Disability-aware acute care — communication OSCE

Objectives

1. Partner with the caregiver as the baseline expert. [4]
2. Name and avoid diagnostic overshadowing. [6]
3. Implement reasonable adjustments in real time. [3]
4. Describe pain assessment with an observational tool. [1] [9]
5. Communicate a clear medical hunt and safety-net plan. [6]

Candidate brief

12-minute station. Parent present; child distressed. Focus on communication and plan; full physical exam may be spoken. [3]

Marking anchors

• Opens with ABC safety and respect for caregiver concern. [4] [6]
• Explicitly rejects “just disability” as the whole answer. [6]
• Names quieter bay/time/predictable sequence. [3]
• Mentions r-FLACC or equivalent observational pain tool. [1]
• Lists medical differentials for behaviour change. [6] [9]
• Uses teach-back for next steps. [4]

Sample lines

"You know your child best — what is different from normal today?" [4]

"We will not stop at behaviour. We will look for pain and illness, and we will make this bay quieter while we do it." [3] [6]

"Because they cannot tell us a number, we use a structured pain score made for children with communication difficulties, then treat and reassess." [1] [9]