Family-centred and child-rights-based care — viva

Stem

Examiner-led viva on a family-centred, rights-based encounter in a complex child. [1]

Examiner: The parents ask you not to tell the child what is happening. How do you respond? [5]

Strong answer: I explore why — usually fear — while holding the child's right to accessible information and to be heard. Withholding information "to protect" breaches the information-sharing core concept and the child's rights. I offer to share age-appropriate honest information with the child together with the parents, so the child is not left frightened and alone. [1] [5]

Examiner: Name the four PFCC core concepts and the four UNCRC guiding principles. [1]

Strong answer: The four core concepts are dignity and respect, information sharing, participation, and collaboration. The four UNCRC guiding principles are non-discrimination, the best interests of the child, survival and development, and the right of the child to be heard. The first set tells me how to partner; the second tells me why the child is owed it. [1] [5]

Examiner: The parents speak limited English. How do you handle communication? [9]

Strong answer: I book a professional interpreter for every substantive conversation, and I never use the child or a sibling as interpreter for high-stakes information. I share information in plain language and check understanding with teach-back rather than trusting a nod. [9]

Examiner: How would you grade the child's participation here? [12]

Strong answer: Using Hart's ladder, manipulation, decoration and tokenism are not participation. For a nine-year-old, genuine participation means assigned-but-informed at minimum — I tell her in concrete terms what will happen and ask her view, weighted to her developmental stage, and I record her own views in the notes. [12] [6]

Examiner: What is the commonest failure mode of family-centred care as policy? [10]

Strong answer: The implementation gap — endorsed policy that never reaches the bedside, worst where acuity and under-resourcing press hardest. Knowing the policy is not the same as practising it; the fix is concrete bedside moves like greeting the child by name first and recording her views. [10]

Examiner: One key pitfall to avoid? [5]

Strong answer: Letting "the family will decide" silence the child's own voice. The child holds rights independently of the parent, so I ask her directly and weight what she says, while still partnering with the family. [5] [12]