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Simulated Patient Brief

DEAN · Ankle Sprain

Patient Details
Name
Frankie / Frances (Fiona) Dean
Age
22 years
Opening statement
"I think I've broken my ankle doc"
Clinical Details

Three days ago you were playing football when you were tackled heavily and hurt your right ankle. The pain was quite severe for some minutes after the tackle but then settled to a throbbing pain. You needed help from teammates to get up but could then walk very gingerly off the pitch. You were given a lift home as you couldn’t drive.

When you got home your ankle was very swollen, more so over the outer ankle, and a bit tender. It hurts to move your foot more than a twitch. Your dad (who was in St John Ambulance) bandaged it and made you apply ice packs, which helped the swelling a bit.

Yesterday you were still struggling to walk and couldn’t drive, so you went to A&E — but there was a 12-hour wait for “minors”, so you left. Your mum then arranged today’s GP appointment.

Today the ankle is still swollen and tender over the outer aspect. It hurts to move the foot and walking is quite painful, but you can manage short distances. You have no other symptoms.

Response to questions
Patient Perspective (ICE & Feelings)

Ideas: You think you might have broken your ankle — “surely a sprain would have got better by now.” Your best friend Emma says doctors missed her broken ankle. “I think I’ve broken it doc.”

Concerns: Worried you won’t be able to play football for months (like Emma, even though she didn’t have surgery or a cast). Also worried about getting to work — “How am I going to get to work doc, I can’t drive my car.”

Expectations: You want the doctor to arrange an X-ray. You will be disappointed and upset if they don’t, unless they give a good explanation why not.

Feelings: Fed up by the restrictions this injury is already placing on your life. If asked how you feel, say that you are angry.

Past Medical History
Drugs & Allergies
Family History

None of note.

Social History
Simulated Patient Non-verbal Behaviour
Information for the Doctor (before seeing patient)
Name
Fiona / Frankie Dean
Age
22 years
PMH
Chickenpox age 8
Medication
None on computer – no allergies
Other
Single · Smoker 10/day (record may be outdated) · Alcohol ~5 units/week
Physical Examination Findings
Primary Care Block · University of Buckingham