CERTIFICATION

EXAMINATION IN
FAMILY MEDICINE

SIMULATED OFFICE
ORAL EXAMINATION
SAMPLE 2

THE COLLEGE OF FAMILY PHYSICIANS OF CANADA

CERTIFICATION EXAMINATION IN FAMILY MEDICINE
SIMULATED OFFICE ORAL EXAMINATION
INTRODUCTION
The Certification Examination of The College of Family Physicians of Canada is
designed to evaluate the diverse knowledge, attitudes, and skills required by
practising family physicians (FPs). The evaluation is guided by the four principles of
family medicine. The Short-Answer Management Problems (SAMPs), the written
component, are designed to test medical knowledge and problem-solving skills. The
Simulated Office Orals (SOOs), the oral component, evaluate candidates abilities to
establish effective relationships with their patients by using active communication
skills. The emphasis is not on testing the ability to make a medical diagnosis and
then treat it. Together, the two instruments evaluate a balanced sample of the
clinical content of family medicine.
The College believes that FPs who use a patient-centred approach meet patients
needs more effectively. The SOOs marking scheme reflects this belief. The marking
scheme is based on the patient-centred clinical method, developed by the Centre
for Studies in Family Medicine at the University of Western Ontario. The essential
principle of the patient-centred clinical method is the integration of the traditional
disease-oriented approach (whereby an understanding of the patients condition is
gained through pathophysiology, clinical presentation, history-taking, diagnosis,
and treatment) with an appreciation of the illness, or what the disease means to
the patients in terms of emotional response, their understanding of the disease,
and how it affects their lives. Integrating an understanding of the disease and the
illness in interviewing, problem-solving, and management is fundamental to the
patient-centred approach. This approach is most effective when both the physician
and the patient understand and acknowledge the disease and the illness.
In the SOOs, candidates are expected to explore patients feelings, ideas, and
expectations about their situation, and to identify the effect of these on function.
Further, candidates are scored on their willingness and ability to involve the patient
in the development of a management plan.
The five SOOs are selected to represent a variety of clinical situations in which
communication skills are particularly important in understanding patients and
assisting them with their problems.

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THE COLLEGE OF FAMILY PHYSICIANS OF CANADA

CERTIFICATION EXAMINATION IN FAMILY MEDICINE
SIMULATED OFFICE ORAL EXAMINATION
RATIONALE
The goal of this simulated office oral examination is to test the candidates ability to
deal with a patient who is:
1.

requesting post-coital contraception for his girlfriend;

2.

concerned about genital herpes.

The patients feelings, ideas, and expectations, as well as an acceptable approach

to management, are detailed in the case description and the marking scheme.

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THE COLLEGE OF FAMILY PHYSICIANS OF CANADA

CERTIFICATION EXAMINATION IN FAMILY MEDICINE
SIMULATED OFFICE ORAL EXAMINATION
INSTRUCTIONS TO THE CANDIDATE
1.

FORMAT
This is a simulated office situation, in which a physician will play the part of
the patient. There will be one or more presenting problems, and you are
expected to progress from there. You should not do a physical examination
at this visit.

2.

SCORING
You will be scored by the patient/examiner, according to specific criteria
established for this case. We advise you not to try to elicit from the examiner
information about your marks or performance, and not to speak to him or
her out of role.

3.

TIMING
A total of 15 minutes is allowed for the examination. The role-playing
physician is responsible for timing the examination. At 12 minutes, the
examiner will inform you that you have three minutes remaining. During the
final three minutes, you are expected to conclude your discussion with the
patient/examiner.
At 15 minutes, the examiner will signal the end of the examination. You are
expected to stop immediately, and to leave any notes with the examiner.

4.

THE PATIENT
You are about to meet Mr. DANIEL LABBE, age 26, who is new to
your practice.

SPECIAL NOTE
Because the process of problem identification and problem management plays an
important part in the score, it is in the best interest of all candidates that they not
discuss the case among themselves.

