Paediatric consultation with child, young person and family — communication OSCE

Candidate brief

This is a triadic adolescent consultation in trouble: the patient is being spoken for, no confidentiality has been offered, and the psychosocial driver of school refusal has not been explored. Your task is to restructure the opening and run the adolescent component safely. [1] [2]

Approach

Greet both father and young person, introduce yourself, and set the scene. Acknowledge the father's concern explicitly, then frame confidentiality and its limits and ask the father to step out briefly so you can speak with the young person alone. [1] [4]

With the young person alone, build rapport before any direct questioning. Open with what matters to him, then run the HEEADSSS psychosocial screen — home, education and school, eating, activities, drugs, sexuality, suicide and depression, and safety. School refusal and tiredness in this age group demand screening for mood, bullying, sleep, and risk to self. [3]

Re-unite the family for the explaining-and-planning phase. Share what the young person is comfortable sharing, agree the ideas, concerns and expectations of both, and co-construct a plan in plain language. [1]

Closure and safety-net

Confirm understanding with teach-back. Give an explicit, documented safety-net — warning signs to watch for (worsening mood, self-harm, declining function), the timeframe, and exactly where and when to return — and arrange named follow-up with the appropriate clinician. Document the young person's own words and the parental agenda. [1] [2]

Examiner checkpoints

The candidate must: treat the encounter as a triad and engage the young person directly; offer confidentiality with its limits and secure time alone; run a HEEADSSS-structured screen; use teach-back; and close with a specific, documented safety-net. Failing to offer time alone, or letting the father answer for the adolescent throughout, are critical errors. [3] [4]