← Full lesson and references Paired practice cardsSt Emlyn’s · Early-career EM

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

Make a useful referral

Early-career EM · Paired practice

Your task

Refer this patient to a colleague for assessment. Make the concern and your request clear, and agree what will happen next.

Starting information

A 55-year-old has ongoing chest pain and lateral ST depression. Observations are currently stable and troponin is pending.
They take metformin and antihypertensive medication. Further history, exact observations and treatment already given have not been supplied.
Use only these teaching-case facts. State what you need to check; do not add a treatment or result to make the referral sound stronger.

Suggested practice: a 3-minute call, 2 minutes of feedback and a 2-minute retry. Then swap. These are practice suggestions, not official examination timings.

St Emlyn’s · Early-career EM · Practice aid, not an official mark schemeCandidate card

Show examiner checklist

Examiner / observer

Make a useful referral

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

Make a useful referral

A clear opening and relevant information

Play the receiving clinician. After the opening, ask whether the caller only wants someone to chase the troponin. Listen for their concern, request and proposed next steps. Use the supplied facts and keep missing details unknown. Discuss the plan together after the call. A blank SBAR or local referral template is useful; no real patient identifiers are needed.

State the purpose

Identifies themselves, their role and location.

Identifies the patient using agreed simulation details.

States the ongoing chest pain and ECG concern early. Key step

Makes a clear request for urgent assessment. Key step

Explain the assessment

Summarises relevant information without burying the urgent concern.

Distinguishes supplied facts, working interpretation and unknowns. Key step

Identifies treatment, monitoring or other information that needs checking.

Answers clarification calmly and explains why the request is more than a blood-test chase.

St Emlyn’s · Early-career EM · Practice aid, not an official mark schemeObserver 1 of 2

Examiner / observer · 2 of 2

Make a useful referral

Agree action, timing and responsibility

Close the referral

Agrees the next action and timeframe with the recipient. Key step

Clarifies who provides interim care and follows pending results. Key step

Agrees what happens if review is delayed or the patient deteriorates. Key step

Checks both clinicians have understood the agreed plan.

After the call

States what they would document, including the recipient and agreed plan.

Explains what they would tell the patient about the next steps.

Ask the candidate

What has been agreed, and who is responsible while review is awaited? A specific next action, timeframe and interim responsibility, with a route to help if the plan fails. No invented observations, diagnoses or treatment. The caller states what still needs checking.

Feedback

What went well:

One thing to improve:

Try again focusing on:

St Emlyn’s · Early-career EM · Practice aid, not an official mark schemeObserver 2 of 2

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Return to the teaching notes and references

Apply this

Making a useful referral (Emergency medicine)
Use the referral cases and facilitator discussion.

Go deeper

Chapter 3: History taking (FRCEM)
Optional postgraduate reading on selecting and summarising the relevant history.