Digital media, gaming and cyberbullying OSCE — screening, the function filter and a safeguarding exit

Station objectives

1. Secure time alone and state conditional confidentiality with its limits. [1] [3]

2. Screen the four digital-media exposures using normalised, non-judgemental questions. [1]

3. Apply the function filter and the content-contact-conduct-compulsion frame. [3]

4. Recognise and act on the safeguarding exit for cyberbullying-suicidality and online exploitation. [2] [4]

Candidate brief

You are the paediatric doctor in a youth-friendly clinic. You have 10 minutes for Station A (private digital-media assessment, function filter, and brief intervention) and 12 minutes for Station B (online exploitation disclosure and safeguarding response). Examiners score process, safety, non-judgemental rapport, and the quality of the safeguarding decision. [1] [3]

Station A — School decline, daily group-chat bullying

Setup: A 14-year-old, seen alone, has three months of declining school attendance and tearfulness. They disclose daily group-chat bullying including a manipulated image, and have had thoughts of "not being here" with no plan. They sleep with the phone and check it through the night. [2] [7]

Expected actions:

• Normalise the questions; ask the four exposures and run the function filter. [1]
• Screen for suicide: ideation, plan, intent, prior attempts, means, protective factors, ability to keep safe. [2]
• Secure the means, do not leave alone, explain the confidentiality override for serious harm. [2]
• Preserve evidence, plan blocking/reporting/takedown of the image; engage crisis pathway, school, safeguarding. [2] [3]
• Negotiate a sleep-protective schedule and a family media plan using motivational interviewing. [1]

Station B — Online grooming disclosure

Setup: A 13-year-old, seen alone, describes an online "friend" who sends gifts and is now demanding more images, threatening to expose earlier messages. [4]

Expected actions:

• Recognise online grooming progressing to sextortion as sexual exploitation of a minor. [4]
• Ask directly and without judgement; distinguish from consensual peer contact. [4] [5]
• Preserve evidence; do not have the family contact the perpetrator. [4]
• Activate mandatory reporting and child-protection and law-enforcement pathways per local statute. [4] [5]
• Provide trauma-informed support and clear follow-up; frame the young person as a victim. [5]

Marking anchors

Clear pass: secures time alone and conditional confidentiality; screens all four exposures without judgement; runs the function filter; acts on suicidality and exploitation immediately; negotiates a concrete harm-reduction and family media plan; clear safeguarding reasoning. [1] [3] [2] Borderline: good rapport but incomplete screening, vague safety plan, or a harm bundle limited to one domain. Fail: no private time; abstinence lecturing; files a positive cyberbullying or exploitation disclosure without acting; ignores suicidality; punitive stance. [2] [4]

Debrief pearls

• Digital-media risk is clinical risk; function, not hours, is the discriminator. [3]
• Cyberbullying roughly doubles the odds of self-harm and suicidality — always screen for suicide. [2]
• Exploitation hides behind "risk-taking behaviour" unless you ask directly. [4] [5]
• Family factors are both risk and intervention targets in problematic gaming. [6]