ROLE PLAYER INSTRUCTIONS

Just like a consultation with a doctor, the candidate will ask you a series of questions.
The OPENING LINE is always to be said exactly as written. This is the only part of the script
which will be the same for all candidates. Where the candidate goes after the opening line is
up to them.

The remainder of the information is to be given based on the questions asked by the
candidate.

The information in the following script are core pieces of information. The core pieces of
information will not necessarily follow the order in the script but should be given when cued
by the candidate’s question.

GENERAL INFORMATION can be given relatively freely. After the opening line, most
candidates will ask an open question like “Can you tell me more about that?” You can provide
the GENERAL INFORMATION in response to that sort of question.

SPECIFIC INFORMATION should only be given when the candidate asks a relevant question.
Candidates don’t need to ask for all the information in the SPECIFIC INFORMATION section,
but all the relevant information is given there should they want to.

Each line or dot point in the SPECIFIC INFORMATION section is an appropriate chunk of
information which can be provided to the candidate when asked a relevant question.

Do not give extra information than asked.

Do not provide details which are not given in the information chunks (i.e.: do not elaborate
or ad-lib).

If the candidate asks a question that is not given in the script, the best way to respond is with
a generic response indicating there is no problem. For example:

Candidate: “How many hours do you sleep?”
Response: “I’m sleeping fine.” / “I don’t have any concerns about my sleep.”

The case may have specific QUESTIONS to ask the candidate. You can start asking the
QUESTIONS if the candidate asks about your ideas or concerns or questions.

Ask the other questions in a conversational way. You do not need to ask all the questions. The
aim should be to ask most of the questions but without interrupting the candidate.

The Patient Record Summary is also included. This is not part of the script but is included for
your general information.

If you need help in understanding any of the medical information in the script, ask the College
examiner who will be with you, and they can help to explain the terms or the conditions.

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ROLE-PLAYER SCRIPT

Opening Line

“Doctor, I broke my wrist when I fell last month. Does this mean my bones are weak? Should I be worried about breaking more bones?”

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General Information

Your name is Margaret Dawson, and you are a 68-year-old retired teacher. About a month ago, you tripped over a rug at home and landed on your right wrist, which resulted in a fracture. The hospital put your wrist in a cast, but no one explained if this could mean you have osteoporosis.

You haven’t had any fractures before, but this injury has made you worried about your bone health. You have noticed that you feel stiffer and slower than you used to, and you sometimes feel unsteady on your feet, though you haven’t had any other falls.

You have never been tested for osteoporosis and didn’t think you were at risk. However, your mother had a hip fracture in her 70s, and you are now concerned that the same thing might happen to you.

You don’t take any calcium or vitamin D supplements and are not sure if your diet is giving you enough calcium. You don’t do regular weight-bearing exercise—you occasionally go for walks, but nothing structured.

You have heard mixed things about osteoporosis medications. You are hesitant about starting long-term medication and want to know if you can improve your bones naturally through diet and exercise. You are especially worried about side effects, particularly about osteoporosis drugs causing jaw problems or stomach issues.

You want to understand:

• If this fracture means you have osteoporosis.
• If you need a bone density test.
• What lifestyle changes you can make to strengthen your bones.
• Whether medications are really necessary or if you can manage with natural methods.

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Specific Information (Only Provide if Asked Relevant Questions)

Symptoms and Functional Impact

• You don’t have chronic pain, just mild discomfort in your wrist from the fracture.
• You sometimes feel unsteady on your feet, particularly when getting up quickly or walking on uneven surfaces.
• You worry about falling again and breaking a hip.

Lifestyle and Risk Factors

• No structured exercise—occasional walking but no strength or balance exercises.
• Dietary calcium intake is low—you drink milk in your tea but don’t eat much cheese or yoghurt.
• No vitamin D supplements and you don’t spend much time in direct sunlight.
• Drinks one glass of wine most nights.
• No smoking history.

Concerns and Expectations

• You want to know if you already have osteoporosis or if it’s just age-related bone loss.
• You want to know if there is a test to check your bone strength.
• You have heard that osteoporosis medications cause jaw necrosis and are worried about this side effect.
• You want to know if you can strengthen your bones without taking medication.
• You want practical advice on preventing falls to avoid breaking another bone.

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Emotional Cues and Behaviour

• You start the consultation feeling worried about your future risk of fractures.
• If the doctor validates your concerns and provides clear explanations, you feel reassured.
• If the doctor recommends medication, you may hesitate and ask about natural alternatives, saying:
  • “I really don’t like taking medication unless it’s absolutely necessary. Can’t I just fix this with diet and exercise?”
• If the doctor mentions a bone density scan, you nod and agree, saying:
  • “That sounds like a good idea. At least I’ll know where I stand.”
• If the doctor discusses fall prevention, you pay close attention, as you are worried about falling again.
• If the doctor mentions family history, you look more concerned, asking:
  • “So does this mean I’ll definitely get osteoporosis like my mother?”
• If the doctor explains that osteoporosis medications have side effects but are generally safe, you still seem hesitant and ask:
  • “How do I know the benefits outweigh the risks? I just don’t want to take something that could cause problems later.”

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Questions for the Candidate

You should naturally ask these questions during the consultation:

1. “Does this mean I have osteoporosis?”
2. “Do I need a bone scan or any tests?”
3. “I don’t like taking medication. Can I improve my bones naturally?”
4. “I heard osteoporosis medications cause jaw problems. Are they safe?”
5. “What can I do to prevent another fall?”
6. “Is my diet enough, or should I take calcium supplements?”
7. “Will weight training actually help, or is it too late for me to build stronger bones?”
8. “Does this mean I’m at risk of a hip fracture like my mum?”

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Possible Responses to the Doctor’s Suggestions

If the Doctor Recommends a Bone Density Scan (DEXA Scan):

• You nod and agree, saying:
  • “That makes sense. I’d like to know for sure if I have osteoporosis.”

If the Doctor Suggests Starting Bisphosphonates or Another Osteoporosis Medication:

• You look hesitant and say:
  • “I’ve heard those medications can cause jaw problems. How do I know they’re safe?”
• If the doctor explains the benefits versus risks, you still seem reluctant but open to discussion.

If the Doctor Suggests Calcium and Vitamin D Supplements:

• You nod but ask for clarification, saying:
  • “How much calcium do I need? And what about vitamin D—should I take a supplement, or is sunlight enough?”

If the Doctor Discusses Exercise and Fall Prevention:

• You pay close attention, as you are genuinely concerned about falling again.
• You ask:
  • “What kind of exercises should I do? Is it safe for me to do weight training at my age?”

If the Doctor Explains That Osteoporosis Can Be Managed Well:

• You look relieved, saying:
  • “So this isn’t a death sentence? I can actually do something to stop it from getting worse?”

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Final Behaviour and Conclusion

• If the doctor explains things clearly and provides reassurance, you leave the consultation feeling more confident about managing your bone health.
• If the doctor fails to address your concerns about medication side effects, you remain sceptical and may delay starting treatment.
• If the doctor provides clear advice on diet, exercise, and fall prevention, you express interest and commit to making changes.
• You leave the consultation feeling more informed and motivated to take action but still unsure about long-term medication use.