MODEL ANSWER: Introduce yourself: full name, role Find out who you are speaking to, confirm their relationship to the patient. Find out what is concerning the relative but maintain a calm approach. “I can see you are in a lot of distress; is there anything that I could help you with?” Signpost: I will explain fully what happened but please could you first tell me how much you know about your mother’s recent admission? What do you know about what happened so far? Do you have any ideas about why or how it happened? Actively listens to relatives concerns. Indications: That’s correct; she was admitted for a UTI and was being treated for it. Apology and Explanation: As you know she is diabetic and one of her medications includes insulin. I made an error in writing up the amount of insulin on her drug chart; I am sorry about this and accept full responsibility for this. Current care: I can tell you that your mother is receiving the best care possible at the moment; as soon as the mistake was discovered she was given sugar to reverse her condition. At the moment she is doing well and is being closely watched as she recovers. Her further care will not be compromised as a result of my error. We aim to get her back to her normal self as soon as possible. Risks: I want to reassure you that the risks of insulin overdose are overcome by giving glucose, as hypoglycaemia; what we call low blood sugar is a reversible condition. The risks were her undergoing seizures and becoming unconscious but we have taken the necessary steps to prevent this. Lessons learned: I am personally taking this very seriously and as soon as I recognized the mistake I highlighted the error to other staff and have also let the senior staff within the team know about this. In the future I plan on being more careful and cross checking my prescriptions with my colleagues. I have learnt a very serious lesson from this incident. I have also approached the risk management department in the hospital and we will work on ways to avoid prescribing errors like this in future. Future prevention: A serious incident report form has also been completed, critical event analysis will occur and a full enquiry will be held into why my error was not spotted and rectified at an earlier stage. Hospital managers have also been informed. We hope to implement methods of preventing such an error from occurring in future. Complaints procedure: I can understand that you are very distressed and would understand if you would like to make a formal complaint. You can do this by: - Speaking to my consultant and raising this with him/her - Speaking/writing to the ward manager - Alternatively you can approach the Patient Advice and Liaison Service; an independent body who can take your complaint further.
How's the candidate supposed to know what "depth" to go into for further treatment? After all these are pre-med candidates, would it even be acceptable for them to give a qualified opinion on treatment (especially in depth)? Also I don't like the question phrasing so much as it clearly states "he" made the mistake and does know what happened and kind of straight up lies to the family member. You can say the statement is up to interpretation and I can just as easily say that's a poorly worded statement of the situation at hand; which in turn might confuse some good candidates.
Hi Samuel, that is a very valid and fair point. In this scenario, we did not want the candidate to get too caught up into the medical side of things. The main focus is breaking bad news, rather than relating information. It is a slight assumption that the patient is doing well, so if a candidate said ‘we are monitoring regularly and I can’t give any further information on his progress at this point’, then this would be equally valid. However, a little more clarification could be given in the stem, and we’ll take that feedback on board for next time! Additionally, the ‘next steps in treatment’ is again challenging pre-medical students slightly, however simple answers would have sufficed such as: • Discussing how this would not happen again • Explaining how the patients insulin level will be monitored regularly • Perhaps hinting that appropriate medication will be prescribed to aim to fix the situation (without needing to list specific medications) Thanks for the feedback, and also for your compliments on the second comment 🙂
If my last comment seemed brash I apologize but stand by those remarks. Still a great video all around other than those points and really enjoy the MMI series.
Hi, just 2 quick questions. In this station, it says YOU have given her 22 units but the candidate in this instance says there was a mistake made and doesn't explicitly say it was his fault. Why is that? Also he talked about the patients condition, saying she is stable and talked about what the hospital is going to do now, even though it isn't mentioned in the starting statement. So can you make things up?
Hi Joyal, the situation is up to interpretation, this candidate presents it as the team making a mistake rather than him individually. Additionally, you can be proactive and make up the details to play along with the context of the scenario. If you stick only to the 3-4 lines in the briefing, then you are in no position to hold a conversation with the patient / family member for more than a few seconds. Of course, don't go over the top and make up too much - e.g. the candidate here clearly states that he doesn't know the reason for the mistake, and is unsure on why it happened. Essentially, they are testing your ability to communicate with the patient and manage the situation, so if you add some filler details during the role play that should not be an issue. For example, each hospital can have a different complaints procedure which is different to the one outlined by the candidate, but its fine for him to stick to one procedure and explain it clearly.
Ok, stupid question, but I've never been able to find a solid answer to it - if you make a mistake like this, should you directly ask the patient/their relative if they'd like to make a complaint? Because I understand it's completely within their rights to make a complaint, but as a doctor do you want to be encouraging them to do so, especially if it's something relatively minor or a complete accident, like something going slightly wrong in surgery?
