Well-child visit OSCE — health supervision and conversion counselling

Station objectives

1. Structure a well-child visit with shared agenda. [1] [7]
2. Act on developmental concern using surveillance/screening principles. [3]
3. Respond to social determinant and caregiver mood risks. [5] [23]
4. Convert the visit when wellness or safety fails. [1]
5. Close loops and safety-net. [9] [21]

Candidate brief

You are the doctor in a community clinic. Station A is 12 minutes with a parent and infant. Station B is 8 minutes focused on conversion and safeguarding language. [1]

Station A — Nine-month health supervision

Setup: Parent booked for “needles and weight.” Baby not sitting. Food money is tight. Sleep is fragmented. [9] [23]

Expected actions:

• Confirm the infant is currently well enough for a preventive visit. [1]
• Elicit parent agenda before checklist. [7]
• Review growth trajectory and perform focused exam talk-through. [1]
• Treat developmental concern as actionable; outline surveillance vs screen vs referral. [3]
• Address food insecurity with a concrete pathway, not only advice to “eat better.” [23] [24]
• Reconcile immunisations and give or book due vaccines. [1]
• Give brief sleep safety guidance and arrange follow-up. [1]
• Document deferred items and referral ownership. [9] [21]

Station B — Conversion

Setup: Same clinic; next child is lethargic with reduced wet nappies, or alternatively a disclosure of partner violence. [1] [5]

Expected actions:

• Name conversion from well-child mode. [1]
• Prioritise ABCDE or immediate safety. [1]
• Use clear words with the family about why prevention is pausing. [7]
• Escalate using local emergency or child-protection pathways. [20]
• Hand off key facts if transferring. [21]

Marking anchors

Clear pass: shared agenda, acts on development and social risk, vaccines not the only task, converts appropriately, closes loops. [1] [3] [23]
Borderline: kind tone but no referral owner or no conversion language. [9]
Fail: checklist-only vaccines; dismisses parent concern; continues well-child chatter during acute illness or active safety threat. [1] [3]

Debrief pearls

• Well-child care is prevention architecture, not paperwork. [1]
• Caregiver concern is clinical data. [3]
• Poverty response is part of the visit. [23]
• Conversion protects children; it is not rudeness. [1]