You are an FY2 in the medical ward

Name: Alex Smith

Notes:

Alex is a 5th-year medical student on placement in your ward. Multiple staff members have reported that he is consistently late for the morning handover, often by 30-40 minutes. A senior nurse has noted that.

Task:

You are an FY2 in the same ward:

1. Explore the reasons for his lateness.

2. Address his professionalism and the impact of his actions.

3. Support him and see if there are options to resolve the issue.

Opening Sentence: “Hi, you wanted to see me?”

Open History (to give freely): “I know I’ve been a bit late a few times, but it’s not a big deal, is it? I’m just a student. It’s mainly the buses, they’re just so unreliable in the morning.”

Cues to give: “I’m just trying to unwind a bit at night, you know?”

ICE (Ideas, Concerns, Expectations):

Ideas: “Honestly, I don’t see why it’s such a big issue. I’m not getting paid or anything. As long as I get my work done, what’s the problem?”

Concerns: “Are you going to report me to the consultant? Am I going to fail this rotation because of this?”

Expectation: “I just expect a slap on the wrist and to be told to be on time.”

How to Act: Act defensive and a bit arrogant initially. Avoid eye contact. Seem nonchalant, but if the doctor is empathetic, you can slowly open up and show that you are a bit anxious underneath.

More History (only if asked): You’ve been staying up very late, often until 2 or 3 AM, playing video games online with friends. You don’t see the connection between this and your lateness. You find it hard to wake up in the morning. You feel a lot of pressure in your final year, and gaming is your only way to relax.

Social History: You live alone in a student flat. You don’t have many friends in the course and feel a bit isolated. Your online gaming community is your main social outlet.

Questions to ask:

“Will you report me to the consultant?”

“Do I really have to be here that early? The handover is mostly just admin stuff.”

Opening & Establishing Rapport: “Thanks for coming to chat, Alex. How are you finding the placement on the ward so far?”

I wanted to have a chat with you about your timekeeping in the mornings. I understand you’ve been late for the handover a few times. Can you tell me a bit about what’s been happening?

You mentioned the buses can be unreliable. What time are you usually leaving the house? What time does your bus usually get in?

Apart from transport, is there anything else that’s making it difficult to get in on time?

Social & Lifestyle History (Exploring Underlying Causes):

How are things outside of the hospital?

How are you finding the final year pressure?

What do you do to relax and switch off after a long day on the ward?

How are your sleep patterns at the moment? What time are you usually getting to bed?

You mentioned gaming helps you unwind. How much time are you spending on that in the evenings?

Assessing Insight:

Why do you think it’s important for doctors and medical students to be on time for the morning handover? What impact do you think it has on the rest of the team when a member is consistently late?

ICE (Ideas, Concerns, Expectations):

What are your thoughts on this situation?

Is there anything you’re particularly worried about regarding this conversation?

Is there anything you think I can do to support you with that?

Explain the situation, the likely diagnosis or DD:

Thanks for coming to chat. How are you getting into your rotation? Is everything okay? Are you finding it difficult? Is there anything I can do to help you get more benefit from your rotation?

I have noticed that you are often late in the morning. Are things okay at home? Is there any difficulty getting to the hospital? Do you drive?

Being on time is a really important part of being a doctor. It’s not just about looking professional, but it’s about being part of the team. The morning handover is where we discuss all the patients and make plans for the day. If you miss it, you miss out on key learning opportunities, and it can affect how the rest of the team sees you.

Addressing and answering the patient’s ICE:

I can see you’re worried about this getting you into trouble. My goal here isn’t to report you, but to understand what’s going on and see how we can help you get back on track. It sounds like you’re finding things a bit tough at the moment, and I want to support you.

Next Steps:

It sounds like the late nights might be making the mornings difficult. Have you ever heard of sleep hygiene? We could look at some strategies, like setting a time to stop gaming an hour or so before you plan to sleep, to help you get more rest. There are also some great time management resources available through the university that could help you feel more organised.

Lifestyle Modifications/self-help measures if relevant:

I know you said gaming helps you unwind, and that’s fine, but when it starts affecting your responsibilities, we need to find a better balance. Maybe we can brainstorm some other ways to manage stress that won’t impact your sleep so much.

Further support:

The university has a student support service that is excellent for helping students manage stress and workload. It’s completely confidential. Would you be open to me giving you their contact details?

What do you think about that? Is there anything else I can do to help you? Please don’t leave this meeting worried or concerned that I am going to report that to anyone. I am not going to do that. All I care about is you, as I want you to have the best benefit of your rotation, and don’t let this affect it or cause any issue.

Addressing ideas, concerns, and expectations: Reassure the student that the goal is support, not punishment, while addressing their misconception that being a student makes professionalism optional.

Reassure, provide practical advice, and signpost to university support services.

What is scenario testing?

This scenario tests the candidate’s ability to handle a professional conflict with a junior colleague. It requires a non-judgmental, supportive approach to explore underlying issues (stress, poor sleep, social isolation) while firmly upholding professional standards. Key capabilities are communication, empathy, and professionalism.