What you must demonstrate
- Introduce role and confirm identity
- Set an agenda
- Use open then focused questions
- Name and validate emotion
- Check understanding with teach-back
- Close with a clear plan and safety net
11-minute performance map
1. Opening and immediate safety
Introduce yourself, confirm identity, explain the task, obtain consent and identify instability before routine questioning.
2. Focused assessment
Clarify onset, progression, severity, associated features, discriminating positives/negatives and the most relevant background risks.
3. Targeted examination
Perform only the examination maneuvers needed to assess severity, confirm localization and discriminate the leading diagnoses.
4. Synthesize
Give a one-sentence summary, leading diagnosis and two to four prioritized alternatives including the dangerous diagnosis you cannot miss.
5. Investigations
Choose tests that answer a specific diagnostic or safety question; state urgent tests first.
6. Immediate management
Treat instability, begin syndrome-specific care, consult early when needed and define disposition.
7. Communication and safety net
Explain the plan, check understanding, address concerns and state exact deterioration/return criteria.
Focused history prompts
Define the presentation
- Onset, chronology, triggers and progression.
- Severity and effect on function.
- Associated symptoms that support the leading diagnosis.
- Relevant negatives that reduce dangerous alternatives.
Risk context
- Relevant past medical/surgical/obstetric/psychiatric history.
- Medications, allergies and adherence.
- Family, social, substance, travel/exposure or safeguarding factors as applicable.
- Patient ideas, concerns, expectations and goals.
Dangerous alternatives to prioritize
- Coercion
- Lack of capacity
- Immediate safety risk
- Abuse or neglect
- Privacy breach
- Failure to disclose urgent findings
Targeted investigations
Clarify the decision, patient understanding, values and information needs
Assess capacity for the specific decision when relevant
Review records/facts before disclosure or consent discussions
Use interpreter/support resources when needed and authorized
Immediate management and disposition
- Clarify the patient’s goals and what decision must be made.
- Give information in small sections using plain language.
- Address emotion, autonomy, capacity, confidentiality and coercion explicitly.
- Confirm understanding with teach-back and document the agreed plan.
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