As for communication stations in general, candidates were expected to provide an empathic explanation of the situation, using appropriate body language, and appropriate attention to the needs of the wife.  Other factors looked for included appropriate listening to the wife’s concerns, and  conveying the need to give the benefit  of the doubt with regard  to final neurological outcome. The clinical scenario provided was as follows:

“A 45 year old man is admitted to the hospital with a reduced level of consciousness (GCS =
7/15).    A CT scan shows a subarachnoid haemorrhage from a ruptured anterior communicating artery aneurysm.  Neurosurgical opinion is that the aneurysm is amenable to both surgical and interventional radiological correction.  The patient’s wife is insistent that he would not wish to have any medical intervention in the event that he is on “life support”. She states they have previously discussed this issue and his wish is not to be treated in this situation.
The nursing staff state that she is refusing to consent for surgery or interventional radiology, despite the assurances that these are safe procedures, with the possibility of a reasonable neurological  outcome.     She  insists  mechanical  ventilation  is  ceased  and  no  further treatments be given.

You wish to discuss the possibility of coiling the aneurysm.  Please explain the situation regarding the aneurysm to his wife Deborah who is now waiting to speak with you.  Explain the diagnosis and the required procedure and the probable outcome.”

Disclaimer: the viva stem above may be an original CICM stem, acquired from their publicly available past papers. Or, perhaps it is a slightly altered version of the original CICM stem. Or, it is a completely original viva stem, concocted by the monstrously amoral author of Deranged Physiology for nothing more than his own personal amusement. In either case, because the college do not make the main viva text or marking criteria available, almost everything here has been confabulated. It might sound like a plausible viva and it could be used for the purpose of practice, but all should be aware that it does not represent the "true" canonical CICM viva station.