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THE COLLEGE OF FAMILY PHYSICIANS OF CANADA

CERTIFICATION EXAMINATION IN FAMILY MEDICINE
SIMULATED OFFICE ORAL EXAMINATION
CASE DESCRIPTION
INTRODUCTORY REMARKS
You are Mr. DANIEL LABBE, a 26-year-old car salesman. You have come to the
candidates office without an appointment. You dont know this family physician
(FP), and selected his or her office because it is close to your workplace.
You describe without hesitation a problem that requires urgent attention:
your girlfriend needs the "morning-after" pill.
HISTORY OF THE PROBLEM
Need for post-coital contraception
At about eight o'clock last night you had sexual intercourse with your 18-year-old
girlfriend, MARIE MERCIER. You wore a condom, but it broke. The risk of
pregnancy is high because intercourse occurred on the 14th day of Maries very
regular, 28-day menstrual cycle. She uses no hormonal contraception.
Last night was the first time you and Marie have had intercourse. Her parents,
AGATHE MERCIER, a 50-year-old housewife, and ANDRE MERCIER,
a 52-year-old bank employee, were at the hospital. They had been there since
the morning because of a family emergency: Maries grandmother, JACQUELINE
GENEST, had suffered a stroke in the middle of the previous night. Marie called
you because she was very upset. You went over to her house to comfort her as
soon as you could, and one thing led to another.
Although you and Marie had not planned to have intercourse, you did have a
condom in your wallet. After some very heavy petting with some genital contact,
you and Marie both wanted to continue and you put on the condom.
After your initial panic when the condom broke, you calmed down and looked up
contraception on the internet. You found some information on post-coital
contraception, which stated that a woman can take a morning-after pill prescribed
by a physician. No further explanation was given.

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You have come to this FP hoping to obtain the morning-after pill for Marie.
She is unable to visit a physician this morning because she has an important
algebra examination. (She is in her last year of high school.) You know she must
take the pill soon if it is to be effective, but you know nothing else about it.
You are concerned about contraindications, but do not know what these might be.
You are also worried about complications that may occur if a woman becomes
pregnant after taking such medication.
You know that Marie would take the morning-after pill. However, because of her
strong religious beliefs, she would never have an abortion.
Marie has always been healthy. Her FP did a physical examination two months ago,
at the beginning of the school year. Results of this exam were normal.
Herpes infection
You have genital herpes, and are concerned because last night you felt a tingling
sensation, which you have come to recognize as the beginning of a breakout.
Sure enough, this morning there was a lesion on the glands. You havent noticed
any swollen glands in your groin. You thought Marie would be safe because you
were wearing a condom. You had not considered the possibility that the condom
might break.
You have been unable to tell Marie about your herpes because you are deeply
ashamed of contracting the virus. You remember how devastated you were
when you were told of your diagnosis. Youve been hoping you would not have
another outbreak or, at the very least, that youd be able to avoid intimacy during
a flare-up. The thought of telling Marie about this is mortifying; you feel as if you
will be personifying Maries parents fears about you. They are very strict, have
traditional beliefs, and disapprove of you.
MEDICAL HISTORY
Your first outbreak of genital herpes was seven years ago. You waited five days
before seeing a physician, and were advised that the delay meant that medication
would not be helpful. The physician pointed out that treatment is really effective
only if someone takes it immediately after noticing the first symptoms of an
outbreak.
You remember having a test. This confirmed the presence of herpes simplex virus 2
(HSV-2).
The physician said that medication was available for subsequent outbreaks,
and that this medication would alleviate symptoms. However, you have not
tried any medication.

