Infant health supervision OSCE — early weight check and 2-month counselling

Station A — Day-5 neonate (10 minutes)

Candidate instructions: Take a focused history from the parent, outline examination priorities, and explain your management plan for weight loss and jaundice. [1]

Parent script (key facts if asked):

• Term birth, home day 2, exclusive breastfeeding.
• Birth weight 3500 g; today 3120 g.
• Painful latch; feeds 45 minutes each side.
• 4 wet nappies yesterday; stools present.
• Yellow face and chest noticed this morning.
• Baby wakes for feeds but is sleepier today.
• No fever reported; no bilious vomiting. [1]

Examiner checklist — must hit:

• Assesses wellbeing / red flags for sepsis
• Interprets ~11% weight loss with output
• Plans feed observation and lactation support ± temporary supplementation criteria
• Measures bilirubin and plots by age in hours (local AAP-aligned pathway)
• Gives timed reweigh and clear safety-net
• Mentions full exam including eyes, hips, femorals if time [1]

Domain marks: clinical reasoning 4 · management 4 · communication 2 [1]

Station B — Two-month counselling (10 minutes)

Candidate instructions: Counsel the parents on safe sleep and respond to maternal low mood. Confirm immunisation plan. [1]

Parent script:

• Baby sleeps between parents on a soft adult mattress with a pillow "so he feels snug."
• Mother cries most days, enjoys little, feels guilty; no plan to harm self or baby.
• Infant thriving; mild sniffles, afebrile.
• Vaccines due today; father worries "too many too soon." [1]

Examiner checklist — must hit:

• Supine, firm flat surface, no soft bedding
• Room-share without bed-share; addresses why without shaming
• Smoke-free / risk modifiers if raised
• Maternal mood: empathise, assess safety, warm handover plan
• Immunisation: recommend today; mild URTI not automatic deferral
• Teach-back and written/next-step plan [1]

Domain marks: communication 5 · safety counselling 3 · shared decision-making 2 [1]

Global professionalism

Respectful, jargon-light language; involves both caregivers when present; avoids cultural humiliation around sleep practices while remaining clear about risk. [1]