Marked station

Station: Abdominal pain
marked line by line.

Surgical admissions unit · conversation station · 8:00 station · finished at 7:42

PASScomputed in code
16 / 19
criteria met · pass mark 14
6 / 6
essential criteria met
0 / 12
red flags triggered / monitored
PASS
by rule, not by opinion

PASS requires: score ≥ 14 of 19, every essential criterion met, and no red flags triggered. The rule is arithmetic — the model never decides the verdict.

Domains

  • History & data gathering4 / 6
  • Clinical reasoning5 / 5
  • Communication3 / 4
  • Safety4 / 4

Timeline — what happened when

  1. 0:08Introduces self — name and role
  2. 0:52Pain history begins
  3. 1:34Red-flag screen — fever, vomiting essential
  4. 2:41Requests observations essential
  5. 2:58Escalates raised heart rate
  6. 3:22Requests focused examination
  7. 4:10Examiner question — chosen by code
  8. 4:31Differential stated essential
  9. 5:10Investigations ordered
  10. 6:12Surgical referral essential
  11. 6:30Nil by mouth essential
  12. 7:05Safety-netting essential
  13. 7:42Candidate ends the station — 18s remaining

Every criterion, judged with evidence

metnot metessential
History & data gathering
Clinical reasoning
Communication
Safety
Criterion 14 · CommunicationNOT MET

Acknowledges the patient’s worry before proceeding

When the patient said “I’m really scared it’s something serious”, the next turn moved straight to examination. A single acknowledging sentence was available and not taken.

What went well

  • You opened by introducing yourself by name and role, which oriented the patient from the start (0:08).
  • You asked for the observations rather than waiting to be given them, noticed the raised heart rate, and escalated it with a concrete plan (2:41–2:58).
  • Your differential was structured and ranked, and the referral decision was explicit about urgency: “tonight, not tomorrow” (6:12).

What to do differently — exactly

  • You did not establish the last menstrual period. In right-sided abdominal pain in a woman of child-bearing age, say: “When was your last period?” — ectopic pregnancy has to be excluded, not assumed away.
  • When the patient said she was scared, the next turn moved straight to examination. Acknowledge first: “I can hear this is frightening — let me examine you and then I’ll explain exactly what I’m thinking.”
  • Fasting status was never established. One question — “When did you last eat or drink?” — and the surgical team’s options stay open.

This is the report every simulated station produces — each judgement anchored to a quote, each verdict computed by rule. How the engine behind it works, and what we measured when we tried to trust it, is written up in full.