By Dr Sarah Llewelyn
Throughout your medical school journey, one of the most important skills which is drilled into you over and over again is your communication skills. You will most likely get weekly sessions on this, covering the most common framework used to speak to a patient and gather information. This is something you may have noticed when you go to the doctors, they all use a similar style of asking questions.
The roleplay stations are essentially assessing your base line communication skills. You’re not expected to know the specific structures used, but you are expected to act with empathy, and to be able to pick up on clue’s given to you by the actor.
What will the role play stations be?
Usually the scenario’s revolve around you either needing to gather information about something, or explain something to someone. You can find many examples online but here is a few examples:
‘You have ran over your friends cat, please break this news to them’
‘Explain to a 5 year old how to tie a shoelace’
‘You notice an old lady crying on the bus, speak to her and find out what’s going on’
‘You’re a medical student on placement and the doctor has asked to speak to a woman about how her chronic condition affects her life’
Sometimes they can be this straight forward but other times they can be more interactive. I remember one station I had in an interview, I had to speak to a patient who was in hospital and wanted to make a list of complaints because she hadn’t received any food, and I had to help fill out the complaints form. Whilst this might seem straightforward, all I got told was ‘speak to a patient on the ward’ and so I had to use my communication skills to work out that they wanted to complain which lead to them asking me to fill out the form with them. You could view this as a 2 step station, I wouldn’t be able to do the form unless I asked the right questions to find out they had not been given their food and were not happy.
How to approach the station?
You will probably have 1-2 minutes to read the station. When you enter the room remember to be in role! This is so important, you need to take on the position of whatever character they’ve given you. If you’ve been told you’re a medical student, introduce yourself as a medical student. If you’ve been told you’re friends with the actor, pretend that you are friends.
Remember what they ask you to do in the scenario, they might ask you to explore their support network, or find out why they are upset. This needs to be your priority but don’t let it hold you back from having a natural conversation.
As soon as you walk in to a role play, introduce yourself with your full name and whatever your reason for being there is. For example ‘hello my name is Paul Smith, I’m a medical student on placement here and the GP has asked me to have a chat with you before your consultation, does that sound okay with you?’ if the character is a stranger to you, ask their name! if they are a patient then ask their date of birth. Remember that not all role play stations will be patients, some will be random people- base your introduction around the scenario!
Tip: In my interviews, when I was in the waiting room I would rehearse my introduction make sure it sounded natural when I was in the room!
During the conversation
Remember the instructions you’ve been given and make sure you achieve each objective. This sounds easy but it’s easy to get lost in conversation and run out of time. Don’t rush into them, get to know the person first.
Because the actor is acting, try to speak to them as if you’re having a normal conversation. This can be very strange because you are aware that it isn’t real, so you have to act a bit yourself to make it feel like it’s a genuine conversation happening. The more you persuade yourself that it’s a real situation, the easier it will be!
Remember the key thing with these stations is EMPATHY!!!! I once had a roll play station in an interview which was clearly set up to make me laugh (I had to speak to a patient who’d boyfriend had slept with her daughter and she was writing her daughter out of her will. The whole thing was ridiculous but it was clearly there to check I could stay empathetic even with the most ridiculous scenarios)
Keep your questions nice and OPEN, you’ll get a lot more out of the actor that way. For example ‘what has brought you here today’, ‘could you tell me how you are feeling’, ‘is there anything I can assist you with’, ‘could you tell me about your support network you have’
Pick up on the clues given to you! It might start like a really narrow conversation but the patient mentions stress or a change in habits etc and before you know it you’ve uncovered some really important information. This is a bit of a detective game and you need to be able to pick up on things they mention!
Make sure the conversation flows well, don’t jump from one topic to another unless it’s clearly relevant to do so. This leads me on to:
Sign posting: this is a skill where you pick up on a clue a patient or the actor gives you, and you go back to it at a more relevant and convenient time. For example: you are speaking to the actor about their family who are supporting them, and they mention ‘my sister has helped me after I lost my job’. It is worth continuing to explore the family members they have supporting them so you gather a nice clear picture of the patient, but you also really want to ask about them losing their job because that is an important thing too. In this situation, you use sign posting. Carry on talking about the family, and when you have got the information you need you can say ‘earlier you mentioned you lost your job, would you mind telling me about this and how it’s affected you’.
Sign posting is a key skill you will learn in medical school, if you use it now you will get brownie points! It comes naturally to most people, you probably already do it with your friends and family without realising it!
Everything you do and say should be focused on the actor. Avoid giving too much advice. For example, a patient in pain: ask them what they have already done to try and stop the pain and how they are doing. Don’t say ‘you should try this’ unless in your objective is to give them advice. Instead of telling them what to do say ‘have you tried this?’ the change in wording makes it about the patient and it will lead to them exploring more. Even better is to say ‘what have you tried so far?’ this way you’ve got an open question AND you’re making it patient centred.
MAKE SURE THE ACTOR TALKS MORE THAN YOU!!! This is a good sign! It means you’re asking open questions. If you find that you’re talking a lot and they’re not giving you much information, try broadening your questions. You can say things like ‘can you tell me more about that’ to get them to explore a topic further.
Keep them talking. If you run out of things to say, ask about home life, their feelings, their life style habits. Unless the brief says to close the chat up, then keep the patient talking until you get told the station is over. If you really feel like there’s nothing else to say at least say ‘thank you for your time it’s been really beneficial talking to you today I hope you manage to solve the problems you’ve come to see the doctor about’ or something like that which fits with the scenario you have been given.
Explanation stations.
All of the above advice still counts, but these are slightly different stations
In an explanation scenario (like the explain tying a shoe lace), ask them what they already know. This way you save time by only having to fill in the bits they don’t understand. If what they’re saying is correct but not in enough detail, then you can say things like ‘yes that’s great, to expand on what you’ve already told me…’ and fill in the more complex parts of the conversation.
This will also help you gather an idea of the knowledge level your actor has, and how simple or complex to make the explanation
Get them to repeat the stages back to you, or repeat their understanding back. This checks their understanding and also whether you’ve explained it well enough
Try to use visual language. For example with a shoe lace ‘make a figure of 8’ most people can picture this so the explanation will fit better in their head.
Ask them if they have any questions for you at the end. This gives you a chance to cover your bases if you miss something!
Some general tips:
If you freeze, take a breath and summarise what the person has said. This is something we’re taught at medical school and it helps you gather your thoughts and ideas. It also shows you have been listening.
Always be open minded and don’t assume, use words like partner instead of husband/wife etc. unless the patient actively mentions that word.
At this level, they’re interested in seeing your social skills and if you can hold a conversation and show empathy more than anything.
ACTIVELY LISTEN: use your body language, lean forward a bit, nod your head along, frown and nod when they are complaining about things. Try to mirror their emotions, tone, volume etc.
Finally- good luck! The role play station has the potential to be your easiest station- you don’t need to prep for it, and if you have good people skills (which you really need for medicine) you will be great at it. It’s a strange concept speaking to an actor about a fake situation but once you can get over that and speak to them as if it’s a real conversation, it’s easy to sink your teeth in and have a great conversation.
Further Reading: