CCE-CE-028

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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Opening Line:

“Doc, I just thought I’d ask about this rough patch on my temple. It’s been there a while, but now it’s getting thicker and a bit redder. Should I be worried?”

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General Information

(Freely Given):

• You are 67 years old and have lived in rural NSW your entire life.
• You worked as a farmer for over 40 years and spent most of your days outdoors in the sun.
• You never really worried about sun protection—you rarely wore a hat and only used sunscreen when someone reminded you.

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Specific Information

(Only Given If Asked):

Background Information

• Your skin has always been rough and dry, but over the past few years, you’ve noticed more scaly patches appearing on your face, scalp, and arms.
• The patches are not painful but sometimes feel itchy or irritated.
• You have never had a proper skin check before, but your wife has been nagging you to get one.
• You feel otherwise healthy, no fever, no weight loss, and no recent changes in your overall health.

History of Presenting Complaint:

• The lesion on your left temple started as a small, rough patch about a year ago.
• Over the past 3–4 months, it has become thicker, redder, and feels a bit raised.
• It sometimes gets itchy, but it doesn’t bleed, scab over, or ulcerate.
• You haven’t noticed it changing rapidly, but it has definitely gotten worse over time.
• You have other similar rough patches on your forearms, scalp, and nose, but they haven’t changed as much as this one.

Sun Exposure History:

• You grew up in the era before sun safety was a big thing—as a kid, you ran around shirtless in the summer and never used sunscreen.
• You had many bad sunburns as a child and young adult, including a few that blistered and peeled.
• Even as an adult, you spent most of your days outside on the farm and only wore a hat on very hot days.
• You still go fishing and gardening regularly, often without sun protection.

Family and Personal History of Skin Cancer:

• Your older brother had melanoma about two years ago—he had it removed and is doing fine now.
• You don’t recall anyone else in the family having skin cancer.
• You haven’t had any moles removed before, and no doctor has ever told you to worry about your skin.

Other Relevant History:

• Medical Conditions: Type 2 Diabetes (diagnosed 10 years ago), Hypertension.
• Medications: Metformin and Amlodipine.
• Smoking/Alcohol: Never smoked, drinks occasionally (3-4 standard drinks per week).
• Preventive Health: Up to date with routine vaccinations, but hasn’t had a skin check in over 10 years.

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Emotional Cues & Body Language:

• You appear calm but mildly concerned. You haven’t lost sleep over this but you don’t want to ignore it if it’s serious.
• When talking about your brother’s melanoma, you shift slightly in your seat—you aren’t overly worried but it made you think more about your own skin.
• When the doctor mentions biopsy or removal, you frown slightly, showing hesitation about having a procedure done.
• If the doctor suggests sunscreen and sun protection, you laugh a little and say “I’ve gone 67 years without it, is it really worth starting now?”
• If the doctor dismisses the lesion too quickly, you become slightly more serious and say “Are you sure? I don’t want to regret not getting this checked properly.”

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Patient Concerns & Expectations:

Primary Concerns:

1. Could this be cancer? – You aren’t panicked, but you want an honest answer about whether this could turn into something dangerous.
2. Do I need a biopsy? – You’d rather avoid it if possible, but you want to do the right thing for your health.
3. Can I get rid of these spots without surgery? – You are open to creams or freezing treatments but are not keen on anything invasive.
4. How can I stop these from appearing? – You have never taken sun protection seriously but would consider changes if it makes a real difference.

Expectations from the Consultation:

• You want the doctor to have a good look at your skin and give you clear advice.
• You expect a straightforward answer about whether this is harmless, pre-cancerous, or something worse.
• If a biopsy is needed, you want to understand why before agreeing to it.
• If treatment is suggested, you want to know all the options—you’d rather avoid surgery if possible.
• If prevention is discussed, you need convincing that sunscreen and hats will actually help at your age.

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Potential Questions You Might Ask:

• “If I leave this alone, what happens?”
• “Is this different from the other rough patches I have?”
• “What are the treatment options?”
• “Do I need to get these checked every year now?”
• “My brother had melanoma—does that mean I’m at higher risk?”

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If the Candidate Does Not Address Key Issues:

• If they dismiss the lesion without examination or discussion, say: “But this one feels different. Shouldn’t I be more concerned?”
• If they don’t explain solar keratosis vs skin cancer well, ask: “So how do I know when a spot is dangerous?”
• If they don’t talk about prevention, say: “So should I start using sunscreen now, or is it too late to bother?”

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Final Notes for Role-Player:

• Keep your tone friendly but slightly concerned. You trust the doctor’s opinion but want clear explanations.
• If the doctor explains things well and reassures you, accept their advice and say something like: “Alright, I’ll keep an eye on it and start being more careful in the sun.”
• If they push for an urgent biopsy without explaining why, hesitate and ask more questions before agreeing.
• If they don’t discuss prevention, express doubt about whether sun protection will make a difference at your age.