Name of Patient: Andrew Wilson 46

Description of the patient & instructions to simulator:

Requesting vasectomy
Has 2 children from same partner
Partner has had used contraception till now, he now thinks it is his turn, had tried
OCP, implants.
His partner hasnt tried any IUDs/IUS
They both dont want any more children
Children are 5 and 2.
Knows it is a permanent method, doesnt want to go to hospital, as has bad memories
when mum died there.

Doctors (GP ST) Instructions

Name & age of patient

Andrew Wilson , 46 years
Summary Card
PMH: Hypertension
DH: Ramipril
Allergies: none
BP 130/80, BMI 27, non smoker

Case Notes - Last few entries in records:

6 month ago annual HT review bloods in date, non smoker, CVD risk 5% and BP at target meds
re authorised

CSA EXAMINATION CARD

Patient Name: Andrew Wilson
Examination findings: BP 120/70
Genital exam (if requested by GPST) = normal

CSA Case Marking Sheet

Case Name:

Case Title:

Context of case
Vasectomy

request

Assessment Domain:
1.
Data-gathering, technical and assessment skills
Positive descriptors:

Negative descriptors:

ICE explored

Doesnt clarify it is a joint decision

Clarifies both wants vasectomy

Clarifies that family has been completed

Assessment Domain:
2.
Clinical Management Skills
Positive descriptors:

Negative descriptors:

Offers alternatives

to vasectomy

No offer of contraceptive alternatives

Clarifies

it is irreversible and if needed to

reverse it is not available in NHS, and
success rate is low

Describes vasectomy clearly and its risks

No

clear description of procedure and risks

and benefits

Doesnt clarify if patient knows it is permanent

No offer of review

Offers a PIlealfet
Gives

the choice , GPwSI or hospital

Explains

failure rate and when it is deemed to

have been effective

Offers

opportunity 'to go away and think about

it' and review with GP

Assessment Domain:
3.
Interpersonal skills
Positive descriptors:
Identifies

Negative descriptors:

agenda,
preferences

health

belief

and

Doesnt listen to cues

Doesnt give

choices

Identifies

cues that he would like to go ahead

with vasectomy, rather than partner
having coil

Explore

psychosocial history,
wanting to do in hospital

Communicates

about

not

risk to patient, enhances

autonomy
Explanation clear and understandable

Other aspects e.g. time keeping, consultation

structure, comment on consultation skills etc
Positive descriptors:

Negative descriptors: