CCE-CE-200.1

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.

SCRIPT FOR ROLE-PLAYER

Opening Line

“Doctor, I’ve been on painkillers for years, and I don’t want to rely on them forever. What else can I do?”

General Information

• You are David Thompson, a 58-year-old retired builder.
• You have had chronic lower back pain for 8 years, which started after a workplace injury (lifting heavy equipment).
• The pain has been constant since then but worsens with activity, cold weather, and stress.
• You describe the pain as a deep ache with occasional sharp stabbing sensations in your lower back.
• Pain radiates down both legs sometimes but no numbness or weakness.
• You have tried physiotherapy, hydrotherapy, acupuncture, and chiropractic care, but nothing has provided lasting relief.
• Medications help a little, but the pain never fully goes away.

Pain Impact on Daily Life

• You wake up stiff every morning and need time to loosen up.
• Sitting for long periods makes the pain worse. You avoid long drives or going to the cinema.
• You used to love gardening and fishing, but you stopped these activities because of your back pain.
• Your wife says you seem down and withdrawn.
• Your sleep is poor because of pain. You wake up multiple times at night and feel tired during the day.
• You feel frustrated, helpless, and angry that your pain controls your life.

Concerns About Opioids

• You have been on oxycodone SR 10mg BD for over 5 years.
• You are worried about dependence but feel scared to stop because the pain gets worse when you try.
• Your pharmacist mentioned reducing opioids, and you’re worried about withdrawal symptoms.
• You don’t want to increase your dose but don’t see any alternatives.
• You are interested in medical cannabis and want to know if it’s better than opioids.

Mental and Emotional Health

• You feel low and irritable most days.
• Your wife says you are not yourself anymore.
• You were started on sertraline 50mg daily six months ago, but you’re unsure if it’s helping.
• You don’t talk to friends as much and feel like a burden on your family.
• You sometimes think, “What’s the point of all this?” but you haven’t had suicidal thoughts.
• You are open to seeing a psychologist but don’t know if it will help.

Social and Lifestyle Factors

• You smoke 10 cigarettes a day and know it’s bad for healing.
• You drink 4-5 beers on weekends but don’t drink during the week.
• You are overweight (BMI ~30) and know you should exercise, but it hurts too much.
• You live with your wife, who is supportive but worried about your health.
• You are financially okay but worried about expensive treatments.

Specific Information (only provide if asked)

• Pain triggers: Bending, sitting too long, walking long distances.
• Pain relief: Heat packs, occasional massage, stretching.
• Past treatments: Physiotherapy (helped a little), hydrotherapy (good but stopped due to cost), CBD oil (didn’t help).
• Weight and diet: You eat mostly home-cooked meals but admit to overeating snacks and drinking beer on weekends.
• Work history: You worked as a builder for 35 years but had to stop due to pain.
• Support network: Your wife supports you, but you feel like you let her down.

Emotional Cues

• Express frustration: “I feel like I’ve tried everything!”
• Show concern about opioid use: “I don’t want to be addicted, but I don’t know what else to do.”
• Become sad and withdrawn when discussing loss of hobbies and social life.
• Show hopelessness: “I just don’t know if anything will help me.”

Questions for the Doctor

1. Why hasn’t my pain gone away after all these years?
2. Are there any other treatments apart from painkillers?
3. Can I reduce my opioid use safely?
4. Will I ever live a normal life again?
5. Does weight loss or exercise actually help?
6. Can I get medical cannabis for my pain?

Behavioural Expectations for the Role-Player

• Be engaged but skeptical when the doctor suggests lifestyle changes.
• If the doctor acknowledges your pain and frustrations, respond positively.
• If the doctor dismisses your concerns, become more defensive and resistant.
• If the doctor explains pain sensitisation, show mild curiosity but doubt.
• If the doctor suggests seeing a psychologist, respond with “I’m not sure if talking about it will help.” but be open to discussion.