MMI role-play stations: how to handle the actor

In a role-play station an actor plays a patient, relative, friend or colleague, and you have a few minutes to handle a difficult conversation. The scenario is usually not medical at all: telling a friend their pet has died, explaining to a neighbour that you broke something, or calming a customer who has been kept waiting.

Applicants fear these stations because they cannot be revised for. But they are also where listening and kindness score most clearly, and those can be practised.

What the assessor is marking

• Empathy: noticing and acknowledging how the person feels.
• Listening: asking open questions and letting them talk.
• Clear explanation in plain language, in small pieces.
• Honesty, including about mistakes.
• A plan: what happens next, agreed with the person.

Actors are often told to give certain information only if you ask the right open question. If you do all the talking, you may never find out what the station was really about.

A step-by-step approach

1. Introduce yourself and check who you are talking to. Sit down if there is a chair.
2. Find out what they know before you say anything: “What have you been told so far?”
3. Warn before bad news: “I am afraid I have some difficult news.” Then say it simply and stop.
4. Pause. Let the silence happen. Do not fill it with detail.
5. Acknowledge the emotion: “I can see this is a real shock.” Name it before trying to fix anything.
6. Ask what matters to them, and answer their questions honestly.
7. Agree a plan and check they are OK to leave the conversation.

Breaking bad news

Calming an angry person

1. Do not argue or get defensive. Let them say what they need to say.
2. Acknowledge the anger and the reason for it: “You have been waiting four hours and nobody has told you why. I would be frustrated too.”
3. Apologise for their experience, sincerely.
4. Find out what they need most right now.
5. Say what you can do, be honest about what you cannot, and say what happens next.

If the person becomes threatening, it is fine to say you will get help. Safety comes first, for you and for others.

When you made the mistake

Some stations ask you to own up: you borrowed something and broke it, or forgot to pass on an important message. The marked behaviours are honesty, a real apology, no excuses, and a plan to put it right. In healthcare this is called the duty of candour, and it is worth mentioning if it fits naturally.

Role-play scenarios to practise

1. Your friend has failed an exam they needed for their university offer. They are upset. Talk to them.

   Listen first, acknowledge, then options. Do not jump to fixing.

2. You accidentally damaged your neighbour’s car while parking. Explain what happened.

   Honesty, apology, no excuses, a plan.

3. A relative is angry that their mother has been waiting hours to be seen.

   Acknowledge, apologise, explain what you can, agree next steps.

4. Explain to a patient what an MRI scan is, as if they have never heard of one.

   Plain words, small pieces, check understanding.

5. A colleague keeps arriving late and leaving you with extra work. Speak to them.

   Curious, not accusing. There may be a reason.