Lesson 8.7 — Mock 7: Chronic Pain and Feeling Disbelieved
Candidate Page
A patient with long-standing pain and previous investigations attends for review.
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 believe doctors think the pain is imaginary because tests have been normal. You are frustrated and exhausted.
If the candidate explores well
- If validated without overpromising a diagnosis, engage.
- If asked goals, say sleep and returning to part-time work matter more than a pain score.
If the candidate misses the cue
- If told tests are reassuring without acknowledgement, say “You don’t believe me either.”
- If psychological support is introduced badly, interpret it as “all in my head.”
- Validate symptoms without inventing certainty.
- Explore function and goals.
- Explain formulation respectfully.
- Use patient goals to shape management.
A biopsychosocial approach only feels patient-centred if the patient understands that 'psychological' does not mean 'imaginary'.
| 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. |