Vaccine hesitancy OSCE — MMR delay counselling station

Station brief (candidate)

• Child: 12-month-old, well, development normal.
• Vaccines: other antigens acceptable today; MMR deferred by parent.
• Parent concern: autism after online reading.
• Context: measles circulating locally.
• Task: counsel, recommend, negotiate plan, safety-net. [3]

Examiner marking domains

1. Opening recommendation — clear, non-coercive, not purely open-ended.
2. Elicitation — parent’s specific fear in their words; no interruptive lecture.
3. Tailored response — empathy first; brief accurate information; avoids myth-first headline and humiliation.
4. Risk communication — measles disease risk framed honestly; no false absolute safety promises.
5. Plan — same-day MMR preferred; if refused, time-bound revisit booked; partial schedule not abandoned.
6. Documentation/ethics — notes refusal elements, disease advice, door left open.
7. Relationship — calm under challenge; no sarcasm. [5]

Expected process (model)

1. Introduce and check understanding of visit goals.
2. Recommend MMR today as part of routine care.[2]
3. Ask what worries them most; reflect autism concern.[5]
4. Affirm shared protection goal; give short accurate statement; invite further questions.[3]
5. Link local measles context to why delay is not neutral.
6. If still declining: document, safety-net measles symptoms, book early follow-up, keep care relationship.[4]

Common fails

• Opens with "So you are anti-vax?"
• Dumps a five-minute epidemiology lecture before listening.
• Guarantees "no side effects ever".
• Accepts indefinite delay with no booking.
• Ends relationship as first response to refusal. [4]

Teaching note

This station tests process more than schedule tables. Candidates who define the problem as hesitancy on a continuum and run recommend → elicit → tailor → plan → document will outscore those who only recite 3C labels without using them.[5]