Adolescent health care for young people in out-of-home care — OSCE communication and safeguarding station

OSCE — Communication and safeguarding station

Candidate instructions

You are the paediatric registrar. You have 8 minutes per station. ^[1]

Station A (entry assessment). A 15-year-old girl in statutory foster care is brought by her caseworker for an entry health assessment one week after her second placement in nine months. The caseworker expects a full report. Conduct the opening of the consultation: engage the young person trauma-informed, clarify consent authority, state the confidentiality frame, and outline the entry-to-care assessment plan. ^[1]

Station B (lawful override). Later the same day, during private time, the young person discloses an active suicide plan for that night. Manage the immediate situation, including how you break confidentiality ethically and the safety plan. ^[1]

Examiner brief and marking domains

Domain 1 — Trauma-informed engagement (Station A). Greets the young person first; sets a safe, paced frame; explains the purpose of the visit; offers choice about the caseworker's presence and the sequence of the interview. Demonstrates the trauma-informed principles of safety, trust, choice, collaboration and strengths. ^{[3] [4]}

Domain 2 — Consent authority and confidentiality (Station A). Clarifies and documents who holds parental responsibility, recognising statutory care may mean the state holds it; assesses the young person's own capacity for the decisions at hand under the mature-minor principle; states conditional confidentiality aloud and is explicit about what the caseworker and carer will and will not be told, sharing the minimum necessary and lawful. ^[1]