You are an FY2 in the paediatric ward
Personal Details:
Name: Chloe Smith (patient), Mrs Smith (mother)
Age: 11
Medical Record:
Past medical history: Admitted 3 days ago with a first generalised tonic-clonic seizure. No previous medical history.
Regular medication: Starting Sodium Valproate.
Allergies: None known.
Notes:
Chloe has been diagnosed with epilepsy after her first seizure and a confirmatory EEG. She is medically fit and ready for discharge. Her mother has already been given information about the new medication (Sodium Valproate), but remains anxious about Chloe’s future.
•Task:
Talk to the mother and address her concerns
Opening Sentence: “Doctor, they say we can go home now, but I’m so scared. What does this mean for her life?”
Open History (to give freely): “It was the most terrifying thing I’ve ever seen. I feel like I have to wrap her in cotton wool now. She loves being active, she’s always dancing and riding her bike.”
Cues to give: “Her dad wants to stop her from going to her swimming lessons.”
ICE (Ideas, Concerns, Expectations):
Ideas: “I think her life is going to be completely different now. She won’t be able to do normal things.”
Concerns: “Will she be able to swim or dance again? What if she has another fit while she’s doing something active?”
Expectation: “I need to know what’s safe and what’s not. I need to know how to keep her safe.”
How to Act: You are a very anxious and protective mother. You are tearful and looking for clear, practical guidance.
More History (only if asked): Chloe is a keen swimmer, dancer, and loves riding her bicycle with her friends. These activities are a huge part of her social life and happiness. You understand the medication is important, but are more worried about the practical, day-to-day risks.
Social History: Chloe is your only child. You live with your husband.
Questions to ask:
So she can swim? How is that safe?
What do I tell the school?
Explore Concerns: Ask the mother what her main worries are. What activities is she specifically concerned about?
Assess Understanding: Check her understanding of the diagnosis and the purpose of the medication.
Social Context: Ask about Chloe’s hobbies and what is important to her to establish the context for your advice.
Acknowledge and reassure
Mrs. Smith, it’s completely understandable that you’re feeling scared. Seeing your child have a seizure is a frightening experience. I want to reassure you that a diagnosis of epilepsy does not mean Chloe can’t live a full, active, and happy life. Our goal is to control the seizures with medication so she can get back to being the 11-year-old girl she is.
Addressing and answering the patient’s ICE:
You’re worried she won’t be able to do the things she loves, like swimming and dancing. Let’s talk about that, because it’s really important. We don’t want to stop her from being a child. Instead, we just need to put some simple safety measures in place.
Next Steps:
Let’s take swimming first. Once her seizures are well-controlled, she can absolutely go swimming. The rule is that she must never swim alone. She needs to be with a responsible adult who is aware of her condition and can help her if she were to have a seizure in the water. The same goes for having a bath – she shouldn’t lock the door, and someone should be in the house.”
For cycling, it’s important she always wears a helmet, but that’s true for all children. We’d advise against cycling on busy roads for now. For dancing, there are no restrictions at all. It’s great exercise and wonderful for her well-being.”
Support
The most important thing for keeping her safe is to make sure she takes her medication regularly every day. This is what will prevent the seizures from happening. We will give you a care plan for her school, explaining her condition and what to do if she has a seizure there. The school nurse and teachers will be able to support her. Life will be a little different, but it doesn’t have to be smaller.
Addressing ideas, concerns, and expectations: Reassure the mother that the goal is to maintain a normal life for Chloe. Directly address her concerns about specific activities.
The management is providing clear, specific, and practical safety-netting advice for various activities (swimming, cycling, bathing). Emphasise medication adherence as the primary safety measure. Offer to provide a school care plan.
What is scenario testing? This case tests the candidate’s ability to provide practical, lifestyle-oriented counselling following a new diagnosis. It’s not about the medical details of epilepsy but about translating the diagnosis into real-world, common-sense advice for an anxious parent. Key skills are empathy, reassurance, and practical risk management.