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You have had a total of seven outbreaks, approximately one a year. Outbreaks
occur at times when you feel run down. After a warning tingling sensation,
a small lesion usually appears on the glands of your circumcised penis.
Each outbreak usually lasts four days. Before todays outbreak, you hadnt
had one in more than a year.
Except for your herpes outbreaks, you have always been healthy and have had no
major illnesses. You havent had a full check-up in years. You are not under a
physicians care.
SURGERY
Appendectomy at age 17.
MEDICATIONS
None.
LABORATORY RESULTS
After realizing your growing affection for and interest in Marie, you decided to be
tested for sexually transmitted diseases (STDs). Three months ago, at a local STD
clinic, you underwent blood and urine tests for human immunodeficiency virus
infection, hepatitis B infection, Chlamydia trachomatis infection, gonorrhea, and
syphilis. Three weeks later you learned that the test results were negative.
You have experienced no symptoms of any infection since.
ALLERGIES
None.
IMMUNIZATIONS
Up to date.
LIFESTYLE ISSUES
Tobacco:

None.

Alcohol:

None.

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FAMILY HISTORY
You are from a working-class family.
Your father, CHARLES, died of a heart attack three years ago. He was 50 years
old. He was a machinist for a large industrial company.
Your 48-year-old mother, JEANNE, has always worked as a maid to make ends
meet. She supports your brother, ROBERT, who is 15.
PERSONAL HISTORY
Previous sexual relationships
You have had several one-night stands, which you have found more or less
satisfactory. A few years ago you had a long-term relationship with an older
woman. You remember her with great fondness, but you both knew there was no
future in the relationship and parted amicably. During your relationship with her,
you had sexual intercourse once or twice a week and found it very satisfying.
Your last casual encounter was 15 months ago. For the most part you have
practiced safe sex, but sometimes you have been a little careless. However,
you have never had intercourse during a herpes outbreak.
Relationship with Marie
Six months ago you met Marie at the car dealership where you work. Her parents
were purchasing a used Volvo, which Marie needed to commute to work after
school. Subsequently, Marie brought the car to the dealership for tune-ups and
brake repairs. Later you met by chance at the coffee shop next to the bookstore
where she works, and about three months ago you started meeting there regularly.
You were attracted to each other, and have felt a very special bond developing. You
have never felt like this about anyone before. You and Marie like the same books,
music, and films. You feel you could spend the rest of your life with her. Marie is
warm and supportive, and has told you how deeply she cares for you, but youre
trying not to rush things.
Maries parents disapprove of you. Marie is Andre and Agathas only child. The
family is very close and has always lived in the same neighborhood. Her mother is
very active in the local Roman Catholic church, where she volunteers with the
seniors' club and does part-time housekeeping for the priests. Her father plays the
organ at Sunday mass.

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Although Marie adores her parents, she feels that they are too old world and that
shes old enough to have more freedom. In fact, Marie says they treat her as if she
were made of crystaland that they wouldnt approve of any boyfriend.
They impose strict limits on her, which she thinks are unfair. For example,
she must account for how she spends her time and is expected to return home
almost immediately after school and work. Her telephone calls are monitored.
Until she got her car, her father drove her to and from school and her part-time job
at the bookstore.
Now that she has a car, Marie feels she has a little more freedombut not much.
You see her only after school and as often as you can during her evening shifts at
work. You do not call her at home anymore. A month ago her parents learned of
your romance and forbade Marie to see you again. They threatened to sue you for
corruption of a minor if she failed to obey them.
Before yesterday evening, Marie was a virgin. You are her first boyfriend.
During your sexual encounter, Marie experienced a little pain, irritation,
and light vaginal bleeding.
EDUCATION AND WORK HISTORY
At 18 you left school to find full-time employment. You had several jobs before you
became a used-car salesman six months ago. Your income is a combination of a
base salary plus commission. You are completely independent and self-supporting
but barely earn a living. You do not feel financially (or emotionally) ready to
support a family. Today you have been too anxious to concentrate at work.

