Patient Instructions
Name of Patient:
Sarah aged 48
Description of the patient & instructions to simulator:
You have come to see your GP today as for the last 3 months you have been bleeding
between periods.
You are concerned that you might be going through the menopause and want reassurance
as to whether this is the case. If the Dr thinks you are peri-menopausal – you want advice
about possible treatments.
Your periods remain regular, but in between you have been bleeding approx 2-3 times per
cycle. The bleeding is light and not painful
You are up to date with your smears – all have been normal
No history of pain during, or bleeding after sex.
No discharge
You have 2 children, both teenagers, both normal vaginal deliveries.
Things are going well at home, you are normally fit and well
You have not been experiencing any mood swings or hot sweats.
You are using condoms as contraception, and don’ t think there is any chance of pregnancy.
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Doctor’s (GP ST) Instructions
Name & age of patient
Sarah, age 48
Summary Card
Infrequent attender
Normal smear May 2012.
Skin rash July 2012 – settled with emollients and loratadine.
Previous 2 x vaginal deliveries
No relevant FH
No alcohol, never smoked
PMH – nil of note.
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CSA EXAMINATION CARD
Patient Name:
Sarah
Examination findings:
Abdominal examination – normal
PV exam – normal appearance of vulva, vagina and cervix, no discharge. Anteverted uterus, no
masses. Normal examination.
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CSA Case Marking Sheet
Case Name: Intermenstrual bleeding.
Case Title:
Context of case

Recognition of intermenstrual bleeding.
Assessment Domain:
1.
Data-gathering, technical and assessment skills
Positive descriptors:

Distinguishes between irregular periods
and intermenstrual bleeding
Negative descriptors:

Fails to clarify details about pattern of
bleeding

Takes a thorough gynae and sexual history

Does not ask about other PV symptoms

Conducts PV exam.

No sexual history.
Assessment Domain:
2.
Clinical Management Skills
Positive descriptors:

Recognises need to refer for DAPH

Explains why hysteroscopy needed and
what concerns are

Offers bloods for FBC, TFTs and
menopause screen if patient requests
Negative descriptors:

Falsely reassures re. Symptoms and
attributes to menopause.
Assessment Domain:
3.
Interpersonal skills
Positive descriptors:

Elicits ICE and involves in management
plan

Explains DAPH in sensitive manner

Good rapport
Negative descriptors:

Fails to explain without jargon – or in an
abrupt manner.

Does not appreciate patient ideas re.
Menopause.
Other aspects e.g. time keeping, consultation
structure, comment on consultation skills etc
Positive descriptors:
Negative descriptors:




Grading: Clear pass = 3, Marginal Pass = 2, Marginal Fail = 1, Clear Fail = 0
Data Gathering Score =
Clinical Management Score =
Interpersonal Skills Score =
Total for case =
(max = 9)
General
Feedback/Comments
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