CCE-CE-047 - GP Exams

CASE INFORMATION

Case ID: CCE-HE-007
Case Name: Jessica Taylor
Age: 29
Gender: Female
Indigenous Status: Non-Indigenous
Year: 2025
ICPC-2 Codes: A98 – Health maintenance/prevention, T98 – Diet/nutrition NOS

COMPETENCY OUTCOMES

Competency Domain	Competency Element
1. Communication and Consultation Skills	1.1 Establishes rapport and engages the patient 1.2 Explores the patient’s concerns, ideas, and expectations 1.3 Provides clear and structured explanations about health education and lifestyle advice
2. Clinical Information Gathering and Interpretation	2.1 Takes a focused history, including diet, exercise, lifestyle habits, and risk factors 2.2 Identifies any underlying health conditions or risk factors that require further intervention
3. Diagnosis, Decision-Making and Reasoning	3.1 Assesses the patient’s overall health status and determines appropriate interventions 3.2 Identifies when further investigations or specialist referral are required
4. Clinical Management and Therapeutic Reasoning	4.1 Provides individualised health education and lifestyle recommendations 4.2 Discusses evidence-based approaches to dietary and lifestyle changes
5. Preventive and Population Health	5.1 Promotes long-term health maintenance through education and preventive strategies 5.2 Encourages screening, vaccinations, and health checks where appropriate
6. Professionalism	6.1 Demonstrates empathy and a non-judgemental approach to lifestyle discussions
7. General Practice Systems and Regulatory Requirements	7.1 Identifies available Medicare-funded health services, such as dietitian referrals and preventive care plans
8. Procedural Skills	8.1 Performs relevant health assessments, such as BMI, waist circumference, and cardiovascular risk calculations
9. Managing Uncertainty	9.1 Recognises when lifestyle concerns may indicate an underlying medical condition (e.g., eating disorder, metabolic disease)
10. Identifying and Managing the Patient with Significant Illness	10.1 Identifies and addresses early signs of chronic disease (e.g., prediabetes, hypertension)

CASE FEATURES

Potential risk factors requiring screening or further assessment (e.g., family history of chronic disease, hidden dietary issues).
Patient seeking general health and dietary advice for maintaining long-term well-being.
Concerns about nutrition and weight management despite an active lifestyle.
Need for evidence-based lifestyle recommendations to support a balanced diet and physical activity.

INSTRUCTIONS

You have 15 minutes to complete the tasks for 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.
Outline the differential diagnosis and key investigations required.
Address the patient’s concerns.
Develop a safe and patient-centred management plan.

SCENARIO

Jessica Taylor, a 29-year-old teacher, presents to your clinic for general health and nutrition advice. She describes herself as healthy and active but wants guidance on how to optimise her diet and lifestyle. She is particularly concerned about maintaining a healthy weight and energy levels as she has noticed fluctuations despite regular exercise.

PATIENT RECORD SUMMARY

Patient Details

Name: Jessica Taylor
Age: 29
Gender: Female
Indigenous Status: Non-Indigenous

Allergies and Adverse Reactions

None known

Medications

Nil regular medications

Past History

No significant medical conditions

Social History

Works as a teacher, active job but can be stressful
Regular gym-goer (four times a week)

Family History

Father has type 2 diabetes and high cholesterol
Mother is healthy with no chronic conditions

Smoking

Non-smoker

Alcohol

Drinks 1–2 glasses of wine per week

Vaccination and Preventative Activities

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 feel like I’m doing all the right things, but I just want to make sure I’m looking after my health properly. Am I eating the right foods?”

General Information

Jessica Taylor, a 29-year-old teacher, presents for a general health check and dietary advice. She considers herself healthy and active but wants professional guidance on how to optimise her diet and lifestyle. She is concerned about maintaining a healthy weight and energy levels and wants to prevent chronic diseases like diabetes, which runs in her family.

Specific Information

(To be revealed only when asked)

Background Information

Jessica exercises regularly but follows an online diet plan that she found on social media. She feels unsure whether it meets her nutritional needs. She has noticed that she sometimes feels fatigued in the afternoons and wonders whether she is missing key nutrients or eating enough carbohydrates.

She does not have any known medical conditions and is not taking any regular medications, but she has never had a full health check before.

Her main concerns are:

“Am I eating the right foods for my body?”
“How can I make sure I stay healthy as I get older?”
“Should I be taking supplements?”
“Do I need any blood tests to check for things like diabetes or cholesterol?”

Diet and Lifestyle Factors

Breakfast: Often skips breakfast or has a protein smoothie.
Lunch: Typically has a salad with chicken or tuna.
Dinner: Usually grilled meat with vegetables or a stir-fry.
Snacking habits: Occasionally snacks on nuts, protein bars, or fruit.
Carbohydrate intake: Tries to limit bread, pasta, and rice as part of her diet plan.
Hydration: Drinks 2–3 litres of water per day.
Alcohol: Drinks 1–2 glasses of wine per week.
Caffeine: Drinks one coffee in the morning, sometimes another in the afternoon.

Exercise Routine

Gym 4 times a week, does a mix of cardio (running, HIIT) and weight training.
Occasionally does yoga or weekend walks.
Feels fit but unsure if she should focus more on strength training.

Concerns About Health

Fatigue in the afternoons—wonders if she is eating enough or if she needs to adjust her diet.
Weight maintenance—not trying to lose weight but wants to avoid fluctuations.
Unsure about supplements—sees conflicting advice online about whether she should take vitamins.
Family history of diabetes—father has type 2 diabetes and high cholesterol, so she is worried about her long-term risk.
No previous cholesterol or blood sugar tests—wants to know if she should get tested.

Emotional Cues

Jessica is enthusiastic about health but uncertain about nutrition and long-term health risks. She is open to advice but wants evidence-based recommendations rather than vague guidance.

Motivated: “I just want to make sure I’m doing the best I can for my health.”
Curious about nutrition: “There’s so much conflicting information online—what should I actually be eating?”
Concerned about family history: “My dad has diabetes, and I want to make sure I don’t go down the same path.”
Slightly unsure: “Do I need blood tests even though I feel fine?”

Questions for the Candidate

Jessica may ask the following:

“Is my diet balanced, or do I need to change anything?”
“Should I be taking any supplements?”
“How can I prevent diabetes if it runs in my family?”
“Do I need any health checks, like blood tests?”
“How do I maintain my energy levels throughout the day?”
“Should I be eating more carbs if I’m feeling tired?”
“Is it bad that I skip breakfast most days?”
“Do I need to see a dietitian, or can I manage this myself?”

Expected Reactions Based on Candidate Performance

If the candidate provides a clear explanation and structured plan:

Jessica will be receptive and engaged.
She will ask follow-up questions about dietary modifications and health screenings.
She may say, “That makes sense. I’ll try making those small changes.”

If the candidate is vague or dismissive:

Jessica may appear frustrated or unconvinced.
She may continue questioning the advice or express hesitation about lifestyle changes.
She might say, “But I thought low-carb diets were good—should I not be doing that?”

If the candidate does not address her concern about family history:

Jessica may say, “So, am I at risk of diabetes or not?”
She may push for unnecessary tests if risk factors are not adequately explained.

Key Takeaways for the Candidate

Jessica is proactive about her health and wants practical, evidence-based guidance.
A well-structured response should include dietary advice, preventive health recommendations, and lifestyle modifications.
Address her concerns about fatigue, supplements, and long-term disease prevention.
Offer screening tests as appropriate (blood glucose, lipids) to assess risk factors.
Avoid giving generic advice—tailor recommendations to her lifestyle and goals.

THE COMPETENT CANDIDATE

The competent candidate should be able to:

Task 1: Take an appropriate history, including dietary habits, lifestyle, exercise patterns, and risk factors.

The competent candidate should:

Elicit a structured history, covering diet, exercise, sleep, stress levels, and hydration.
Assess dietary intake, including meal patterns, macronutrient balance, processed food consumption, and skipping meals.
Explore physical activity, including type, frequency, duration, and barriers to maintaining exercise.
Identify potential risk factors, such as family history of diabetes, cardiovascular disease, or metabolic conditions.
Screen for symptoms suggestive of deficiencies, including fatigue, dizziness, hair loss, or muscle weakness.
Determine psychosocial factors, such as diet culture influences, emotional eating, or body image concerns.

Task 2: Assess whether any medical conditions or risk factors require further investigation or intervention.

The competent candidate should:

Identify potential concerns based on history, including fatigue, restricted carbohydrate intake, and family history of diabetes.
Consider conditions requiring further assessment, such as:
- Iron deficiency or anaemia (if fatigue is present).
- Prediabetes or diabetes (due to family history).
- Hypercholesterolaemia (due to parental history of dyslipidaemia).
- Overtraining or undernutrition (due to structured diet and exercise regimen).
Recommend relevant investigations, including:
- Fasting blood glucose or HbA1c for diabetes screening.
- Lipid profile to assess cardiovascular risk.
- Full blood count and iron studies if symptoms of anaemia are present.
- Thyroid function tests if persistent fatigue or weight changes occur.

