Overview

An adult presents with acute chest pain. Learners practice focused cardiac history-taking, risk stratification, and clear communication under time pressure.

Presentation A 54-year-old presents with central chest pressure that began an hour ago at rest, radiating to the left arm, with shortness of breath and nausea. History to elicit Onset, character, radiation, and severity; associated symptoms; cardiac risk factors; current medications; prior episodes. Expected findings Diaphoretic and anxious but hemodynamically stable. Cardiac and respiratory exams are unremarkable between episodes. Facilitation notes Observe whether the learner orders a timely ECG, considers acute coronary syndrome early, and explains next steps to the patient in plain language.

Roles & portrayals

Learning objectives

1. Take a focused cardiac history under time pressure
2. Recognize and act on a possible acute coronary syndrome
3. Communicate the plan clearly to the patient

Evaluation guide

• Introduced self and confirmed patient identity (checklist)
• Ordered an ECG within the first few minutes (checklist)
• Overall communication quality (rating)

Documents

• SP brief (sp brief) — Background and portrayal notes for the standardized patient.
• Facilitator guide (faculty guide) — Debrief prompts and station timing.
• Assessment checklist (checklist) — Scored items for the encounter.