Adolescent preventive health care — branching viva

Stem

The examiner will test whether you can run a youth-friendly preventive visit under pressure. [1] [4]

Branch 1 — Visit structure

Examiner: How do you start an adolescent preventive visit? [3]

Strong answer: Greet the young person first, set a joint agenda, explain private time as normal, then create time alone. Do not take the whole sensitive history with the parent answering. [3] [2]

Examiner: Give your confidentiality line. [4]

Strong answer: Conditional confidentiality with limits for serious harm, abuse and legal duties; plan any override with the young person when possible. [4] [2]

Branch 2 — HEADSS

Examiner: What does HEADSS stand for? Give one question per domain. [1]

Strong answer: Home, Education, Activities, Drugs, Sexuality, Suicide/depression (safety). One open question each. Mention HEEADSSS Eating/Safety expansion if used locally. [1]

Branch 3 — Screens

Examiner: Depression screen positive—what next? [5]

Strong answer: Same-visit suicide risk assessment and safety disposition. Do not file and forget. [5]

Examiner: What is CRAFFT for? [6]

Strong answer: Validated substance-use risk screen in adolescents; positive result triggers further assessment and brief advice pathways, not automatic diagnosis. [6] [8]

Branch 4 — Emergency disclosure

Examiner: Active suicide plan tonight; begs secrecy. [5] [4]

Strong answer: Override confidentiality as required; secure immediate safety; crisis/ED pathway; explain what must be shared; do not leave high-risk youth unsupported. [5] [4]

Branch 5 — Systems and transition

Examiner: Parent portal will show the contraception note. [9]

Strong answer: Modern confidentiality risk via portals/billing; use local sensitive-note workflows; minimise unnecessary disclosure. [9] [4]

Examiner: Seventeen-year-old chronic disease, no adult team. [7]

Strong answer: Transition is prepare–transfer–integrate in the medical home over years, not a birthday letter. [7]

Examiner extras

• Time alone is quality of care, not optional courtesy. [3]
• Opportunistic HEADSS applies in ED/ward.
• Do not invent universal consent ages; state local statute principle. [4]