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ACTING INSTRUCTIONS
You are dressed in a suit and a tie, which you are required to wear for your job.
At first you are anxious because of the nature of your request. However, you relax
and co-operate with a candidate who puts you at ease and is available to see Marie
after school hours. You are sensitive to the argument that, ethically, the physician
must see Marie for a physical examination and history-taking before post-coital
contraception can be considered. You also understand the need to tell Marie about
your herpes, although you are upset at the thought of it.
If you are asked why Marie hasnt come with you, say, Shes only 18; shes still in
school. (The candidate should elicit the fact that Marie is taking an important
algebra test.)
After the 10 minutes remaining prompt, be sure to guide the candidate toward the
issue of herpes.
If the candidate asks any open-ended questions after the three minutes remaining
prompt, do not introduce any new topics.
If the candidate asks to see Marie, ask, What do you want to see her about?
If, for any moral, religious, or philosophical reasons, the candidate feels unable to
provide the post-coital contraceptive, he or she must acknowledge that it is safe,
effective, and available elsewhere.

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CAST OF CHARACTERS
The candidate is unlikely to ask for other characters names.
If he or she does, make them up.
DANIEL LABBE:

The patient, who is a 26-year-old

used-car salesman.

MARIE MERCIER:

Daniels girlfriend, who is an 18-year-old

high school student.

JEANNE LABBE:

Daniels 48-year-old mother.

ROBERT LABBE:

Daniels 15-year-old brother.

ANDRE MERCIER:

Maries 52-year-old father.

AGATHE MERCIER:

Maries 50-year-old mother.

JACQUELINE GENEST:

Maries grandmother.

CHARLES LABBE:

Daniels father, who died of a heart attack

three years ago.

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INTERVIEW FLOW SHEET

INITIAL STATEMENT:

Doctor, I have come to get the

morning-after pill for my girlfriend.

10 MINUTES REMAINING:*

If the candidate has not brought up the issue

of the herpes, the following prompt must be
said: There is something else Im
worried about.

7 MINUTES REMAINING:*

If the candidate has not brought up the

issue of the contraindications to the
morning-after-pill, the following prompt
must be said:
Does it really work? Is it safe?
(It is unlikely that this prompt will be
necessary.)

3 MINUTES REMAINING:

You have THREE minutes left.

(This verbal prompt AND a visual prompt
MUST be given to the candidate.)

0 MINUTES REMAINING:

Your time is up.

*To avoid interfering with the flow of the interview, remember that the 10- and
seven-minute prompts are optional. They should be offered only if necessary to
provide clues to the second problem or to help the candidate with management. In
addition, to avoid interrupting the candidate in mid-sentence or disrupting his or
her reasoning process, delaying the delivery of these prompts momentarily is
perfectly acceptable.
NOTE: If you have followed the prompts indicated on the interview flow sheet,
there should be no need to prompt the candidate further during the last three
minutes of the interview. During this portion of the interview, you may only clarify
points by answering direct questions, and you should not volunteer new
information. You should allow the candidate to conclude the interview during this
time.

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THE COLLEGE OF FAMILY PHYSICIANS OF CANADA

CERTIFICATION EXAMINATION IN FAMILY MEDICINE
SIMULATED OFFICE ORAL EXAMINATION
MARKING SCHEME
NOTE: To cover a particular area, the candidate must address AT LEAST 50% of
the bullet points listed under each numbered point in the LEFT-HAND box on the
marking scheme.

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Distinguishing a Certificant from a Superior Certificant: Exploration of the Illness Experience

While it is critical that a certificant gather information about the illness experience to gain a better understanding of the patient
and his or her problem, superior performance is not simply a matter of whether a candidate has obtained all of the information.
A superior candidate actively explores the illness experience to arrive at an-in-depth understanding of it. This is achieved
through the purposeful use of communication skills; verbal and non-verbal techniques, including both effective questioning and
active listening. The material below is adapted from the CFPCs document describing evaluation objectives for certification (1)
and is intended to act as a further guide to assist evaluators in determining whether a candidates communication skills reflect
superior, certificant, or non-certificant performance.
Listening Skills

Uses both general and active listening skills to facilitate

communication
Sample Behaviours

Allows the time for appropriate silences

Feeds back to the patient what he or she thinks he or she

has understood from the patient

Responds to cues (doesnt carry on questioning without

acknowledging when the patient reveals major life or
situation changes, such as I just lost my mother)

