Aboriginal and Torres Strait Islander child health — branching viva

Opening (2–3 minutes)

Examiner: How will you start this consultation? [2]

Strong answer: Introduce myself and role. Ask Aboriginal and/or Torres Strait Islander status respectfully and record it. Ask who should be part of decisions. Offer Aboriginal Health Worker involvement. Acknowledge the family’s concern about respect directly and state that cultural safety is judged by their experience. [2] [3]

Branch A — Trust and racism

Examiner: They describe racist comments at another service. What does that mean clinically? [5]

Strong answer: Racism is associated with harm to physical and mental health and destroys access. I believe the family, apologise for the system’s failure, and change the plan: AHW present, slower pace, written plan, ACCHO shared care, no deficit language. [5] [2]

Branch B — Ears and school

Examiner: Teachers say the child does not listen. Your priorities? [9]

Strong answer: Examine ears and hearing behaviour first. Arrange audiology if indicated. Apply under-6 ear/hearing check principles. Do not label behaviour before hearing is assessed. Urban residence does not exclude significant ear disease. [9] [11]

Branch C — Wet cough

Examiner: There is also an 8-week wet cough. How do you reason? [12]

Strong answer: Prolonged wet cough in Indigenous children can sit on a protracted bacterial bronchitis to bronchiectasis pathway. I assess severity, treat infection-driven wet cough, address environment, plan follow-up, and refer if chronic. I do not normalise it or default to asthma without evidence. [12]

Branch D — ARF awareness

Examiner: When would ARF enter your thinking? [15]

Strong answer: Fever with joint symptoms, chorea, carditis features, or high-incidence context. ARF remains a major inequity for Indigenous Australian children. I use structured assessment and local RHD programme pathways rather than inventing criteria or prophylaxis doses. [15]

Branch E — Disposition

Examiner: Close the consultation. [2]

Strong answer: Plain-language summary; written plan; ACCHO letter with consent; hearing and cough follow-up dates; safety-net for breathing difficulty or fever with joint pain; document strengths and goals as well as problems. [1] [2]

Examiner scoring cues

Pass: recipient-defined cultural safety; identity asked; AHW/ACCHO partnership; ear and wet-cough pathways; racism as exposure; no invented ARF doses. [2] [9] [12]
Fail: assumed identity; deficit stereotypes; behaviour label before hearing; chronic wet cough dismissed; cultural safety reduced to posters only. [3] [5]