Family-centred and child-rights-based care — OSCE

Objectives

1. Deliver the four PFCC core concepts and uphold the four UNCRC guiding principles in a real encounter. [1] [5]
2. Arrange a professional interpreter and avoid using the child or a sibling as interpreter. [9]
3. Elicit the child's own view at a developmentally right level and record it. [12]
4. Manage the tension between a family's wish to withhold information and the child's right to accessible information. [5]

Candidate brief

A 12-minute station. A 9-year-old with a complex chronic illness is admitted for investigation. The parents speak a language other than English and ask you to tell them about the plan but "not to worry" the child. The child is drawing quietly in the corner and has not yet been addressed. The nurse asks you how you will run the conversation. [1]

Expected actions

• Greet the child by name first, before turning to the parents; acknowledge the child as a person with a voice. [12]
• Arrange a professional interpreter for the substantive conversation; do not use the child or a sibling as interpreter. [9]
• Explore why the parents wish to withhold information, usually fear, and offer to share age-appropriate honest information with the child together with the parents. [5]
• Use plain language, invite questions, and check understanding with teach-back. [1]
• Ask the child directly, in concrete terms, what she understands and what matters to her; weight her view to her developmental stage. [6]
• Build the plan collaboratively with the family around their goals, and record the child's own views in the notes. [1] [12]
• Document who decided, the information shared, the interpreter used, and the follow-up. [10]

Examiner prompts

• "We don't want her to know — she'll only get upset." → Explore the fear; offer to share age-appropriate honest information together; name the information-sharing core concept. [5]
• "Can't her older brother just translate?" → Decline; arrange a professional interpreter for high-stakes information. [9]
• "She's just a child, she doesn't need to decide." → Reframe: participation is weighted to her stage, not a transfer of decision-making; record her view. [12]

Marking foci

• Demonstrates the four PFCC core concepts and four UNCRC guiding principles in action. [1] [5]
• Arranges a professional interpreter and avoids using a child as interpreter. [9]
• Greets the child first, elicits her view directly, and records it. [6] [12]
• Manages the withholding-information tension without silencing the child or the family. [5]
• Documents who decided, information shared, interpreter used, and follow-up. [10]