← Full lesson and references Paired practice cardsSt Emlyn’s · FRCEM

Candidate brief Examiner checklist

One learner performs. One learner checks the key steps and gives feedback. Then swap roles. This is a practice aid, not an official mark scheme.

Candidate

Focused history and initial plan

FRCEM · Paired practice

Your task

Take a focused history from this patient. Summarise the important information, explain your working assessment and discuss the next step.

Starting information

Your partner will give you the presenting complaint and any information available at the start.
This is a simulated consultation. Do not assume findings that have not been provided.

Suggested practice time: 6–8 minutes, then feedback and a repeat attempt. This is a practice suggestion; follow your examination instructions for official timing.

St Emlyn’s · FRCEM · Practice aid, not an official mark schemeCandidate card

Show examiner checklist

Examiner / observer

Focused history and initial plan

Tick the actions you observe. Discuss any step that was not needed for this task; unchecked boxes are not a score.

Examiner / observer · 1 of 2

Focused history and initial plan

Listen, focus and clarify

Choose a fictional or properly anonymised case you can discuss accurately. Prepare the opening complaint, timeline, relevant background and one concern or priority; give the candidate only the opening information. Play the patient, then use the checklist for feedback. Say when a detail has not been supplied. A third observer is optional. Use the chapter’s system questions to check that the history fits your chosen case.

Open the consultation

Introduces their role and confirms identity.

Checks permission, comfort and communication needs. Key step

Uses an open question and hears the patient’s account.

Establishes why the patient sought help now.

Select useful questions

Clarifies the symptom timeline and effect on function.

Asks questions that change urgency or the differential. Key step

Selects relevant background, medicines, allergies and social context.

Explores and acknowledges the patient’s concern or priority.

St Emlyn’s · FRCEM · Practice aid, not an official mark schemeObserver 1 of 2

Examiner / observer · 2 of 2

Focused history and initial plan

Reason, summarise and plan

Make sense of the account

Follows up unclear or conflicting information.

Explains a supported working assessment and important alternatives.

States missing information and uncertainty without inventing normal findings. Key step

Summarises and invites the patient to correct the account.

Agree the next step

Explains a relevant next assessment, action or escalation. Key step

Checks understanding and addresses remaining concerns.

If discharge is appropriate, specifies follow-up and when to seek help.

Thanks the patient and closes the consultation.

Ask the candidate

Which information most changed your assessment? A finding actually obtained, the decision it changes and any important uncertainty. A clear next step that addresses the patient’s clinical needs and expressed concern.

Feedback

What went well:

One thing to improve:

Try again focusing on:

St Emlyn’s · FRCEM · Practice aid, not an official mark schemeObserver 2 of 2

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Apply this

Making a useful referral (Emergency medicine)
Use the history to explain your assessment and next step.

Related learning

Chapter 4: Communication (FRCEM)
Develop the conversation as well as the clinical assessment.