Lesson 8.1 — Mock 1: Cancer Fear Hidden Inside Dyspepsia
Candidate Page
You are speaking to a 52-year-old with persistent upper abdominal discomfort. Take a focused history and discuss your assessment and next steps.
Consult naturally. Do not try to force every communication skill into the case. Identify the patient’s agenda and use it to shape the consultation.
Role-Player Brief
You are mainly worried about stomach cancer because your brother died from it at 54. Do not volunteer the full fear immediately. Say, “My brother had stomach cancer around my age” once the candidate asks about family history or impact. If they explore sensitively, admit you have been checking symptoms online and losing sleep.
If the candidate explores well
- If asked what worries you most: “I’m scared I’ve left it too late.”
- If the candidate links the plan to your brother’s history, become visibly/verbally relieved.
If the candidate misses the cue
- If the cue is ignored, ask near the end: “But what about cancer?”
- If the candidate gives false reassurance, challenge: “How can you be sure?”
- Pick up the family-history cue.
- Explore the feared outcome without diagnosing from emotion.
- Use the fear in the explanation and plan.
- Give proportionate reassurance and clear next steps.
A strong consultation does not simply ask ICE later. It recognises that the patient has already offered the concern and returns to it during management.
| Reflection | Yes / Partly / No | Evidence from the consultation |
|---|---|---|
| I found the real agenda. | ||
| I responded to the key cue. | ||
| My explanation used patient-specific information. | ||
| The plan was shared and clinically owned. | ||
| My safety-net was specific. | ||
| I sounded natural rather than scripted. |