Task 3: Provide tailored health education, including dietary and lifestyle recommendations.

The competent candidate should:

Reinforce balanced eating habits, ensuring a variety of macronutrients to support energy levels.
Advise on structured meal planning, including regular meals and snacks to maintain metabolic stability.
Address carbohydrate intake, recommending complex carbohydrates instead of restrictive low-carb diets.
Discuss supplement use, advising against unnecessary supplementation unless deficiencies are detected.
Encourage a sustainable approach to exercise, ensuring adequate rest and recovery.
Provide education on dietary myths, helping Jessica distinguish evidence-based nutrition from online misinformation.

Task 4: Discuss preventive health strategies, including routine health checks and appropriate referrals.

The competent candidate should:

Discuss Jessica’s family history, explaining her increased risk of diabetes and cardiovascular disease.
Recommend regular health screenings, including:
- Diabetes screening every 3 years due to family history.
- Cholesterol testing at least every 5 years, or earlier if abnormalities are detected.
- General health checks, including blood pressure and BMI monitoring.
Refer to a dietitian for optimised meal planning and long-term guidance.
Encourage Jessica to engage in self-monitoring, such as tracking her energy levels, sleep, and hunger cues.

SUMMARY OF A COMPETENT ANSWER

Takes a thorough lifestyle and dietary history, assessing risk factors and daily habits.
Identifies potential health risks, including family history of diabetes and cardiovascular disease.
Orders appropriate screening tests, including blood glucose, lipids, and iron studies if indicated.
Provides individualised dietary recommendations, addressing carbohydrate intake, nutrient balance, and sustainable eating.
Explains the importance of preventive health checks, ensuring long-term monitoring of metabolic health.
Refers appropriately to allied health professionals, such as a dietitian for tailored meal planning.

PITFALLS

Failing to assess Jessica’s dietary intake comprehensively, overlooking nutrient imbalances or unhealthy dietary habits.
Not addressing the impact of online diet trends, leading to potential misinformation about nutrition.
Ignoring fatigue complaints, missing possible iron deficiency, undernutrition, or overtraining.
Failing to discuss long-term disease prevention, particularly diabetes risk due to family history.
Overlooking psychological aspects of diet and exercise, such as stress-related eating or body image concerns.
Not providing structured advice, leaving Jessica without clear take-home strategies.

REFERENCES

MARKING

Each competency area is on the following 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 Communication is appropriate to the person and the sociocultural context.
1.2 Engages the patient to gather information about their symptoms, ideas, concerns, expectations of healthcare and the full impact of their illness experience on their lives.
1.3 Provides clear and structured explanations about health education and lifestyle advice.

2. Clinical Information Gathering and Interpretation

2.1 Takes a focused history, including diet, exercise, lifestyle habits, and risk factors.
2.2 Identifies any underlying health conditions or risk factors that require further intervention.

3. Diagnosis, Decision-Making and Reasoning

3.1 Assesses the patient’s overall health status and determines appropriate interventions.
3.2 Identifies when further investigations or specialist referral are required.

4. Clinical Management and Therapeutic Reasoning

4.1 Provides individualised health education and lifestyle recommendations.
4.2 Discusses evidence-based approaches to dietary and lifestyle changes.

5. Preventive and Population Health

5.1 Promotes long-term health maintenance through education and preventive strategies.
5.2 Encourages screening, vaccinations, and health checks where appropriate.

6. Professionalism

6.1 Demonstrates empathy and a non-judgemental approach to lifestyle discussions.

7. General Practice Systems and Regulatory Requirements

7.1 Identifies available Medicare-funded health services, such as dietitian referrals and preventive care plans.

8. Procedural Skills

8.1 Performs relevant health assessments, such as BMI, waist circumference, and cardiovascular risk calculations.

9. Managing Uncertainty

9.1 Recognises when lifestyle concerns may indicate an underlying medical condition (e.g., eating disorder, metabolic disease).

10. Identifying and Managing the Patient with Significant Illness

10.1 Identifies and addresses early signs of chronic disease (e.g., prediabetes, hypertension).

Competency at Fellowship Level

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