4-month health supervision OSCE

Objectives

1. Run a structured 3–6 month health-supervision agenda. [5]
2. Counsel safe sleep and tummy time without unsafe compromises. [1] [7]
3. Include maternal mood screening and next steps. [3]
4. Plot growth and perform age-adapted developmental surveillance. [4] [5]
5. Safety-net and plan follow-up. [15]

Candidate brief

12-minute station. Mother and 4-month-old present. Infant is currently well. [5]

Expected actions

• Open concerns; ask about sleep surface/position, feeding, vitamin D, smoke, injury risks. [1] [2]
• Screen/explore maternal mood with a clear pathway for support. [3]
• Measure/plot weight, length, OFC and interpret trend.
• Observe developmental domains with evidence-informed expectations. [4] [5]
• Examine including head shape; distinguish positional features from craniosynostosis red flags. [7]
• Correct prone-for-flat-head advice; teach awake supervised tummy time. [1] [7]
• Offer due immunisations with consent discussion as appropriate.
• Safety-net concrete return triggers and next visit. [15]

Marking

Pass: multi-domain visit structure, safe sleep correctly taught, maternal mood addressed, growth and development covered, clear safety-net. [1] [3] [5]

Fail: advises prone night sleep; ignores maternal mood; needles-only visit; misses faltering growth or tone red flags; no safety-net. [1] [3] [7]