It's how you word the complaint, you can advise the patient if they want to make a complaint but you shouldn't mention it frequently as it makes it look as you're incompetent and that you don't want to help nor care, you're just telling them "here you go, go complain somewhere else" but if you word it by saying " i understand this is hard to take in and if you feel unsatisfied you are able to complain but i hope we won't need to go through this as we can sort this issue" (medical law grad)
At 6:48 it says the candidate showed empathy, yet it says the candidate also showed a lack of empathy. I'm slightly confused, as it seems contradictory. Can you explain the reasoning behind such an assessment by the examiners, please?
Hi! Sorry for the confusion but that card essentially is for examiners when they are judging a station. For example, a good answer would do X, Y, Z whereas a bad answer would do X, Y, Z. Our candidate showed great empathy throughout. We use a term in medicine called Ideas, Concerns and Expectations and you can really tell our candidate fulfilled those!
Hi, this is a very good question. I would recommend going for the "I don't have the full information at the moment, but I will get back to you". You are correct in saying that this information was not given and therefore should not have been mentioned.
I mentioned in my quick practise that his mother was in stable condition and resting with the nurses doing ward rounds. I said if the relative wanted he could go see his mother. Would this be okay?
I think that's good thinking as it will help bring the relative some reassurance that his mother is doing okay - I think always use the information they give you and stick to that and try not to avert from this as the examiner will think otherwise - Hope that helps 😚
I understand why the candidate didn’t specify that he himself made the mistake, but it seems like you could be marked down and lying about not knowing what happened... strange approach imo
Free MMI Mock!
www.medicmind.co.uk/free-mmi-mock.html
Good Luck! 😊
MODEL ANSWER:
Introduce yourself: full name, role
Find out who you are speaking to, confirm their relationship to the patient.
Find out what is concerning the relative but maintain a calm approach. “I can see you are in a lot of distress; is there anything that I could help you with?”
Signpost: I will explain fully what happened but please could you first tell me how much you know about your mother’s recent admission? What do you know about what happened so far? Do you have any ideas about why or how it happened? Actively listens to relatives concerns.
Indications: That’s correct; she was admitted for a UTI and was being treated for it.
Apology and Explanation: As you know she is diabetic and one of her medications includes insulin. I made an error in writing up the amount of insulin on her drug chart; I am sorry about this and accept full responsibility for this.
Current care: I can tell you that your mother is receiving the best care possible at the moment; as soon as the mistake was discovered she was given sugar to reverse her condition. At the moment she is doing well and is being closely watched as she recovers. Her further care will not be compromised as a result of my error. We aim to get her back to her normal self as soon as possible.
Risks: I want to reassure you that the risks of insulin overdose are overcome by giving glucose, as hypoglycaemia; what we call low blood sugar is a reversible condition. The risks were her undergoing seizures and becoming unconscious but we have taken the necessary steps to prevent this.
Lessons learned: I am personally taking this very seriously and as soon as I recognized the mistake I highlighted the error to other staff and have also let the senior staff within the team know about this. In the future I plan on being more careful and cross checking my prescriptions with my colleagues. I have learnt a very serious lesson from this incident. I have also approached the risk management department in the hospital and we will work on ways to avoid prescribing errors like this in future.
Future prevention: A serious incident report form has also been completed, critical event analysis will occur and a full enquiry will be held into why my error was not spotted and rectified at an earlier stage. Hospital managers have also been informed. We hope to implement methods of preventing such an error from occurring in future.
Complaints procedure: I can understand that you are very distressed and would understand if you would like to make a formal complaint. You can do this by:
- Speaking to my consultant and raising this with him/her
- Speaking/writing to the ward manager
- Alternatively you can approach the Patient Advice and Liaison Service; an independent body who can take your complaint further.
But he does knows what the mistake is! He gave her a dosage before looking at the letter. So shouldn't he be open about that?
This channel is a lifesaver. WoW. Thumbs up to you sir.
I was scared just watching this video. I'm gonna due on Friday...
How's the candidate supposed to know what "depth" to go into for further treatment? After all these are pre-med candidates, would it even be acceptable for them to give a qualified opinion on treatment (especially in depth)? Also I don't like the question phrasing so much as it clearly states "he" made the mistake and does know what happened and kind of straight up lies to the family member. You can say the statement is up to interpretation and I can just as easily say that's a poorly worded statement of the situation at hand; which in turn might confuse some good candidates.
