Role-play stations

What a role-play station actually is

A role-play station puts you in a small room with two people. One is a trained actor — often called a simulated participant — working from a written brief with a character, a backstory and a set of responses. The other is a marker who usually says almost nothing and scores you against a rubric; on some circuits the actor is also asked for a rating of their own.

The actor is not improvising freely. They have instructions about what to disclose and when, and briefs typically build in triggers: ask an open question and they open up, fire closed questions and they answer in single words while the scene stalls. How the station unfolds is largely a readout of what you did.

The scenario rarely turns on clinical knowledge, and you are rarely cast as a doctor. More often you are a student, a flatmate, a colleague or a friend — someone with no authority to fix anything. Applicants have not trained yet, so anything a rubric could fairly score is communication rather than medicine; where a brief does have a clinical setting, whatever you need to know is written on the instruction sheet.

The five archetypes you will meet

Circuits recycle a small number of shapes. If you can play these five, you can play almost any variation a school invents.

• Difficult news to a peer. A friend has failed a resit, lost a place, or the trip you organised has fallen through. The information is trivial; the handling is the station.
• An angry or distressed person. They may shout, interrupt, or blame you personally. The test is whether you stay steady rather than defensive.
• A colleague who has made a mistake or is struggling. You are a peer, not a supervisor. Can you raise it without humiliating them, and do you know when it has to go further?
• Explaining something complex in plain language. A set of rules, instructions, information the other person needs in order to act. Jargon and pace are the traps.
• Persuading someone whose decision you disagree with. A friend is dropping a subject or doing something unwise. This one punishes the eager: it is not a debate to be won.

The spine that works in every station

Underneath the archetypes there is one process. It is the same signposting discipline as structuring answers under pressure, applied to a conversation rather than an answer.

1. Open warm and open. One short, genuinely open question, then silence. How are you doing. What happened. Anything narrower hands you a station you have to drag along by yourself.
2. Listen, then reflect back. Say what you heard in your own words before adding your own: so if I have got this right, the shift was changed at the last minute and nobody told you. It is the clearest evidence a marker has that you were actually listening, and the step candidates most often skip.
3. Name the emotion before you touch the content. Out loud: that sounds really frustrating; I can see how upsetting this is. Empathy is scored when it is spoken, not when it is felt quietly.
4. Only then give information, one idea at a time. Short sentences, no jargon, a pause after each piece so it can land.
5. Check understanding. Ask them what they have taken from it, rather than whether they understood.
6. Agree a next step inside what you can deliver. Small, specific and real. Never promise an outcome, a decision, or an answer that belongs to somebody else.

The order matters more than the wording. Almost every failed role-play is the same failure in a different costume: the candidate hears a problem, feels the pull to be useful, and jumps to step four. Most of what follows is wasted, because the person was not ready to hear it.

Persuasion stations need the same restraint. Staying silent about a genuine risk is not neutrality, so say once and plainly that you would choose differently and why. Then stop: repetition rarely persuades anybody, the actor is usually briefed to hold their position, and your job is to make sure they are deciding with full information, not to make them decide your way. Leave the door open — if you change your mind I am here, and none of this changes anything between us.

Difficult news: warning shots and SPIKES

Where you carry information the other person does not have, the structure worth owning is SPIKES — a six-step protocol published in 2000 by Baile and colleagues for oncologists delivering a cancer diagnosis, and still one of the frameworks most commonly taught for breaking bad news. It transfers cleanly to a friend or a colleague.

1. Setting. Get the situation right first: somewhere private, sitting down, phone away, enough time. Say it aloud — shall we sit down, I have got the whole afternoon.
2. Perception. Find out what they already know. What have you heard so far. This stops you delivering news they have, or assuming knowledge they do not.
3. Invitation. Find out how much they want to know, and ask before you go on. Is it all right if I tell you what I know. It sounds small, and it hands them the pace.
4. Knowledge. Warning shot, pause, then the news in one plain sentence. No preamble, no cushioning phrase that buries the point.
5. Emotions. Stop. Let the reaction happen and respond to it before you add a single further fact.
6. Strategy and summary. Only once they are ready: what happens next, in small pieces, and a recap of what you agreed.

