Simulated Patient Brief — PATEL
- Name
- ||| Pam / Patrick Patel
- Age
- ||| 84 years (DOB 01/09/1942)
- Address
- 24 Dorset Lane
- Opening context
- (Pleasantly confused) Happy to talk — believes students are from a charity and that they are currently at home
You had a fall at home, were admitted to hospital with a broken left hip, and have become suddenly confused on the ward.
- Hypertension
- Osteoarthritis
- Amlodipine 5 mg once daily
Nil
- Lives alone after partner passed away 15 years ago
- Struggling to walk around due to arthritis
- Daughter visits monthly
- Agitated, confused and anxious
- Broke left hip — will not be able to move this leg much
- Easily distracted, poor eye contact; pull at sheets & clothing occasionally
- Often do not finish sentences; contradict yourself
- Start cooperative; after ~10 minutes become more agitated and annoyed, less cooperative
This is not actually correct — it is what the patient thinks is going on. If the student attempts to correct you, become more agitated.
Overall confused and lacking in logical thinking. Easily distracted; may need prompting multiple times to answer questions.
- You briefly remember having a fall yesterday; not sure what caused it but feel fine today
- You think you are currently at home and that the medical students are going to talk to you about their charity
- You feel happy to listen and answer their questions for the time being
- They must not keep you for long — you must get started on cooking for your husband/wife soon!
- If asked about any specific symptoms — answer in the negative
If the student attempts a memory assessment: perform poorly on short-term memory questions and correctly on long-term memory questions.
Item
Your response
Age
Incorrect
“It’s rude to ask one’s age, but I’ve just recently turned 50”
Time
Incorrect
“Nearing dinner time”
Current year
Incorrect
“1985”
Home address
Correct
“24 Dorset Lane”
What jobs do these people do?
Incorrect
“You’re here from that charity aren’t you”
Date of birth
Correct
“01/09/1942”
Year WWI started
Correct
“1914”
Current prime minister / monarch
Incorrect
“Who can keep up nowadays? Is it that Tony chap?”
Count backwards from 20 to 1
Incorrect
“20, 19, 7, 5… wait, what was I saying again?”
Escalation (~10 minutes)
Start off pleasantly confused and cooperative. As time approaches ~10 minutes , become more agitated and refuse to answer questions or allow examination.
Reason you give: you must get started with cooking dinner for your husband/wife and have no more time for their charity!