Patient Instructions
Name of Patient:
Barbara White
Description of the patient & instructions to simulator:
52 year old lady.
PMH: 3xnormal vaginal delivery – last delivery very large baby, 10lb and prolonged labour.
Smears up to date and normal
Postmenopausal, LMP 2 years ago
Hypertension
BMI 31
Doesn’t attend practice very often.
DH: Ramipril 5mg OD.
SH: minimal alcohol, non-smoker, drinks 6+ cups of coffee per day, office worker, married
with 3 children all have left home aged 19, 21 and 23.
Last week at work while laughing with friends had a larger leak of urine leaking over the
tenna lady pad been wearing. Stained chair/sofa sat on at the time. Absolutely
mortified/embarrassed. Had to ask manager if could leave early to go home and change.
Quite a proud lady very very embarrassed.
For last few months occasionally leaking urine on laughing, sneezing, coughing or exercising.
Gradually worsening.
No other urinary symptoms.
Ideas – thinks it might be a prolapse as another friend has one and has similar leaking
symptoms.
Concerns – very embarrassing, will it worsen? Doesn’t want people to know.
Expectations – an operation to repair the problem like friend needed.
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Doctor’s (GP ST) Instructions
Name & age of patient
Barbara White 52 years old.
Summary Card
PMH: Hypertension, 3 normal vaginal deliveries
DH: Ramipril 10mg od
Allergies: nil
BP/BMI/ ?smoking and alcohol hx:
Case Notes - Last few entries in records:
BP annual review, Bp to target, no changes made.
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CSA EXAMINATION CARD
Patient Name:
Barbara White 52 years.
Examination findings:
Urine Dip – NAD
BP 124/68
Abdominal examination normal
Speculum – no prolapse, mild wall laxity, nil else to note.
BMI 31
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CSA Case Marking Sheet
Case Name: Barbara White
Case Title:
Context of case

Urinary incontinence in a middle aged
woman
Assessment Domain:
1.
Data-gathering, technical and assessment skills
Positive descriptors:
Negative descriptors:

ICE explored

No red flags assessed

Psycho social impact

No exploration of ICE

Red flags, Weight loss, Back pain

Doesn’t identify work place

Haematuria & urinary symptoms abnormal
PV bleeding, symptoms of prolapse

Lack of gynae history

Lack of social history

Thirst/lethargy/DM symptoms

Previous obstetric delivery, tears etc
Assessment Domain:
2.
Clinical Management Skills
Positive descriptors:
Negative descriptors:

Comprehensible
incontinence

Fluid diary

Shares options

Lifestyle – reduce caffeine intake, weight
loss, reduce fluids drank

Incontinence pads

Referral to physio for pelvic floor exercises

Referral to urogynaecology

Written information provided

Safety net: if worse return or review in 4-6
weeks
explanation
of
stress

Incomprehensible explanation

Not doing anything

Immediate referral to surgeons

No safety netting

Runs out of time
Assessment Domain:
3.
Interpersonal skills
Positive descriptors:
Negative descriptors:

Empathetic

Interrupts

Listens

Lack of empathy

Shares options

Assumptions

Picks up on cues and does something with
them

Derogatory about outcomes
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