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’ve had this stomach pain for a while now, and my bowels have been all over the place. I’m worried—could this be bowel cancer?”

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General Information

• You are Peter Williams, a 62-year-old retired builder.
• You have had intermittent lower abdominal pain and bloating for about six months.
• The pain is mostly in the left lower abdomen (LLQ), crampy in nature, and relieved after passing gas or a bowel motion.

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Specific Information

(Reveal only when asked directly)

• You describe your bowel habits as inconsistent, alternating between constipation and loose stools.
• You sometimes feel urgent bowel movements, but you haven’t noticed blood in your stool.
• You have not lost weight unintentionally, nor have you had fevers, vomiting, or night sweats.

Pain Characteristics

• The pain comes and goes but has been occurring more frequently.
• It is usually mild to moderate, but sometimes more uncomfortable after eating heavy meals.
• You feel bloated often, especially after eating processed foods or red meat.
• You haven’t noticed the pain radiating to your back.

Bowel Symptoms

• You pass hard stools some days, then have loose stools on others.
• Some days, you feel like you haven’t completely emptied your bowels.
• You haven’t noticed mucus or obvious blood in your stool, but you haven’t looked closely.
• You haven’t done a bowel cancer screening test (FOBT) recently.

Diet and Lifestyle Factors

• Your diet is low in fibre, mostly white bread, meat, and takeaway food.
• You rarely eat fruits, vegetables, or whole grains.
• You don’t drink much water, mostly tea and soft drinks.
• You drink 2-3 standard drinks per night and smoke 5 cigarettes per day.
• You used to be active in your job, but since retiring, you have become more sedentary.

Medical and Family History

• You have never had a colonoscopy.
• Your father had bowel cancer at age 70, so you are worried about your own risk.
• No family history of inflammatory bowel disease (IBD).
• You have hypertension, but it’s diet-controlled and you take no regular medications.

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Concerns and Expectations

• You are worried that this could be bowel cancer because of your father’s history.
• You are frustrated by the ongoing bloating and pain and want to know how to prevent flare-ups.
• You want to know if you need a colonoscopy or other tests.
• You are open to making lifestyle changes if they will help, but you need clear advice on what to do.
• You prefer to avoid unnecessary medications, but you will take them if needed.

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Red Flag Symptoms (Reveal only when asked directly)

• No unexplained weight loss.
• No persistent blood in stool, but you haven’t checked closely.
• No severe, persistent pain or fever.
• No night sweats.
• No history of black or tarry stools.

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Emotional Cues & Body Language

• You appear mildly anxious about bowel cancer, but not panicked.
• If the doctor downplays your concerns, you may press further:
  • “But my father had bowel cancer—how do I know this isn’t the same?”
• If the doctor doesn’t mention dietary changes, you will ask:
  • “Does my diet have anything to do with this?”
• If the doctor recommends a colonoscopy, you may ask:
  • “Is that really necessary? What happens if I don’t get one?”
• If the doctor explains things well, you become more reassured and open to making changes.

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Questions for the Candidate

(Ask these naturally throughout the consultation.)

1. “Could this be bowel cancer?”
2. “Do I need a colonoscopy?”
3. “How can I stop getting these stomach pains?”
4. “Does my diet have anything to do with this?”
5. “Are there any medications that can help?”
6. “If I don’t change anything, could this get worse?”
7. “Would drinking more water actually help?”
8. “What foods should I be eating more of?”

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Key Behaviours & Approach

• You expect clear, evidence-based advice and practical steps.
• If the doctor doesn’t mention colon cancer screening, you will ask about it.
• If the doctor only focuses on medication and ignores lifestyle changes, you will ask about diet.
• If the doctor sets realistic, achievable goals, you will feel motivated to make changes.

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Additional Context for the Role-Player

• You are open to lifestyle changes but need practical advice rather than vague suggestions.
• You are not against medical tests but prefer to avoid unnecessary procedures.
• You will follow medical advice if it is well-explained and logical.
• If the doctor explains diverticular disease clearly, you will feel relieved and more in control.

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