ICE is not a tick-box exercise. Formulaic ICE is one of the most common reasons candidates score poorly on "Relating to Others." The RCGP's own toolkit explicitly warns against asking about ICE in a "mechanistic way."
Bad ICE (Avoid These)
- "Do you have any ideas about what's going on?" (robotic, sounds like a checklist)
- "Are you concerned about anything?" (too vague, feels scripted)
- "What were you expecting today?" (sounds like a customer service survey)
Good ICE (Use These Instead)
- "What do you think might be causing this?" or "Have you had any thoughts about what this could be?"
- "Is there anything in particular that's been worrying you about this?" or (after a cue) "You seem quite worried - can you tell me more about that?"
- "What were you hoping we could do about this today?" or "Was there something specific you wanted from today's appointment?"
⚠ COMMON PITFALL: If you ask ICE as three rapid-fire questions at the end of data gathering, it will feel forced and unnatural. Instead, weave ICE throughout the consultation, responding to cues and following the patient's lead.