Name: Clinical History Taking 8
Creator: Leya Luhar
Keywords: Dermatology,History Taking

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Scenarios

By Leya Luhar • October 24, 2026 • Last reviewed: 2026-10-24 •

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Summary Beginner

A patient has been booked in to see the practice pharmacist by their GP, who has asked for a full clinical history to be taken before the GP decides what to do next.

The student must take a structured clinical history, then summarise and explain the next steps to the patient.

You will need a student pharmacist and an actor playing the patient for this scenario. The patient can be played by a male or female actor.

Revision Topics

Be aware, this may reveal any answers!

Student Instructions

Actor Instructions

This may reveal scenario objectives!

You are Hamza Rashid (HAM-zah, rash-EED) or Hana Rashid (HAH-nah, rash-EED).

Opening statement: ‘Hi. It’s my hands. Look at them, they’re so sore and itchy.’ (Hold out the backs of both hands.)

Patient information:

To be given if the student asks.

Name: Hamza Rashid or Hana Rashid
Date of Birth: 02/10/1998
Age: 28
Address: Flat 3, Wednesfield Court, Wolverhampton, WV11 1RD
Past medical history:
- ‘I had eczema as a kid, and I get hay fever.’
- If asked about operations: ‘No.’
Medication history:
- ‘Nothing from the doctor.’
- If asked about bought medicines: ‘I got a hydrocortisone cream from the chemist and used it twice a day for a week. I finished it about five days ago. And I take cetirizine in the summer for hay fever, not at the moment.’
- If asked what you have tried: ‘The hydrocortisone calmed it down a little but it came straight back. I use a hand cream from the high street as well.’
- If asked about herbal remedies or supplements: ‘No.’
- If asked about creams: ‘Just the hydrocortisone and the hand cream.’
- If asked about eye drops: ‘I use hay fever eye drops in the summer.’
Allergies:
- ‘No allergies to medicines. Cheap earrings make my ears itchy.’
Symptoms:
- Where: ‘The backs of both hands, between my fingers and on my fingertips.’
- Started: ‘About six weeks ago. I started my new job at the salon two weeks before that.’
- What it is like: ‘Really itchy and dry. It cracks, and it stings when I wash my hands.’
- Spread: ‘No, just my hands.’
- When: ‘All the time, but it’s worst by the end of the week. I had four days off last month and it got a lot better, then it came back.’
- Worse or better: ‘Worse after shampooing clients, and in the cold. Moisturiser helps a little.’
- How bad: ‘The itch is about a 6 out of 10. The cracks are sore.’
- Before and since: ‘I had eczema in the creases of my elbows as a kid, but never on my hands. It’s getting worse.’
- No other symptoms.
Lifestyle factors:
- Job: ‘I’m a hairdresser. I started at a new salon two months ago. I wash 15 to 20 people’s hair a day.’
- Home: ‘I live with my husband (or wife) in a flat.’
- Hobbies: ‘The gym, and I love baking.’
- Travel: ‘No, not this year.’
- Smoking: ‘No, I don’t smoke.’
- Alcohol: ‘A couple of drinks at the weekend.’
- Recreational drugs: ‘I’ve tried cannabis a couple of times at parties, but not for over a year.’
If the pharmacist asks further questions:
- Family history: ‘My sister has eczema and my mum has asthma.’
- Effect on daily life: ‘I can’t stop scratching, and the cracks bleed when I’m washing hair.’
- What you think it is: ‘The shampoo at the new salon.’
- Worries: ‘I’m scared I’ll have to give up hairdressing. I’ve only just got this job.’
- What you hoped for: ‘Something to clear it up so I can keep working.’
- How you feel: ‘Embarrassed. Clients look at my hands.’
- Gloves at work: ‘Only when I’m colouring. I can’t feel what I’m doing with them on.’
- Rings: ‘I wear my wedding ring all the time.’
- Anyone else at work or home with a rash: ‘No.’
- Pets: ‘No.’
- Taking anyone else’s medicines: ‘No.’
- Contraception (female actor only): ‘We use condoms.’

Acting notes:

Use everyday language.
Answer only what you are asked, one thing at a time.
If the student uses a term you do not understand: ‘Sorry, what does that mean?’

Mark Scheme

Introduction

0 / 3

Introduces themselves by name and states their role as a pharmacist

+1

Example wording: ‘Hello, my name is Sam and I’m one of the pharmacists who works with the GPs here.’ Does not earn the mark: a name without the role, or a role without a name.