Hi Samuel, that is a very valid and fair point. In this scenario, we did not want the candidate to get too caught up into the medical side of things. The main focus is breaking bad news, rather than relating information. It is a slight assumption that the patient is doing well, so if a candidate said ‘we are monitoring regularly and I can’t give any further information on his progress at this point’, then this would be equally valid. However, a little more clarification could be given in the stem, and we’ll take that feedback on board for next time! Additionally, the ‘next steps in treatment’ is again challenging pre-medical students slightly, however simple answers would have sufficed such as:
• Discussing how this would not happen again
• Explaining how the patients insulin level will be monitored regularly
• Perhaps hinting that appropriate medication will be prescribed to aim to fix the situation (without needing to list specific medications)
Thanks for the feedback, and also for your compliments on the second comment 🙂
What would you do if you didn't know how to resolve the situation? i.e. if you couldn't think of auditing and stuff
literally I'm so scared for this station :')
If my last comment seemed brash I apologize but stand by those remarks. Still a great video all around other than those points and really enjoy the MMI series.
Hi, just 2 quick questions. In this station, it says YOU have given her 22 units but the candidate in this instance says there was a mistake made and doesn't explicitly say it was his fault. Why is that? Also he talked about the patients condition, saying she is stable and talked about what the hospital is going to do now, even though it isn't mentioned in the starting statement. So can you make things up?
Hi Joyal, the situation is up to interpretation, this candidate presents it as the team making a mistake rather than him individually. Additionally, you can be proactive and make up the details to play along with the context of the scenario. If you stick only to the 3-4 lines in the briefing, then you are in no position to hold a conversation with the patient / family member for more than a few seconds. Of course, don't go over the top and make up too much - e.g. the candidate here clearly states that he doesn't know the reason for the mistake, and is unsure on why it happened. Essentially, they are testing your ability to communicate with the patient and manage the situation, so if you add some filler details during the role play that should not be an issue. For example, each hospital can have a different complaints procedure which is different to the one outlined by the candidate, but its fine for him to stick to one procedure and explain it clearly.
@@MedicMind hi there- could this not be classed as dishonesty ? If you know you gave the insulin but told the family member you were unaware who ?
Ok, stupid question, but I've never been able to find a solid answer to it - if you make a mistake like this, should you directly ask the patient/their relative if they'd like to make a complaint? Because I understand it's completely within their rights to make a complaint, but as a doctor do you want to be encouraging them to do so, especially if it's something relatively minor or a complete accident, like something going slightly wrong in surgery?
It's how you word the complaint, you can advise the patient if they want to make a complaint but you shouldn't mention it frequently as it makes it look as you're incompetent and that you don't want to help nor care, you're just telling them "here you go, go complain somewhere else" but if you word it by saying " i understand this is hard to take in and if you feel unsatisfied you are able to complain but i hope we won't need to go through this as we can sort this issue" (medical law grad)
At 6:43, using simple language is written as bad answer? Can you please elaborate this.
No, it means you should use simple language
At 6:48 it says the candidate showed empathy, yet it says the candidate also showed a lack of empathy. I'm slightly confused, as it seems contradictory. Can you explain the reasoning behind such an assessment by the examiners, please?
Hi! Sorry for the confusion but that card essentially is for examiners when they are judging a station. For example, a good answer would do X, Y, Z whereas a bad answer would do X, Y, Z. Our candidate showed great empathy throughout. We use a term in medicine called Ideas, Concerns and Expectations and you can really tell our candidate fulfilled those!
@@MedicMind Oh, I see. Thank you.
@@MedicMind using simple language is Bad? How is the actor supposed to understand.if you use jargon?
Are you allowed to say his mother is in a stable condition even if it doesn’t say so on the scenario card?
Hi, this is a very good question. I would recommend going for the "I don't have the full information at the moment, but I will get back to you". You are correct in saying that this information was not given and therefore should not have been mentioned.
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I mentioned in my quick practise that his mother was in stable condition and resting with the nurses doing ward rounds. I said if the relative wanted he could go see his mother. Would this be okay?
I think that's good thinking as it will help bring the relative some reassurance that his mother is doing okay - I think always use the information they give you and stick to that and try not to avert from this as the examiner will think otherwise - Hope that helps 😚
I understand why the candidate didn’t specify that he himself made the mistake, but it seems like you could be marked down and lying about not knowing what happened... strange approach imo
I really like it.
The actor thinks he’s auditioning for a movie or what 😂 so dramatic
how re you suppose to go into depth when youre not a doctor yet... *rolls eyes*
The acting in this is quite cringe, but good advice :)
I think he did pretty well tbh.