PLAB 2 Clinical History-Taking & Communication

Question 1

In the Calgary-Cambridge model of consultation, which phase involves establishing why the patient has come to see you today?

Accepted Answer

Initiating the session

Answer

The Calgary-Cambridge model begins with initiating the session: preparation, establishing initial rapport, identifying the reason(s) for the consultation, and agreeing the agenda. This is where you greet the patient, introduce yourself, and explore the presenting complaint(s) before moving to information gathering.

Question 2

A patient presents with chest pain. Using the SOCRATES framework, which aspect of the pain does 'R' represent?

Accepted Answer

Radiation — where does the pain spread to?

Answer

SOCRATES: Site, Onset, Character, Radiation, Associations, Time course, Exacerbating/relieving factors, Severity. 'R' is Radiation — asking where the pain spreads to (e.g., left arm, jaw in MI; back in aortic dissection; right shoulder tip in biliary colic).

Question 3

During a consultation, a patient suddenly becomes tearful. What is the most appropriate immediate response?

Accepted Answer

Pause, acknowledge the emotion with empathy ('I can see this is upsetting for you'), allow silence, and offer a tissue if available

Answer

Effective consultation requires responding to emotional cues before continuing to gather information. Acknowledging the patient's distress with empathy validates their feelings, builds rapport, and creates a safe space. Ignoring emotions and continuing mechanically with the history impairs communication and trust.

Question 4

What does the ICE framework stand for in patient-centred consulting?

Accepted Answer

Ideas, Concerns, and Expectations

Answer

ICE — Ideas (what the patient thinks is wrong), Concerns (what they are worried about), Expectations (what they hope will happen) — is a cornerstone of patient-centred consulting. Eliciting ICE helps understand the patient's perspective, address hidden agendas, and provide appropriate reassurance or management.

Question 5

During a PLAB 2 station, you are taking a history from a patient who gives only 'yes' and 'no' answers. Which type of question would be most useful to elicit more information?

Accepted Answer

Open-ended questions

Answer

Open-ended questions ('Tell me more about that', 'How has this affected you?') encourage the patient to expand in their own words and provide richer information. After opening up with open questions, you can use closed questions to clarify specific details. Starting with closed questions limits the patient's responses.

PLAB 2 Practice Test

PLAB 2 Practice Test

PLAB 2 Clinical History-Taking & Communication