CCE-CE-007 - GP Exams

Case ID: 0036
Case Name: Sarah Williams
Age: 30 years
Gender: Female
Indigenous Status: Non-Indigenous
Year: 2025
ICPC-2 Codes: A44 (Preventive immunisation/medication), A98 (General check-up), T83 (Overweight/obesity)

COMPETENCY OUTCOMES

Competency Domain	Competency Element
1. Communication and Consultation Skills	1.1 Communicates effectively and respectfully, engaging the patient in shared decision-making. 1.3 Provides clear and evidence-based explanations of preventive health measures.
2. Clinical Information Gathering and Interpretation	2.1 Takes a detailed history, including lifestyle, diet, exercise, and risk factors. 2.3 Identifies key preventive health needs based on age and risk profile.
3. Diagnosis, Decision-Making and Reasoning	3.1 Recognises the importance of preventive care in a healthy individual.
4. Clinical Management and Therapeutic Reasoning	4.1 Develops a tailored health promotion plan, incorporating lifestyle and screening recommendations.
5. Preventive and Population Health	5.1 Provides age-appropriate screening, vaccinations, and lifestyle advice.
6. Professionalism	6.2 Promotes patient-centred care while respecting autonomy.
7. General Practice Systems and Regulatory Requirements	7.1 Engages with Medicare-funded health assessments and recalls for preventive health.

CASE FEATURES

Explores patient concerns and expectations regarding long-term health.
30-year-old female attending for a routine general check-up, feeling completely well.
No current medical issues, non-smoker, no chronic conditions.
Works in an office job, does some exercise but is interested in optimising health.
Preventive health focus: Cervical screening, vaccinations, cardiovascular risk, diet, exercise, mental health.

NSTRUCTIONS

You have 15 minutes to complete this case.

You should treat this consultation as if it is face-to-face.

You are not required to perform an examination.

A patient record summary is provided for your information.

Perform the following tasks:

Take an appropriate history
Explain appropriate health screening and vaccinations
Provide personalised health advice
Address the patient’s concerns and expectations

SCENARIO

Sarah Williams is a 30-year-old female who has come in for a general check-up. She has no medical conditions, no symptoms, and feels completely well.

She is generally health-conscious, exercises 2-3 times per week, and eats a reasonably healthy diet, but she wants to make sure she’s doing everything right for her long-term health. Her BMI is 23.

PATIENT RECORD SUMMARY

Patient Details

Name: Sarah Williams
Age: 30 years
Gender: Female
Indigenous Status: Non-Indigenous

Allergies

Nil known

Medications

Nil regular medications

Past History

Nil significant medical history

Social History

Works as a marketing manager, mainly office-based.
Exercises 2-3 times per week (gym and walking).
No smoking, drinks socially (~6 drinks per week).

Family History

No family history of diabetes or early cardiovascular disease.
Father has hypertension, controlled on medication.
Mother has hypothyroidism.

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.

Opening Line

“I just thought I’d come in for a check-up to make sure I’m doing everything right for my health.”

General Information

You are Sarah Williams, a 30-year-old woman who is healthy and well.
You have no medical conditions but want to make sure you’re looking after yourself.
You try to exercise regularly, eat well, and maintain a balanced lifestyle.
You are thinking about having children in the next few years and want to be in the best health possible.

Specific Information (Only Reveal When Asked)

Lifestyle and Health Habits

You exercise 2-3 times per week, mostly gym classes and walking.
You eat mostly healthy food but like occasional takeaways and wine on weekends.
You sleep well (7-8 hours per night) and have no mental health concerns.
You feel a little stressed at work sometimes but generally enjoy your job.

Preventive Health History

Cervical screening: Last test was 2 years ago, normal.
Vaccinations: Had COVID-19 and flu vaccines, unsure about others.
Breast health: No concerns, performs occasional self-checks.

Questions You Might Ask

“Are there any tests I should be doing at this age?”
“Do I need any vaccinations?”
“Is there anything I should change in my diet or exercise routine?”
“How do I reduce my risk of things like heart disease later in life?”
“Should I be doing anything to prepare my body for pregnancy in the next few years?”

Emotional and Behavioural Cues

Engaged and proactive—wants useful health advice.
Curious but not overly anxious about long-term health risks.
Wants clear, practical recommendations on maintaining health.
More interested in lifestyle and prevention than medical interventions.

Final Thoughts & Decision-Making

If the doctor explains things clearly and supports prevention, you feel reassured.
If the doctor dismisses your concerns as unnecessary, you feel frustrated.
If the doctor suggests personalised steps, you feel more motivated to stay healthy.
If the doctor asks about family planning, you appreciate the discussion and may consider preconception care.

