‘Please just check her ears’ — structured PE OSCE

Candidate brief (8 minutes)

You are the paediatric doctor in a busy acute clinic. A caregiver says: “Please just check her ears — she has had fever since last night.” The child is 11 months old, sitting on the caregiver’s lap, intermittently crying, fully dressed. [15]

Tasks

1. Prepare the encounter and explain your plan to the caregiver in plain language. [15]
2. Demonstrate an age-adapted examination sequence. [15]
3. Measure and interpret age-banded vital signs with correct caveats. [1]
4. Respond if the examiner injects a deterioration cue. [15]
5. Close with documentation of incomplete parts and safety-netting. [15]

Examiner script and expected behaviours

Marking domains

• Communication and explanation [15]
• Observation-first and opportunistic sequencing [15]
• Technical measurement awareness for age-banded heart rate and respiratory rate, and CRT limits [1] [3] [4]
• Honesty about incomplete ENT examination [15]
• Threat recognition and ABCDE conversion [15]
• Recognition that skin findings may change urgency [11]

Model synthesis line

“This is an 11-month-old with fever; cardiorespiratory examination on the lap first; heart rate elevated while crying and will be rechecked using age-banded ranges; full skin examination showed the stated findings; ears not yet visualised; plan is ABCDE with senior review, or safety-net and re-examination if stable.” [15] [1]