Clarifies jargon used by the patient

Non-verbal Skills
Expressive

Conscious of the impact of body language on

communication and adjusts appropriately
Sample Behaviours

Eye contact is appropriate for the culture and comfort of

the patient

Is focused on the conversation

Adjusts demeanour to be appropriate to the patients

context

Physical contact is appropriate to the patients comfort

Receptive

Aware of and responsive to body language, particularly

feelings not well expressed in a verbal manner
(e.g., dissatisfaction, anger, guilt)
Sample Behaviours

Responds appropriately to the patients discomfort (shows

appropriate empathy for the patient)

Verbally checks the significance of body

language/actions/behaviour.
(e.g., You seem nervous/upset/uncertain/in pain.)

Language Skills
Verbal

Adequate to be understood by the patient

Able to converse at an appropriate level for the patients

age and educational level

Appropriate tone for the situation - to ensure good

communication and patient comfort
Sample Behaviours

Asks open- and closed-ended questions appropriately

Checks back with the patient to ensure understanding

(e.g., Am I understanding you correctly?)

Facilitates the patients story

(e.g., Can you clarify that for me?)

Provides clear and organized information in a way the

patient understands
(e.g., test results, pathophysiology, side effects)

Clarifies how the patient would like to be addressed

Cultural and Age Appropriateness

Adapts communication to the individual patient for

reasons such as culture, age and disability
Sample Behaviours

Adapts the communication style to the patients disability

(e.g. writes for deaf patients)

Speaks at a volume appropriate for the patients hearing

Identifies and adapts his or her manner to the patient

according to his or her culture

Uses appropriate words for children and teens

(e.g., pee versus void)

Prepared by:
K. J. Lawrence, L. Graves, S. MacDonald, D. Dalton, R. Tatham, G. Blais,
A. Torsein, V. Robichaud for the Committee on Examinations in Family
Medicine, College of Family Physicians of Canada, February 26, 2010.
Allen T, Bethune C, Brailovsky C, Crichton T, Donoff M, Laughlin T, Lawrence K, Wetmore S.
(1) Defining competence in family medicine for the purposes of certification by The College of Family Physicians of Canada: the
evaluation objectives in family medicine; 2011 [cited 2011 Feb 7}. Available from:
http://www.cfpc.ca/uploadedFiles/Education/Definition%20of%20Competence%20Complete%20Document%20with%20skills%
20and%20phases%20Jan%202011.pdf

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1.

IDENTIFICATION: POST-COITAL CONTRACEPTION FOR GIRLFRIEND

Post-coital contraception
Areas to be covered include:
1. reasons for Maries absence from
this visit:
She is an 18-year-old
high school student.
She is writing an exam at school.
2. contraception/risk of pregnancy:
No hormonal contraceptive.
A condom was used, but broke.
Marie is at the midpoint of
her menstrual cycle.
3. nature of the relationship:
The patient met Marie six months
ago. They have been dating for
three months.
They had sexual intercourse for the
first time last night.
They have clandestine meetings.
(Maries parents disapprove of the
patient.)
This is the patients first important
serious relationship.
4. unplanned but consensual
intercourse.

Illness Experience
Feelings

Anxiety.
Concern over the possible side
effects of the morning-after pill.
Distress about the repercussions
if Marie gets pregnant.

Ideas

Marie could get pregnant.

Effect/Impact on Function

This situation is uppermost in his

mind.
He is unable to concentrate.

Expectations for this visit

The FP will prescribe the morningafter pill.

A satisfactory understanding of all

components (Feelings, Ideas,
Effect/Impact on Function, and
Expectations) is important in
assessing the illness experience of
this patient.

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Superior
Certificant

Covers points
1, 2, 3, and 4.

Certificant

Covers points
1, 2, and 3.

Noncertificant

Does not cover

points 1, 2, and
3.