Confirms the patient’s identity using at least two identifiers: full name plus date of birth or address

+1

Example wording: ‘Before we start, can I just check your full name and your date of birth, please?’

Explains the purpose of the consultation and gains verbal consent to take a clinical history

+1

Example wording: ‘Your GP has asked me to go through some questions with you about what’s been happening and your general health, and then I’ll share what we discuss with them. Is that all right with you?’ Award only if the student asks and waits for the patient to agree. Explaining the purpose without asking does not earn the mark.

Medical History

0 / 7

Confirms the patient’s past medical history

+1

Example wording: ‘Do you have any medical conditions that you see the doctor or nurse about?’ and ‘Have you ever had any operations or been in hospital?’

Confirms the patient’s current medicines, asking about both prescribed medicines and medicines bought over the counter

+1

Example wording: ‘Are you taking any medicines at the moment, either ones the GP prescribes or ones you buy yourself from a pharmacy or supermarket?’ and ‘How often are you taking that?’ The student must identify the hydrocortisone cream.

Confirms the patient has tried hydrocortisone cream and a moisturiser, and they helped only slightly

+1

Example wording: ‘Have you tried anything on your hands so far? Did it help?’

Asks about herbal or homeopathic medicines, vitamins or supplements

+1

Example wording: ‘Do you take any herbal remedies, vitamins or supplements?’

Asks about recreational or illicit drug use

+1

Example wording: ‘This is something I ask everyone. Do you use any recreational drugs, such as cannabis?’ Asking in a neutral, non judgemental way is good practice. The student should not lecture the patient.

Asks about medicines in other forms: at least two of creams or ointments, inhalers, nasal sprays and eye drops

+1

Example wording: ‘Some people don’t think of these as medicines, so I always ask: do you use any creams, inhalers, nose sprays or eye drops?’

Asks about allergies

+1

Example wording: ‘Do you have any allergies to medicines, foods or anything else?’ Asking what happens (itchy ears) is good practice.

Social History

0 / 6

Confirms family history

+1

Example wording: ‘Do any medical conditions run in your family, for example in your parents, brothers or sisters?’

Confirms living arrangements

+1

Example wording: ‘Who do you live with at home?’

Confirms occupation

+1

Example wording: ‘What do you do for work?’

Asks about recent travel

+1

Example wording: ‘Have you travelled anywhere recently, in the UK or abroad?’

Asks about hobbies

+1

Example wording: ‘What do you like to do in your spare time?’

Asks about smoking and alcohol

+1

Both smoking and alcohol must be asked about for the mark. Example wording: ‘Do you smoke, or have you ever smoked?’ and ‘How much alcohol would you drink in a typical week?’

Closing Consultation

0 / 4

Summarises the findings back to the patient, including the main problem, how long it has been going on, and at least two other relevant points from the history

+1

Example wording: ‘So, you’ve had sore, itchy, cracked skin on both hands for about six weeks, starting soon after your new job at the salon, where you’re washing hair all day. It was better on your days off, the hydrocortisone cream only helped a little, and you’re worried about your job. Have I got that right?’ Does not earn the mark: ‘So that’s everything, thank you’ with no content, or a summary of the presenting complaint alone.

Asks if the patient has anything further to add or any questions

+1

Example wording: ‘Is there anything else you’d like to tell me, or anything you’d like to ask before we finish?’

Explains the next steps: they will discuss the history with the GP, and tells the patient how and when they will hear back

+1

Example wording: ‘Thank you. I’m going to go through this with your GP today, including how much your hands are in water at work, and the GP or I will call you tomorrow with the plan. Is that OK?’ Accept another appropriate plan, for example asking the GP to join the consultation now. Both parts are needed: discussing with the GP, and how or when the patient will hear back. Does not earn the mark: ‘I’ll pass this on’ with no indication of what happens next. Linking the rash to wet work at the salon is not required and earns no extra mark.

Thanks the patient for their time, says goodbye or closes with another polite phrase

+1

Example wording: ‘Thank you for going through all of that with me. Take care, and we’ll speak later today.’

Patient Safety

0 / 1

Keeps the patient safe throughout the consultation: stays within their role as a pharmacist who is not a prescriber and gives no advice that could cause harm

+1

Forfeited by any of the following: promising or recommending a prescription only steroid cream or any other prescription only medicine; telling the patient they will have to give up their job; dismissing a red flag the patient reports in error. Advice is not required in this station. A student who gives safe, general advice earns no extra marks and is not penalised.