Handover and consultation OSCE — ED to ward with residual risk · Paeds Cases

Prompt

A 6-year-old with abdominal pain is partially treated in ED. Focal tenderness persists. The caregiver is worried and speaks limited English. You must consult surgery, hand over to the ward team and communicate with the family.

Candidate brief

Time: 12 minutes. You are the paediatric ED registrar. Roles present: surgical registrar (phone), ward registrar (bedside), professional interpreter (available if requested), caregiver. [1] [4]

Tasks

Make an ISBAR surgical consult call. [2]
Perform an I-PASS handoff to the ward team with residual risk and pending results ownership. [1] [3]
Explain the plan to the caregiver via professional interpreter and check understanding. [4] [6]

Examiner checklist

Clear question, urgency and callback on the consult. [2]
Illness severity, contingency and receiver synthesis on handoff. [1] [3]
Caregiver concern included. [5]
Professional interpreter used; no child interpreter. [4]
Verbal plan matches what will be written. [1]

Domains assessed

Communication, clinical prioritisation, equity, teamwork, documentation alignment, safety culture. [1] [6]

References

[1]Starmer AJ Changes in medical errors after implementation of a handoff program. The New England journal of medicine, 2014.PMID 25372088
[2]Finnigan MA ISBAR for clear communication: one hospital's experience spreading the message. Australian health review : a publication of the Australian Hospital Association, 2010.PMID 21108899
[3]Huth K Implementing receiver-driven handoffs to the emergency department to reduce miscommunication. BMJ quality & safety, 2021.PMID 32299957
[4]Boylen S Impact of professional interpreters on outcomes for hospitalized children from migrant and refugee families with limited English proficiency: a systematic review. JBI evidence synthesis, 2020.PMID 32813387
[5]Mills E Association between caregiver concern for clinical deterioration and critical illness in children presenting to hospital: a prospective cohort study. The Lancet. Child & adolescent health, 2025.PMID 40451224
[6]Khan A Patient safety after implementation of a coproduced family centered communication programme: multicenter before and after intervention study. BMJ (Clinical research ed.), 2018.PMID 30518517

Domains assessed

Communication, clinical prioritisation, equity, teamwork, documentation alignment, safety culture. [1] [6]

References

[1]Starmer AJ Changes in medical errors after implementation of a handoff program. The New England journal of medicine, 2014.PMID 25372088
[2]Finnigan MA ISBAR for clear communication: one hospital's experience spreading the message. Australian health review : a publication of the Australian Hospital Association, 2010.PMID 21108899
[3]Huth K Implementing receiver-driven handoffs to the emergency department to reduce miscommunication. BMJ quality & safety, 2021.PMID 32299957
[4]Boylen S Impact of professional interpreters on outcomes for hospitalized children from migrant and refugee families with limited English proficiency: a systematic review. JBI evidence synthesis, 2020.PMID 32813387
[5]Mills E Association between caregiver concern for clinical deterioration and critical illness in children presenting to hospital: a prospective cohort study. The Lancet. Child & adolescent health, 2025.PMID 40451224
[6]Khan A Patient safety after implementation of a coproduced family centered communication programme: multicenter before and after intervention study. BMJ (Clinical research ed.), 2018.PMID 30518517