driving after seizure scenario
candidate brief
You have just seen Ash, a 45 yo who has experienced their first tonic clonic seizure. They feel well now, and you have mentioned referring to first fit clinic. They have some questions about what this might mean for them.
20% history taking / 20% clinical reasoning / 60% communication skills
actor brief
Ash Kaur 23/4/1981
You are a 45yo who works as a carer doing house visits which requires you to drive. This is the first time you have ever had a seizure - in public, lost consciousness, woke up with ambulance crew around you.
You feel well in yourself now, though tired. You are keen to get home.
You are initially upset - doesn't understand why you can't drive as you are clearly safe to discharge
examiner brief
- Introduces self to patient
- Asks to discuss driving with patient
- Clarify nature of seizure
- while awake or asleep?
- lost consciousness? (i.e. tonic-clonic or partial/focal/etc.)
- Clarifies patient’s understanding of events so far
- Clarifies patient’s understanding of advice regarding driving
- Reiterates reasons for not driving to patient
- Asks patient about occupation
- Asks about frequency of driving/type of vehicles driven
- Advises patient must inform DVLA
- Acknowledges patient’s anxieties regarding not driving
- Informs the patient they can seek a second opinion
- Explains the advice will be documented in the notes and letter to GP
- Suggests employer may be able to provide alternative work
- Gives broader safety advice - e.g. swimming/showering/etc.
- Good use of silence to allow patient time to reflect
- Is appropriately sympathetic
- Asks if patient has any questions
- Summarises situation to patient – agrees outcome
- Global mark from patient
- Global mark from examiner
adapted from 125 OSCE stations