Paeds Cases · adolescent-and-young-adult-medicine
Adolescent contraceptive consult OSCE — confidentiality, 5 Ps, method choice and a coercion disclosure
Observed structured encounter testing private time, conditional confidentiality, the 5 Ps, LARC-first counselling, dual protection and a controlling-partner safety assessment.
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Study tools
Target exams
RACP General PaediatricsRACP DCEMRCPCH ClinicalRCPSC Pediatrics
Prompt
Station A is a contraceptive request with a parent who will not leave the room. Station B is a private disclosure of a controlling older partner requiring a 5 Ps history, method counselling and a safety plan.
Station objectives
- Negotiate private time and explain conditional confidentiality. [3] [8]
- Take a structured 5 Ps sexual history including a coercion question. [3]
- Counsel methods LARC-first using Medical Eligibility Criteria principles and agree dual protection. [1] [4] [7]
- Conduct a safety assessment after a controlling-partner disclosure and plan accordingly. [3]
References8ShowHide
- [1]Winner B, Peipert JF, Zhao Q, Buckel C, Madden T, Allsworth JE, Secura GM Effectiveness of long-acting reversible contraception. N Engl J Med, 2012.PMID 22621627
- [2]Mestad R, Secura G, Allsworth JE, