common and usually harmless but give instructions as to when
to seek immediate attention.
_____________________________________________________________________
Setting: Suburban clinic, 11 pm
Patient
You have brought your four-year-old child, Tom, in with you. Tom had a mild runny nose through
the day and this evening developed a cough. He went to bed as usual and awoke with a terrible deep
cough. He sounded like a barking dog. You feel very worried about the cough and his breathing.
Task
 Seek reassurance from the doctor. Find out if it is dangerous and requires treatment.
 Be really anxious.

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Setting Rural Community Health Clinic

Setting Rural Community Health Clinic

Setting: Children’s Hospital

Setting: Children’s Hospital

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Setting: Suburban General Practice

Setting: Suburban General Practice

This resource was developed by OET Online

Setting: Family General Practice

Setting: Family General Practice

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BREAKING BAD NEWS

Setting: Hospital Ward

Setting: Hospital Ward

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BREAST CANCER PATIENT

Setting: Hospital Ward

Setting: Hospital Ward

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CHILD – BROKEN LEG

Setting: Family General Practice

Setting: Family General Practice

This resource was developed by OET Online and is subject to copyright © 1

Setting: General Practice Family Clinic

Setting: General Practice Family Clinic

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COMPLAINT AGAINST HOSPITAL STAFF

Setting: Private Hospital

Setting: Private Hospital

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Setting: Hospital Outpatients

Setting: Hospital Outpatient

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DISCHARGE OF AGED PATIENT

Setting: Hospital Ward

Setting: Hospital Ward

Doctor – Medical Resident on Ward

This resource was developed by OET Online

Setting: General Practice Surgery

Setting: General Practice Surgery

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Setting: General Practice Surgery

Setting: General Practice Surgery

• Know about and supervise child’s medication.

This resource was developed by OET Online

Setting: Hospital Emergency

Setting: Hospital Emergency

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Setting: Hospital Surgical Ward

Setting: Hospital Surgical Ward

Doctor - On duty Surgical Resident

This resource was developed by OET Online

Setting: Suburban GP Family Clinic

Setting: Suburban GP Family Clinic

This resource was developed by OET Online

HEART MURMUR - CHILD

Setting: Suburban General Practice

This resource was developed by OET Online

Setting: Suburban Clinic

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