The warning shot is worth drilling until it is automatic: one sentence telling the other person that difficult news is coming, a beat before the news itself. I am afraid I have got some bad news. Then two or three seconds of nothing. That pause is not dead air — it is the moment the person braces, and skipping it makes news land as an ambush.

Mini-script one: telling a friend the trip is cancelled

• You: I wanted to catch you in person rather than message. Have you got a few minutes?
• Them: Sounds serious. What is it?
• You: I am afraid it is not good news. (pause) The trip has been cancelled. The provider pulled out yesterday and there is no replacement date.
• Them: You are joking. I have spent eleven hundred pounds on this.
• You: (pause, no rush) I know. It is a horrible outcome, and you put more into organising it than any of us.
• Them: So what am I supposed to do about the money?
• You: Honestly, I do not know yet, and I do not want to guess and get it wrong. What I can do is email them tonight and forward you what they say.

Notice what the script does not do. It does not apologise five times, it does not reach for a solution before the reaction has landed, and where a weaker candidate promises a refund, it promises only an email — a thing inside the speaker’s control.

Anger, silence and staying in character

Anger stations tend to go wrong fastest, because being shouted at makes people defend themselves. The rule is a simple one: do not argue with the actor. You are not there to establish who is right, and the marker is not scoring the facts of the dispute.

What works is lowering your volume instead of matching theirs, getting to their eye level, letting them finish, then reflecting it back: you are angry because you were told someone would call on Monday and nobody did. Naming the grievance accurately takes the heat out, because it proves you were listening. Only then ask what they would like to happen.

Silence is the second thing candidates handle badly. When an actor stops talking, or starts crying, the instinct is to fill the gap with reassurance. Do not. A three-second pause is not a failure, it is space you are handing to someone who needs it. If you must break it, break it with something that does not demand an answer: take your time.

Finally, stay in the scene. Do not turn to the marker to explain what you would do in real life, do not narrate your own technique, and do not step out to check whether you are doing it right. If the examiner wants a debrief they will ask — some circuits reserve the final minute for exactly that, and the question is your invitation, not a moment earlier.

Jargon, teach-back and the close

Explaining stations are easy to underestimate, because you can be entirely accurate and still score badly. The failure mode is language. Anything belonging to your world rather than theirs is jargon, and not only medical jargon: deferred entry, capacity, escalate and referral pathway all count.

Two habits fix it. Chunk and check — one idea, a pause, then a check, instead of a paragraph. And teach-back: never ask does that make sense, because everybody says yes. Ask instead, what will you say to your mum when you get home. That verifies understanding and makes any gap yours to fix rather than their failure to follow.

Mini-script two: a colleague who has made a mistake

• You: Have you got two minutes? There is something I wanted to mention, and I would rather say it to you than to anyone else.
• Them: Go on.
• You: The stock sheet from Saturday had the counts in the wrong columns. I am not raising it to have a go — I wanted to check you are all right, because it is not like you.
• Them: I was covering two sections on my own. I have not told anyone, but I am really struggling at the moment.
• You: (pause) Thank you for telling me. That sounds like a lot to be carrying on your own.
• Them: Please do not say anything to the manager.
• You: I am not going behind your back. What I cannot do is promise nobody finds out, because if the counts are wrong the order goes wrong. What I would rather do is come with you tomorrow, so it is you telling her.

That last move is the whole station. The candidate does not promise secrecy they cannot keep, does not threaten, and does not take over — they offer to go with them. Support the person, be honest about the limits of what you can hold, escalate with them rather than around them: the shape Good Medical Practice asks of doctors when a colleague is struggling.

Practise out loud with another person, inside the real time limit — commonly somewhere between five and ten minutes, though it varies by school, so check the format your circuit publishes; the MMI guide covers how the circuits are run. Ask your partner to mark two things only: did you name the emotion before you gave information, and did you check understanding before you closed. Pacing, posture and what nerves do to your hands sit in nerves, delivery and presence.