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.

ROLE-PLAYER SCRIPT

Opening Line

“Doctor, my breathing is getting worse, and my legs are swelling. I feel like my heart is failing completely.”

General Information

You are John Richards, a 68-year-old retired truck driver. You have been experiencing worsening breathlessness over the past three weeks. You used to be able to walk around the house without issues, but now you feel short of breath even when walking to the kitchen or bathroom. Over the past week, you have been waking up gasping for air at night and have had to sleep with three pillows to breathe comfortably.

Specific Information

(Reveal only when asked)

Background Information

In addition to breathlessness, you’ve noticed your legs and ankles are swollen. Your shoes feel tighter, and you gained 3 kg in the past two weeks, despite not eating more than usual. You urinate more frequently at night, sometimes waking up two to three times. You feel tired all the time, and your wife says you seem more forgetful and slower than usual.

You were diagnosed with high blood pressure and had a heart attack five years ago. You were prescribed perindopril, bisoprolol, and atorvastatin, but you often forget to take them, especially when you’re feeling fine. You still smoke about 10 cigarettes a day and have 2-3 beers most nights. You haven’t seen your GP in over a year because you felt you were managing well.

You are worried that your heart is failing completely. You don’t want to be admitted to hospital, as you prefer to be treated at home.

History of Symptoms

• The breathlessness started mildly but has rapidly worsened over the past few weeks.
• You now struggle with short walks and feel exhausted most of the day.
• You feel better sitting up but worse when lying flat.
• You have had no chest pain, but sometimes you feel a fluttering sensation in your chest.
• You have no dizziness or fainting episodes, but occasionally, you feel lightheaded when standing up too quickly.
• You sometimes cough up clear or frothy sputum, especially when lying down.

Medical History and Medications

• You had a heart attack five years ago and were told to take heart medications, but you only take them when you remember.
• You were diagnosed with high blood pressure years ago but have never been very strict with your medications.
• You have never had an echocardiogram, or at least you can’t remember the last time you had one.
• You were advised to quit smoking, but you find it difficult to stop completely.

Lifestyle Factors

• You smoke 10 cigarettes per day and have been smoking since your 20s.
• You drink 2-3 beers most nights but do not drink heavily.
• You don’t do much exercise because of your breathlessness and fatigue.
• Your diet is fairly high in salt, with takeaway meals a few times a week.

Concerns

• You fear that your heart is failing completely and that you might not live much longer.
• You’re worried about hospitalisation, as you prefer to be treated at home.
• You want to know if you will need heart surgery.
• You are afraid of becoming dependent on others and losing your independence.

Expectations

• You want to know what’s wrong and if it’s too late to fix it.
• You want to avoid going to hospital if possible.
• You are willing to cut back on smoking and alcohol if it will help your heart.
• You want to know if this condition is reversible.
• You are worried about how much longer you have to live if your heart is failing.

Emotional Cues & Body Language

• You appear worried and anxious, occasionally shaking your head or sighing when discussing your breathlessness.
• You lean forward slightly in your chair, resting your hands on your knees, as if trying to catch your breath.
• You become more engaged when the doctor explains things in simple terms and offers clear solutions.
• If the doctor mentions hospital admission, you look concerned and may say, “I really don’t want to go into hospital—can we manage this at home?”
• If the doctor dismisses your concerns or rushes the consultation, you appear frustrated and less engaged.

Questions for the Candidate (Ask Naturally During the Consultation)

1. “Is my heart failing completely? Is this the end for me?”
2. “Do I need to go to hospital? Or can I manage this at home?”
3. “Is there anything I can do to fix this, or is it too late?”
4. “Will I need heart surgery?”
5. “What’s causing this? Is it because of my smoking and drinking?”
6. “How can I stop this from getting worse?”

Response to Advice Given by the Candidate

• If the candidate explains things clearly and reassures you, you gradually feel more hopeful.
• If they suggest hospitalisation, you hesitate and express reluctance, asking if there are any alternatives.
• If they suggest lifestyle changes, you agree but say you’ve tried quitting smoking before and struggled.
• If the candidate provides a structured management plan, you feel more in control and willing to comply.
• If the candidate ignores your concerns about independence or hospitalisation, you become frustrated and less engaged.

Final Thought

If the candidate acknowledges your fears, explains heart failure in simple terms, and offers practical solutions, you leave the consultation feeling hopeful and motivated. If they dismiss your concerns or fail to address your reluctance about hospitalisation, you leave feeling worried, frustrated, and doubtful about their recommendations.