Actively explores the illness experience to arrive at

an in-depth understanding of it. This is achieved
through the purposeful use of verbal and non-verbal
techniques, including both effective questioning and
active listening.
Inquires about the illness experience to arrive at a
satisfactory understanding of it. This is achieved by
asking appropriate questions and using non-verbal
skills.
Demonstrates only minimal interest in the illness
experience, and so gains little understanding of it.
There is little acknowledgement of the patients
verbal or non-verbal cues, or the candidate cuts the
patient off.

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2.

IDENTIFICATION: HERPES INFECTION

Herpes infection
Areas to be covered include:

1.

history of STDs:
Genital herpes was diagnosed
seven years ago.
Viral culture testing was positive
for HSV-2.
The patient was tested for other
STDs three months ago.
His last previous sexual encounter
was 15 months ago.

Illness Experience
Feelings

Guilt/anguish about the possibility

of spreading herpes infection.
Fear that Maries parents will
discover his ongoing relationship
with Marie.
Embarrassment.

Ideas

He may have infected Marie with

history of herpes:
herpes.
He has had seven outbreaks in
total.
Effect/Impact on Function
He has outbreaks when he feels
run down.
Pain.
Previous episodes lasted four days.
Need to avoid sexual contact
He takes no antiviral therapy.
during an outbreak.
3. risk of transmission:
Expectations for this visit
He had a tingling sensation of the
glands last night.
He hopes the FP will help with his
In the past, he used condoms but
herpes.
sometimes has been a little
careless.
A satisfactory understanding of all
He had a lesion on his penis this
components (Feelings, Ideas,
morning.
Effect/Impact on Function, and
Expectations) is important in
4. Marie is not aware of his herpes
assessing the illness experience of
infection.
this patient.

2.

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Superior
Certificant

Covers points
1, 2, 3, and 4.

Certificant

Covers points
1, 2, and 3.

Noncertificant

Does not cover

points 1, 2, and
3.

Actively explores the illness experience to arrive at

an in-depth understanding of it. This is achieved
through the purposeful use of verbal and non-verbal
techniques, including both effective questioning and
active listening.
Inquires about the illness experience to arrive at a
satisfactory understanding of it. This is achieved by
asking appropriate questions and using non-verbal
skills.
Demonstrates only minimal interest in the illness
experience, and so gains little understanding of it.
There is little acknowledgement of the patients
verbal or non-verbal cues, or the candidate cuts the
patient off.

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3.

SOCIAL AND DEVELOPMENTAL CONTEXT

Context Identification
Areas to be covered include:
1. family history:
His father died of a myocardial
infarction three years ago.
His mother works as a maid to
make ends meet.
He has one younger brother.
2. employment and working
history:
He is a car salesman.
He is financially independent and
self-supporting.
He has a high school education.
3. Maries family:
Marie is an only child.
She is very close to her loving
but strict parents.
She comes from a very religious
Roman Catholic family.
4. the patients fear of legal
repercussions.

Context Integration
Context integration measures the
candidates ability to:

integrate issues pertaining to the

patients family, social structure,
and personal development with
the illness experience;

reflect observations and insights

back to the patient in a clear and
empathetic way.

This step is crucial to the next phase

of finding common ground with the
patient to achieve an effective
management plan.
The following is the type of statement
that a Superior Certificant may make:
You are involved in a very
important relationship thats been
made difficult by the disapproval of
Maries parents. Now you are in a
situation where you might have
exposed Marie to genital herpes,
and youre worried about the risk of
her getting pregnant.

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Superior
Certificant

Covers points
1, 2, 3, and 4.

Certificant

Covers points
1, 2, and 3.

Noncertificant

Does not cover

points 1, 2, and
3.

Demonstrates initial synthesis of contextual factors,

and an understanding of their impact on the illness
experience. Empathically reflects observations and
insights back to the patient.
Demonstrates recognition of the impact of the
contextual factors on the illness experience.
The following is the type of statement that a
Certificant may make:
Sounds like you are really worried about the
fact that you may have exposed Marie to
genital herpes, and you are worried about the
risk of her getting pregnant.
Demonstrates minimal interest in the impact of the
contextual factors on the illness experience, or cuts
the patient off.
The following is the type of statement that a Noncertificant may make:
Well, with a broken condom there certainly is
a risk that Marie could be pregnant and now
have genital herpes.

