You may write your notes in the fields below as the dialogue unfolds, or at the end. When finished, please click the blue, arrow button to complete the entry. Only click this button when you are completely finished with your note and trainee feedback.

Prompt: Imagine that you are observing an in-person trainee-patient interaction through a live video feed. Please enter observational notes about the clinical interaction from whatever perspective you most often hold in clinical interactions—e.g. as a clinician/educator writing a chart note, as a patient/family member note-taking, etc.

Background: Samantha is known to the supervising physician. She is 35 years old and identifies as female. The doctor has been seeing her recently for fertility-related concerns, as she and her partner have been planning to try to conceive. The reason for today’s visit is listed on the appointment sheet is “anxiety.”

Henrietta: Hi there, my name is Henrietta and I’m a senior medical student working with Dr. Robles today, who thought it would be ok if I see you first, and then review with her who will finish the visit with us. Does this sound ok to you?

Samantha: For sure, happy to talk to you first.

Henrietta: Great! Thanks so much! So, tell me what’s bringing you in today?

Samantha: Well, I’m sure you can see from my chart, but me and my partner are trying to have a baby. It’s super exciting, but it’s been really challenging going through all this fertility stuff, and thinking about what our future will look like once we have a baby. And I dunno, I’ve just been feeling so overwhelmed recently. I was actually doing pretty well managing all of it, but lately I just feel like I can’t shut off my brain. I can’t sleep, I don’t want to eat, I can’t focus.

Henrietta: Oh wow, I’m so sorry to hear about what you’re going through. That’s so much to deal with.

Samantha: It really is.

Henrietta: I’m going to ask you some more questions about your anxiety if that’s ok.

Samantha: For sure.

Henrietta: What kinds of things do you find yourself worrying about?

Samantha: Anything and everything! The news. The world. The past, the future. My relationship with my partner. My health. Just about everything.

Henrietta: Wow, that must be so overwhelming. Have you felt this way before?

Samantha: I’ve always been a worrier, but lately it’s been more than ever. I think the fertility stuff just really triggered it all.

Henrietta: I can imagine that would be hard. That’s a big stress for a lot of people who are going through fertility issues. And tell me about your sleep.

Samantha: Yeah, that’s been the biggest issue. I can’t stop my brain at night, so I just lay awake worrying. Eventually I might fall asleep, but I usually wake back up and then just lay awake thinking. I’m exhausted because I can’t sleep.

Henrietta: And how has your mood been given all of this?

Samantha: Honestly, not that bad. I still feel happy, and I really do enjoy my life and love my partner. But because I can’t sleep, I’m so tired, that I do feel like I’m kind of dragging my feet just to get through the day.

Henrietta: Do you feel like your anxiety has made you more irritable or agitated? That can commonly happen.

Samantha: Yes! I feel so badly because I’m just rude to the people who I love the most. I didn’t know why. It’s so validating to hear you say that.

Henrietta: It’s definitely normal to feel that way. Sometimes it helps if we understand where our irritability is coming from, so we can communicate it better. And you said you can’t eat? Can you tell me more?

Samantha: I just have this pit in my stomach, like something terrible is going to happen. So I feel kind of nauseous and panicky all the time, and just not interested in eating.

Henrietta: I see. So it sounds like you’re definitely experiencing anxiety, in the context of some really significant life stressors. Was there anything in particular you were hoping we’d be able to do for you today?

Samantha: I don’t know. I really didn’t know where to start and well, Dr. Robles has just seen me through all of this that I thought I should start by talking to her first. I thought maybe a therapist would be a good idea, but it’s so hard to find the right one! I tried looking and the ones I thought would be a good fit were all full. It makes me anxious thinking about trying to find a therapist given how much I’ve tried and how little success I’ve had. Can you help with this?

Henrietta: I’m really glad you came to talk to us today. We can definitely help you with trying to find a therapist, but you’re right, it’s a really complicated system! We’re here to help, though. Was there anything else that you wanted to tell me before I go review with Dr. Robles?

Samantha: Hmm, nope, I don’t think so. Thanks for listening to me. It’s actually been really helpful to just say how I’m feeling.

Henrietta: It’s my pleasure. I’ll be right back.

Please complete your chart note and any debriefing comments for Henrietta in the fields below.

When you are finished, click the blue, arrow button in the bottom right to submit your notes.

Thank you for participating.