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’ve been told my liver tests are abnormal. Does this mean I have cirrhosis or cancer?”

---

General Information

(Can be shared freely if asked open-ended questions)

• You are a 52-year-old male, generally feeling well except for some mild fatigue over the last few months.
• You had a routine health check-up as part of your workplace’s annual medical, and your doctor called to say your liver function tests (LFTs) were abnormal.
• You do not have any major symptoms—no pain, nausea, vomiting, or jaundice.
• You don’t have a history of hepatitis (to your knowledge) or any known liver disease in your family.

---

Specific Information

(Only revealed if asked relevant questions)

Background Information

• You have never smoked and don’t use illicit drugs.
• You drink alcohol daily (about 3–4 standard drinks per night), usually wine or beer, but you don’t see this as a problem because you function well at work and in life.
• Your diet is not the best—you eat out frequently, enjoy fried foods and red meat, and you don’t eat many vegetables.
• You were told that being overweight (BMI 32) and diabetic could be a factor, but you are not sure how that connects to liver disease.
• You are very worried that this could mean something serious like cancer or cirrhosis.
• You don’t like hospitals or invasive tests, and you are afraid of needing a liver biopsy.

Symptoms:

• You have noticed some bloating, but no abdominal pain, nausea, vomiting, or loss of appetite.
• You have not had any jaundice (yellowing of the skin or eyes).
• Your bowels are regular—no diarrhoea or constipation.
• You have not had any bleeding problems, dark stools, or easy bruising.
• You have no itching or skin changes.
• You do feel more tired than before, but you assumed it was due to work stress.

Alcohol Use History:

• You drink every night, typically 3–4 standard drinks.
• You started drinking regularly in your 30s and have continued since.
• You feel you could cut back, but you don’t see it as an addiction.
• You do not binge drink or drink during the day.
• You sometimes feel a little groggy in the morning, but it doesn’t affect your work.
• Your wife has mentioned that you should drink less, but you feel you don’t have a problem.

Medication and Supplement Use:

• You take Metformin, Amlodipine, and Atorvastatin regularly.
• You sometimes take NSAIDs (ibuprofen) for knee pain.
• You don’t use paracetamol regularly.
• You don’t take any herbal or over-the-counter liver supplements.

Family History:

• Your father died of a heart attack at 64.
• Your mother is alive, but she has type 2 diabetes.
• There is no known liver disease in your family.

---

Emotional Cues and Behaviour

• When discussing cirrhosis or cancer: You appear visibly anxious and lean forward, fidgeting with your hands.
• If the doctor dismisses alcohol as a factor: You become defensive and say, “I don’t drink that much, I know people who drink way more than me.”
• If the doctor explains things calmly: You relax and engage in the conversation.
• If the doctor suggests lifestyle changes (e.g., losing weight, reducing alcohol): You sigh and appear resistant at first, but if the doctor explains the reasoning well, you become more open to change.
• If the doctor suggests a liver biopsy: You look visibly worried and say, “Isn’t that painful? Is there another way to check my liver?”
• If the doctor mentions stopping alcohol completely: You react negatively, crossing your arms and saying, “Come on, Doctor, I don’t think that’s realistic.”

---

Questions You Might Ask the Candidate

(Ask these naturally throughout the consultation, not all at once.)

1. Will I need a liver biopsy? (Ask this with concern and a bit of fear.)
2. Could this be liver cancer? (Ask this with urgency and anxiety.)
3. If I stop drinking, will my liver get better? Or is it too late?
4. What kind of tests do I need?
5. Could my diabetes be causing this?
6. Is there any medicine I can take to fix my liver?
7. How serious is this? Am I going to need a transplant?

---

Concerns and Expectations

• You want clear answers about what’s happening with your liver.
• You fear the worst (cirrhosis or cancer) but hope it’s something reversible.
• You don’t want to be told to stop drinking completely, but you might consider cutting down if the doctor explains why.
• You don’t want painful or invasive tests like a biopsy unless absolutely necessary.
• You want to know if you need to see a specialist.
• You are hoping there is some medication or an easy fix for your liver problem.
• You want realistic, practical advice—not just “eat better and exercise” without further guidance.

---

How to Respond to the Candidate’s Advice

If the doctor explains things well and reassures you, you:
Relax a bit, nodding along.
Express appreciation if they say it’s manageable.
Say, “Okay, I guess I could try cutting back on alcohol a bit.”

If the doctor seems uncertain or vague, you:
Push for more information: “But what does this actually mean? Should I be worried?”
Appear frustrated: “I don’t want to wait and see—I need to know if this is serious.”

If the doctor suggests a liver biopsy immediately, you:
Look scared and say, “Isn’t there another way to check first?”
Push back: “I’d rather not do that unless it’s absolutely necessary.”

---

Summary of Role-Player Objectives

• Express concern about liver disease and its implications.
• Display anxiety when discussing serious conditions.
• Show mild resistance to lifestyle changes but willingness to listen if well explained.
• React negatively to the idea of a biopsy unless reassured.
• Ask natural, patient-centred questions that guide the consultation.

---