THE COMPETENT CANDIDATE

The competent candidate should be able to:

Task 1: Take an appropriate history, including lifestyle, diet, exercise, mental health, and preventive health screening.

The competent candidate should:

Elicit lifestyle factors (SNAP), including:
- Smoking
- Nutrition (e.g., processed foods, fruit/vegetable intake, portion control).
- Alcohol consumption
- Physical exercise (habits, type, frequency, duration).
- Sleep patterns and stress levels.
Assess mental health, including mood, anxiety, and work-related stress.
Explore family history, focusing on cardiovascular disease, diabetes, cancer, and other chronic conditions.
Determine reproductive health considerations, such as contraception use and pregnancy planning.
Ask about preventive health screening history, including cervical screening, breast self-examinations, and vaccinations.

Task 2: Explain age-appropriate health screening and vaccinations in a 30-year-old female.

The competent candidate should:

Cervical screening:
- Recommended every 5 years if HPV negative.
- If last test was 2 years ago and normal, next due at 33.
Breast awareness:
- No routine mammograms at this age, but encourage self-awareness.
Blood pressure check:
- Recommended at least every 2 years.
Cardiovascular risk assessment:
- Routine lipid and diabetes screening only if high risk (e.g., family history, overweight, hypertension).
Vaccinations:
- Annual influenza vaccine.
- COVID-19 vaccine as per current guidelines.
- Pertussis (dTpa) booster if planning pregnancy.
- Varicella, MMR, and Hepatitis B immunity check if non-immune.
Sexual health screening:
- Consider chlamydia screening if sexually active and not tested recently.

Task 3: Provide personalised health advice, including diet, exercise, and risk reduction.

The competent candidate should:

Encourage a balanced diet:
- Increase fruit, vegetables, whole grains, and lean proteins.
- Limit processed foods, sugars, and saturated fats.
Discuss physical activity recommendations:
- 5 x 30 minutes of moderate exercise per week, including strength training.
Discuss alcohol guidelines:
- No more than 10 standard drinks per week, max 4 per occasion.
Encourage good sleep hygiene and stress management:
- Mindfulness, relaxation techniques, and work-life balance.
Address reproductive health:
- If planning pregnancy in the next few years, discuss folic acid supplementation (400 mcg/day) and preconception health.

Task 4: Address the patient’s concerns and expectations about her long-term health.

The competent candidate should:

Acknowledge the patient’s proactive approach to health and reinforce the benefits of preventive care.
Provide reassurance that she is on the right track but highlight modifiable risk factors.
Emphasise the importance of small, sustainable lifestyle changes rather than drastic measures.
Address any misconceptions (e.g., needing excessive supplements, unrealistic exercise goals).
Reinforce the importance of follow-up health checks and maintaining long-term engagement with healthcare.

SUMMARY OF A COMPETENT ANSWER

Takes a comprehensive history, including lifestyle, family history, and preventive health factors.
Explains evidence-based screening and vaccination recommendations clearly.
Provides tailored lifestyle advice based on dietary habits, exercise, and reproductive plans.
Addresses concerns with a patient-centred approach, focusing on practical and sustainable health goals.

PITFALLS

Over-medicalising the consultation instead of focusing on patient-centred health promotion.
Failing to assess reproductive health goals, missing preconception planning opportunities.
Not explaining the rationale behind screening recommendations, leading to patient disengagement.
Overloading the patient with too much information instead of prioritising key preventive strategies.
Neglecting to discuss mental health and lifestyle factors, missing holistic care opportunities.

REFERENCES

MARKING

Each competency area is assessed on a scale from 0 to 3.

☐ Competency NOT demonstrated
☐ Competency NOT CLEARLY demonstrated
☐ Competency SATISFACTORILY demonstrated
☐ Competency FULLY demonstrated

1. Communication and Consultation Skills

1.1 Communicates effectively and respectfully, engaging the patient in shared decision-making.

2. Clinical Information Gathering and Interpretation

2.1 Takes a thorough history of lifestyle, diet, exercise, and preventive health factors.

3. Diagnosis, Decision-Making and Reasoning

3.1 Identifies the role of preventive care and age-appropriate screening.

4. Clinical Management and Therapeutic Reasoning

4.1 Provides practical, evidence-based lifestyle advice.

5. Preventive and Population Health

5.1 Implements screening and vaccination recommendations.

6. Professionalism

6.2 Provides patient-centred and culturally appropriate care.

7. General Practice Systems and Regulatory Requirements

7.1 Ensures appropriate documentation, recalls, and follow-up.

Competency at Fellowship Level

☐ CLEARLY BELOW STANDARD
☐ BELOW EXPECTED STANDARD
☐ BORDERLINE
☐ AT EXPECTED STANDARD
☐ ABOVE STANDARD