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4.

MANAGEMENT: POST-COITAL CONTRACEPTION FOR GIRLFRIEND.

Plan
1. Acknowledge that post-coital
contraception is a safe and
effective option for Marie.
2. Offer to see Marie to prescribe
the morning-after pill, or inform
the patient of other sources for
the morning-after pill, which
must be taken within 72 hours.
3. Discuss the need for a more
reliable method of
contraception.
4. Offer to see the couple to help
deal with conflicts with Maries
parents.

Superior
Certificant

Covers points
1, 2, 3, and 4.

Certificant

Covers points
1, 2, and one
other point.
Does not cover
points 1, 2, and
one other
point.

Noncertificant

Finding Common Ground

Behaviours that indicate efforts to
involve the patient include:
1. encouraging discussion.
2. providing the patient with
opportunities to ask questions.
3. encouraging feedback.
4. seeking clarification and consensus.
5. addressing disagreements.
This list is meant to provide
guidelines, not a checklist. The
points listed should provide a sense
of the kind of behaviours for which
the examiner should look.

Actively inquires about the patients ideas and

wishes for management. Purposefully involves the
patient in the development of a plan and seeks his
feedback about it. Encourages the patients full
participation in decision-making.
Involves the patient in the development of a plan.
Demonstrates flexibility.
Does not involve the patient in the development of
a plan.

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5.

1.

MANAGEMENT: HERPES INFECTION

Plan
Discuss oral antiviral treatment
for the present herpes episode
and prevention.

2.

Advise the patient to inform

Marie about her risk of herpes
infection.

3.

Offer follow-up care for Daniel.

4.

Offer to see Marie to advise her

about herpes infection
(signs, symptoms, and
treatment).

Superior
Certificant

Covers points
1, 2, 3, and 4.

Certificant

Covers points
1, 2, and one
other point.
Does not cover
points 1, 2, and
one other
point.

Noncertificant

Finding Common Ground

Behaviours that indicate efforts to
involve the patient include:
1. encouraging discussion.
2. providing the patient with
opportunities to ask questions.
3. encouraging feedback.
4. seeking clarification and consensus.
5. addressing disagreements.
This list is meant to provide
guidelines, not a checklist. The
points listed should provide a sense
of the kind of behaviours for which
the examiner should look.

Actively inquires about the patients ideas and

wishes for management. Purposefully involves the
patient in the development of a plan and seeks his
feedback about it. Encourages the patients full
participation in decision-making.
Involves the patient in the development of a plan.
Demonstrates flexibility.
Does not involve the patient in the development of
a plan.

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6.

INTERVIEW PROCESS AND ORGANIZATION

The other scoring components address particular aspects of the interview. However,
evaluating the interview as a whole is also important. The entire encounter should
have a sense of structure and timing, and the candidate should always take a
patient-centred approach.
The following are important techniques or qualities applicable to the entire
interview:
1. Good direction, with a sense of order and structure.
2. A conversational rather than interrogative tone.
3. Flexibility and good integration of all interview components;
the interview should not be piecemeal or choppy.
4. Appropriate prioritization, with an efficient and effective allotment of time for
the various interview components.

Superior
Certificant

Certificant

Noncertificant

Demonstrates advanced ability in conducting an integrated interview

with clear evidence of a beginning, middle, and an end. Promotes
conversation and discussion by remaining flexible and by keeping the
interview flowing and balanced. Very efficient use of time, with
effective prioritization.
Demonstrates average ability in conducting an integrated interview.
Has a good sense of order, conversation, and flexibility. Uses time
efficiently.
Demonstrates limited or insufficient ability to conduct an integrated
interview. Interview frequently lacks direction or structure. May be
inflexible and/or overly rigid with an overly interrogative tone. Uses
time ineffectively.

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