ROLEPLAYER CARD NO.

SETTING Outpatient Clinic

HP : You are seeing your 28-year-old patient who had a miscarriage last year and had to undergo fetoscopic surgery
and D&C (dilatation and curettage) procedure. She has come to speak to you about her ultrasound results as she
and her partner want to conceive again.

TASK : 1. Greet the patient and tell the patient that the ultrasound results are back -they indicate Asherman
syndrome (occurs when scar tissue forms inside the uterus and/or the cervix)

2. Inform the patient that it could be from the previous fetoscopic surgery after patient’s last miscarriage last year.

3. Empathise with the patient and inform that currently they would need to wait before trying to conceive again.

4. Advise the patient to continue with birth control as the conceiving at the moment will not be safe for the
patient or the baby.

5. Say that it could be another year or two. Regular testing and reviews will keep giving usa clear picture.

INTERLOCUTOR CARD NO. 1

SETTING Outpatient Clinic

PATIENT: You are a 28-year-old patient who had a miscarriage last year and had to undergo fetoscopic surgery and
D&C (dilatation and curettage) procedure. You have come to speak to the HP about your ultrasound results as you
and your partner want to conceive again.

TASK 1.Show surprise at the diagnosis and ask what caused it

2. Sound upset and say that you and your partner are eager to have a child and want to try again.

3. Ask what you need to do right now to manage the condition

4. Seek clarification as to how long you need to wait before trying to conceive again

5. Say that you understand and that you will follow the advice and come for regular check-ups.
Task 1:

HP: Good morning Mrs Morgan (known patient, as indicated in the background information). How are
you doing today?
We have your ultrasound results and I am here to inform you about it, so should we proceed further with
the discussion? (signposting with permission)
Well, I'm afraid the ultrasound indicates Asherman syndrome. May I ask if you have ever heard about it?
(Check patient's prior knowledge). It's a condition where scar tissue forms inside the uterus and/or
cervix. I am sorry about this and we will do our best to help you. Do you want to say anything before we
move ahead (encouraging the patient to respond and provide reaction)

Task 2:
HP: (Empathy) I understand this might be unexpected and you clearly look upset, to answer your
question about the cause, it could be due to the surgical procedure you underwent after the miscarriage
last year (pause for chunking) Sometimes, scar tissue forms as a part of the healing process after
surgery. Was my answer clear or would you like me to explain again ? (check for clarity)

Task 3:
HP: (Empathy and validation) I completely understand your eagerness to start a family. Your reaction is
valid and I'm here to support you, but right now, it's important to wait a bit before trying to conceive
again. Your body needs time to heal. Would you agree with me on this? (Eliciting patient’s response)

Task 4:
HP: For the management, it's advisable to continue with birth control to avoid any complications.
I know it's challenging, but it's crucial for your and the baby's safety (labelling).

Task 5:
HP: It might be another year or two. Additionally, we will perform regular check-ups which will be
important to monitor the situation and give us a clear picture. We'll work together to keep a close eye on
your progress. It's a journey, and we're here for you every step of the way. How does that sound to you ?
(Elicit response)

Wrap up
HP : Is there any other concern that I can address for you?
Closing note
HP: I know it's a lot to take in, but we're a team, and we'll navigate through this together. If you have any
questions or concerns along the way, don't hesitate to reach out.