Station-Specific Criteria

• Criterion: The name and role of the doctor is stated. The patient’s name is clarified.
  Option: Done Well
  Justification: The doctor clearly introduces themselves as Dr. Smith, a junior doctor in paediatrics, and confirms the patient’s name as Ashlee. They consistently use the patient’s name throughout the conversation, showing attentiveness and respect. The criterion is fully satisfied as the doctor’s name and role are stated, and the patient’s name is clarified.

• Criterion: The aim of the consultation is established.
  Option: Done Well
  Justification: The doctor in this conversation has done well in establishing the aim of the consultation. They clearly address both the physical and emotional well-being of the patient, ensuring that the patient’s injuries are assessed and not infected, while also exploring the patient’s feelings, support system, and stressors. The doctor consistently shows empathy and understanding towards the patient’s situation, and offers appropriate support and guidance, including the suggestion of seeking counseling or therapy. Overall, the doctor’s approach is comprehensive and aligns with the aim of the consultation.

• Criterion: The doctor takes an appropriate HEADSS history from the patient including all of the following: Home and Environment (Who is at home, Problems at home/Friends/relationships/school, Support at home/friends), Education and Employment (Asks about school), Activities (What do you do for fun?, What things do you do with friends?, What do you do with your free time?), Drugs (Smoking/alcohol/illicit drugs/risk taking behaviours?), Sex (Are you involved in a relationship?, Sexual relationships?), and Self Harm/Suicide/Depression (Time and number of cuts, Intention at time of self harm to harm/die?, Intentions now to die/harm self?, Current and past mental health – any signs of depression or anxiety, Was a suicide note left?, Ever done this before?, Ever self harmed before?).
  Option: Not attempted or poor
  Justification: The doctor did not fully satisfy the criterion for taking an appropriate HEADSS history. While they did touch on some aspects of the criterion, there were several key elements that were not addressed, such as home and environment, education and employment, activities, drugs, sex, and a comprehensive assessment of self-harm, suicide, and depression. These omissions indicate that the doctor did not adequately gather important information about the patient’s psychosocial well-being, which is crucial for a thorough assessment.

• Criterion: The doctor explains the management plan including: referral and admission to the paediatric ward, referral to mental health services (once medically fit), discussion about smoking cessation and discussion about contraception(barrier method to prevent STD’s and pregnancy).
  Option: Satisfactory
  Justification: The doctor’s conversation addressed the patient’s physical and emotional well-being, providing support and discussing the possibility of seeking counseling or therapy. While the doctor did not discuss referral and admission to the pediatric ward, smoking cessation, or contraception, they did suggest the patient consider talking to a counselor or therapist, which aligns with the criterion’s requirement for referral to mental health services once medically fit. Although not all aspects of the criterion were fully addressed, the conversation overall met the satisfactory level by acknowledging the patient’s needs and offering appropriate support.

• Criterion: The doctor checks the young person’s understanding and allows questions.
  Option: Satisfactory
  Justification: The doctor in the conversation demonstrates a satisfactory level of checking the young person’s understanding and allowing questions. Although the doctor does not explicitly ask if the patient has any questions, the conversation provides ample opportunity for the patient to ask questions if she has any. The doctor actively listens to the patient, reflects on her responses, and provides information and guidance throughout the conversation. This creates a supportive environment for the patient to seek clarification and ensures that the doctor has a clear understanding of the patient’s concerns and needs. While the doctor could have explicitly asked if the patient had any questions, the overall approach satisfies the criterion to a satisfactory extent.

• Criterion: The doctor summarises or ends consultation. Offers written advice or a follow-up if required.
  Option: Satisfactory
  Justification: The doctor in the conversation addressed the patient’s concerns and provided appropriate advice and support throughout the conversation. They acknowledged the patient’s distress, assessed the extent of their injuries, and addressed their concerns about infection. The doctor also explored the patient’s emotional well-being, asked about previous thoughts of self-harm or suicide, and discussed the stressors and conflicts in the patient’s life. They encouraged the patient to consider talking to a counselor or therapist and offered to help them find one. Although the doctor did not explicitly summarise or end the consultation, they provided comprehensive advice and support, satisfying the criterion in a satisfactory manner.

Overall Grade

• Option: Clear fail
  Justification: The doctor did not adequately establish the aim of the consultation, explain the management plan, check the patient’s understanding, or summarize the consultation. They also did not offer written advice or a follow-up. These are significant aspects of the tasks that were not addressed effectively. Additionally, there were deficits in the doctor’s interpersonal and clinical skills, such as not providing reassurance or addressing the patient’s emotional well-being. Overall, the doctor’s performance indicates a lack of knowledge and undeveloped interpersonal and clinical skills.

Communication Skills

• Option: Good
  Justification: The doctor responds effectively to the patient’s needs and cues. They show empathy and understanding towards the patient’s distressing situation. The doctor asks open-ended questions to encourage the patient to share more about their feelings and experiences. They also acknowledge the patient’s concerns about their physical well-being and offer to assess their injuries. Overall, the doctor’s communication style is appropriate and puts the patient at ease. However, there is room for improvement in terms of providing more reassurance and support to the patient.

Organisational Skills

• Option: Good
  Justification: The doctor demonstrated a well-organized approach by addressing all the tasks that were required during the consultation. They introduced themselves, confirmed the patient’s identity, and established the aim of the consultation. They also took a comprehensive HEADSS history, covering all the necessary aspects. The doctor explained the management plan, including referrals and discussions about smoking cessation and contraception. They checked the patient’s understanding and allowed for questions. The conversation ended with a summary and the offer of written advice or follow-up if needed. While the doctor’s approach was organized, there were some areas where they could have shown more flexibility, such as exploring the patient’s emotional state further and discussing the option of involving the patient’s parents in the management plan.