PLAB 2 Communication Skills

Question 1

In a PLAB 2 communication station, you need to break bad news to a patient about a cancer diagnosis. Which framework should you use?

Accepted Answer

The SPIKES framework: Setting, Perception, Invitation, Knowledge, Emotions, Strategy and Summary

Answer

Just tell the patient the diagnosis directly without preparation

Answer

Write the diagnosis on a piece of paper and hand it to the patient

Answer

Delegate the task to a nurse or counsellor

Question 2

A patient in a PLAB 2 station refuses a blood transfusion on religious grounds (Jehovah's Witness). The transfusion could be life-saving. What is the correct approach?

Accepted Answer

Respect the patient's autonomous decision after ensuring they have capacity and understand the consequences, document the refusal, and explore alternative treatments

Answer

Transfuse the patient anyway as it is in their best interest

Answer

Discharge the patient for non-compliance

Answer

Ask the family to override the patient's decision

Question 3

During a PLAB 2 station, an angry patient complains about a long wait in A&E and demands to see a senior doctor. What is the most appropriate response?

Accepted Answer

Acknowledge the patient's frustration empathically, apologise for the wait, explain the situation, and address their concerns while maintaining a calm, professional demeanour

Answer

Tell the patient they are being unreasonable and ask them to calm down

Answer

Ignore the complaint and proceed with the clinical assessment

Answer

Immediately escalate to your consultant without attempting to address the concern yourself

Question 4

You are explaining a surgical procedure to a patient and obtaining informed consent. According to the Montgomery ruling (2015), what is required?

Accepted Answer

You must discuss all material risks that a reasonable person in the patient's position would want to know about, including alternatives to the procedure

Answer

Simply getting the patient to sign a consent form is sufficient

Answer

You only need to mention risks with >10% probability

Answer

Consent can be obtained by the most junior team member without detailed explanation

Question 5

In a PLAB 2 station, a patient asks you to keep their HIV diagnosis confidential from their sexual partner. What is the correct approach?

Accepted Answer

Encourage the patient to disclose to their partner, explain the importance of partner notification, and consider involving the sexual health team. Disclosure without consent may be justified in exceptional circumstances to protect an identifiable person at serious risk

Answer

Always maintain complete confidentiality regardless of circumstances

Answer

Immediately call the patient's partner yourself

Answer

Refuse to discuss the topic further

Question 6

A patient with limited English proficiency presents to your PLAB 2 station. A family member offers to interpret. What is the best approach?

Accepted Answer

Use a professional interpreter (face-to-face or telephone) rather than a family member, as family members may filter information, add bias, or be unable to translate medical terminology accurately

Answer

Accept the family member as interpreter — it saves time

Answer

Speak louder and slower in English

Answer

Postpone the consultation until the patient learns English