Trainer mode

• Print the packs the day before. Put each station’s patient and examiner sheets in an envelope; keep candidate sheets separate.
• One room or corner per group, with a table, two chairs and a clock everyone can see. For telephone stations, seat the candidate and patient back to back.
• Give role-players five minutes to read their sheet before the first round. Ask them to play it straight: say the opening line, answer what is asked, plant each cue once.
• Check timings out loud at the start: 3 minutes reading, 12 minutes consulting, then feedback. The consultation stops at 12 minutes, mid-sentence if need be, just as in the exam.

• Agree ground rules: what is said in the room stays in the room; we critique the consultation, not the person; anyone may pause a station.
• Say plainly that this is practice. Getting it wrong here is the point, and is far cheaper than getting it wrong on the day.
• Role-plays can touch on personal experience (bereavement, miscarriage, safeguarding, mental health). Name this at the start and let people swap a station without giving a reason.
• Let role-players step out of role clearly before feedback (“I’m Sam again now”), and thank them.
• Do not rank trainees or compare scores in front of the group. If you have concerns about someone’s progress, talk to them privately afterwards and involve their educational supervisor if needed.
• Be alert to differential attainment. Trainees who qualified outside the UK may be judged on idiom and cultural shorthand rather than skill; give feedback on what the patient needed, not on accent or phrasing style.

Start with the candidate: “How did that feel? What would you keep?” Then the patient: “How did you feel as the patient? When did you feel heard?” Then the examiner, by domain:

• Data gathering and diagnosis: was the history focused and targeted to the likely problems, were red flags checked, and was a working diagnosis reached and shared?
• Clinical management and medical complexity: was the plan safe, current and specific, did it deal with the uncertainty or several problems, and was there a clear safety-net (what to look for, how soon, where to go)?
• Relating to others: were the patient’s ideas, concerns and expectations explored and then used in the plan, were cues picked up, and was the explanation in plain words with understanding checked?

Keep it specific and observed: quote what the candidate actually said and at what minute. Two strengths, then one change to try next time. Finish by asking the candidate to say their one change in their own words.

• The RCGP feedback statements describe patterns seen across many candidates. Use them as a shared vocabulary, not as a verdict on one practice station.
• Always tie a statement to evidence: “You didn’t come back to her worry about her mum, so the plan didn’t address it” is useful; “Does not identify cues” on its own is not.
• Avoid pass or fail language for a single role-play. One station tells you little; patterns across several stations and sessions tell you much more.
• Do not suggest stock phrases or a script. Examiners reward consultations that respond to the patient in front of them, not rehearsed lines.

• Gather the patient and examiner sheets back in so the cases stay fresh for other groups.
• Ask each trainee to note one learning point and one thing to practise, and to log it in their portfolio if they wish.
• Note which domains came up most in feedback across the group; that is your topic for the next session.