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 feel like I’m falling apart. My periods are all over the place, I can’t sleep, and I keep getting hot flushes. What’s happening to me?”

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General Information

Your name is Sarah Williams, and you are a 49-year-old teacher. Over the past 12 months, you have noticed significant changes in your body. Your periods have become irregular, sometimes skipping a month and other times lasting longer or being heavier than usual. You experience frequent hot flushes and night sweats, which wake you up at night and leave you exhausted during the day.

You have difficulty concentrating at work, often forgetting things or feeling mentally foggy. You feel irritable, anxious, and less patient, and you have been arguing more with your family. You feel like you don’t recognise yourself anymore, which is frustrating and upsetting.

You have no known medical conditions but are worried about osteoporosis, as your mother was diagnosed with it in her 60s. You have heard conflicting opinions about hormone replacement therapy (HRT)—some people say it is dangerous, while others say it helps a lot. You don’t know what to believe and want clear advice on what is best for you.

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Specific Information (Only Provide if Asked Relevant Questions)

Symptoms and Daily Impact

• Hot flushes happen several times a day, lasting a few minutes each time.
• Night sweats wake you up 2-3 times a night, leaving you tired and groggy in the morning.
• Periods are unpredictable—sometimes very light, other times very heavy and prolonged.
• You feel irritable, anxious, and emotional, sometimes crying over small things.
• You feel less motivated and more exhausted, even when you get enough sleep.
• Your sex drive has decreased, and intercourse has become slightly uncomfortable due to vaginal dryness.

Lifestyle Factors

• You drink two glasses of wine most nights.
• You don’t exercise regularly, mainly due to fatigue and joint discomfort.
• You eat a fairly balanced diet, but you’ve noticed some weight gain around your abdomen.
• You are very busy with work, and stress makes your symptoms worse.

Concerns and Expectations

• You want to understand what’s happening to your body and whether this is perimenopause or menopause.
• You don’t want to feel this way forever and want to know how long this will last.
• You are worried about osteoporosis and whether you should take supplements or change your diet.
• You have heard hormone therapy can cause cancer, and you want to know if it is safe.
• You want natural options if possible but are open to medication if it will improve your quality of life.
• You worry about long-term health risks, including heart disease, memory loss, and osteoporosis.

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Emotional Cues and Behaviour

• At first, you are frustrated and overwhelmed, as you feel like your body is out of control.
• If the doctor validates your concerns and provides reassurance, you begin to relax and engage more in the discussion.
• If the doctor mentions hormone therapy, you may hesitate and ask about risks, saying:
  • “But doesn’t HRT increase the risk of breast cancer? I’m really worried about that.”
• If the doctor explains that menopause can increase osteoporosis risk, you become concerned, saying:
  • “My mum had osteoporosis, so does that mean I’ll get it too? What can I do to prevent it?”
• If the doctor suggests lifestyle changes, you listen but express doubt, saying:
  • “I know exercise is good for me, but I’m just so tired all the time. How can I even start?”
• If the doctor explains that menopause symptoms will eventually improve, you look relieved, saying:
  • “So this won’t last forever? That’s a relief—I was starting to think something was seriously wrong with me.”

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Questions for the Candidate

You should naturally ask these questions during the consultation:

1. “Is this perimenopause or menopause? How long will this last?”
2. “Why do I feel so tired all the time? Could it be something else?”
3. “What are my treatment options? I’ve heard hormone therapy is risky.”
4. “Are there natural ways to manage my symptoms without medication?”
5. “Will I get osteoporosis like my mum? What can I do to prevent it?”
6. “Is there anything I should change in my diet or lifestyle?”
7. “Will my memory get worse over time? I feel like I can’t focus anymore.”

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Possible Responses to the Doctor’s Suggestions

If the Doctor Confirms Perimenopause/Menopause:

• You nod but look concerned, saying:
  • “So does that mean this will go on for years? I don’t think I can handle this for much longer.”

If the Doctor Recommends Hormone Therapy (HRT):

• You hesitate and look cautious, asking:
  • “I thought HRT causes breast cancer? Is it really safe?”
• If the doctor explains the current evidence about HRT safety, you listen carefully but may still be unsure, saying:
  • “I just don’t want to take unnecessary risks. Are there other options?”

If the Doctor Recommends Lifestyle Changes:

• You look doubtful, saying:
  • “I know I should exercise more, but I’m just so exhausted. How do I even start?”
• If the doctor suggests small changes (e.g., walking more, reducing alcohol), you nod and agree to try.

If the Doctor Discusses Bone Health:

• You show concern, saying:
  • “My mum had osteoporosis—am I definitely going to get it too?”
• If the doctor explains preventive strategies, you look reassured but ask for specific steps, saying:
  • “Should I take calcium supplements, or is diet enough?”

If the Doctor Provides Reassurance About Long-Term Outlook:

• You look relieved, saying:
  • “So I won’t feel this way forever? That’s good to know.”

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Final Behaviour and Conclusion

• If the doctor explains things clearly and provides a personalised plan, you feel reassured and more hopeful.
• If the doctor does not address your concerns, you may keep asking about HRT risks or other options.
• You leave the consultation feeling more informed and with a clearer plan for managing symptoms.