How will you be tested?
The domains you will be marked against
During the exam you will be marked against three areas or ‘domains' for each scenario.
| Domain | What this domain covers |
|---|---|
| Data gathering, technical and assessment skills | History taking, physical examination, practical procedures, investigations leading to a diagnosis |
| Clinical management skills | Formulating a diagnosis, explaining something to the patient, formulating a management plan |
| Interpersonal skills | How you approach the station: whether you establish a rapport with the patient, how you use open and closed questioning, involving the patient and demonstrating your professionalism and understanding of ethical principles |
When marking against the domains the examiner will assess your competency across a number of skill areas.
Clinical examination
The examiner will assess you on your ability to conduct a physical examination of a simulated patient. This will be an actor who is trained to display signs when required.
Where a station includes uncomfortable or intimate examinations, we will use an anatomical model.
We expect you to be able to carry out any basic physical examinations, such as examination of the abdomen, breast, chest, hand, heart, and joints. You must be able to perform a rectal or bimanual vaginal examination. You must also be able to use the appropriate equipment in carrying out an examination of the ear, eye or nervous system.
You may be required to perform an examination or other procedure on a high-fidelity simulator which can be programmed to show normal and abnormal clinical signs. A role player may speak from outside the room using a microphone connected to the simulator. You can find more information and a video on the manufacturer’s website.
Examination of someone's mental state is a form of clinical examination for the purpose of the PLAB 2 exam.
Practical skills
The examiner will assess you on your ability to perform common practical procedures. Again, we may ask you to deal with a simulated patient or an anatomical model.
The practical skills may include:
- checking blood pressure
- performing venepuncture
- inserting a cannula into a peripheral vein
- calculating drug dosage
- giving intravenous injections
- mixing and injecting drugs into an intravenous bag
- giving intramuscular and subcutaneous injections
- basic cardio-pulmonary resuscitation (adult and child)
- suturing
- interpreting an electrocardiogram (ECG), X-rays or results of other investigations
- interpreting basic respiratory function tests
- performing urinary catheterisation
- taking a cervical smear
- Safe disposal of sharps.
Interpersonal skills
We test these skills by observing the interaction between you and another person, usually a simulated patient or occasionally the examiner. The examiner will assess your approach to the patient all through the examination.
This may include:
- explaining diagnosis, investigation and treatment
- involving the patient in the decision-making
- Communicating with relatives
- communicating with health care professionals
- breaking bad news
- seeking informed consent/clarification for an invasive procedure or obtaining consent for a post-mortem
- dealing with anxious patients or relatives
- giving instructions on discharge from hospital
- giving advice on lifestyle, health promotion or risk factors.
As we may use an anatomical model in some stations it's important to remember the following.
- Don't speak to the model as you won't gain any marks for doing so.
- Tell the examiner what you are doing and why only if the instructions tell you to.
- Don't perform any actions on an anatomical model that would be unsafe or painful to a real person.
