CCE-CE-081

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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SCRIPT FOR ROLE-PLAYER

Opening Line

“Doctor, I need a new contraception method. I stopped taking the pill because it gave me headaches, and I want something long-term.”

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General Information

Emma Collins is a 29-year-old primary school teacher who is in a long-term monogamous relationship. She does not plan on having children for at least five years and wants a reliable and convenient contraceptive option. She has stopped taking the combined oral contraceptive pill (COCP) three months ago due to experiencing migraines with aura and is now using condoms inconsistently.

She is open to trying a long-acting method but has concerns about side effects, reversibility, and suitability. She has heard of implants and IUDs but is unsure which would be best for her.

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Specific Information

(To be revealed only when asked)

Menstrual and Contraceptive History

(Emma will provide the following details when asked.)

• Menstrual cycle: Regular 28-day cycles, with no heavy bleeding or severe pain.
• Past contraception use:
  • Took the combined pill (ethinylestradiol + levonorgestrel) for 5 years.
  • Developed migraines with aura, which led to stopping the pill 3 months ago.
  • Now using condoms but wants a more reliable method.

Sexual and Relationship History

• Has been in a monogamous relationship for 3 years.
• No history of sexually transmitted infections (STIs).
• No concerns about partner infidelity.
• Would prefer not to use condoms regularly unless necessary.

Medical History and Contraindications

• Migraines with aura → Aware she should not take oestrogen-containing contraceptives.
• No history of deep vein thrombosis (DVT), hypertension, or other cardiovascular conditions.
• No personal or family history of clotting disorders.
• No history of polycystic ovarian syndrome (PCOS) or endometriosis.

Lifestyle Factors

(Emma will describe these details if asked.)

• Non-smoker, drinks alcohol socially.
• BMI 23, no history of eating disorders.
• Active lifestyle but does not engage in structured exercise.
• Prefers a low-maintenance option due to her busy job.

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Concerns and Emotional Responses

Emma is generally calm and receptive to discussing contraception, but she has some reservations about long-acting reversible contraceptives (LARCs).

• If the candidate provides clear, patient-centred explanations, she will feel reassured and open to trying a new method.
• If the candidate is dismissive or overly technical, she may become hesitant and reluctant to commit to a method.
• If side effects are not properly addressed, she may say:
  • “I’ve heard horror stories about people gaining a lot of weight with the implant.”
  • “I don’t want something that will mess with my mood.”
  • “If I get an IUD, will it be painful?”

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Questions for the Candidate

Emma may ask some or all of the following:

1. “Which contraceptive is best for me?”
2. “What’s the difference between the hormonal IUD and the copper IUD?”
3. “I heard the implant can make you gain weight—is that true?”
4. “What happens if I want to stop using it early?”
5. “Are there any serious risks with these methods?”
6. “Do I still need to use condoms?”
7. “Does the IUD hurt when they put it in?”
8. “Will these methods affect my fertility later?”

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Expected Reactions Based on Candidate Performance

If the candidate provides a clear and structured discussion:

• Emma will feel reassured and motivated to choose a contraceptive option.
• She will likely opt for a long-acting method if well-informed.
• If given balanced information about side effects, she will feel confident in her choice.

If the candidate is vague, dismissive, or does not address her concerns:

• Emma may feel uncertain and not commit to a method.
• She may delay her decision due to fear of side effects.
• She may continue using condoms inconsistently rather than adopting a more effective method.

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Key Takeaways for the Candidate

• Take a thorough history, including menstrual cycle, past contraception use, sexual history, and medical contraindications.
• Explain contraceptive options clearly, including benefits, risks, and effectiveness.
• Address concerns about side effects, particularly weight gain, mood changes, and reversibility.
• Ensure Emma understands that oestrogen-containing contraception (e.g., combined pill) is contraindicated due to her migraines with aura.
• Provide patient-centred care, offering choices tailored to her lifestyle and preferences.
• Discuss STI prevention, even in a monogamous relationship.
• Arrange follow-up, particularly if she chooses an implant or IUD.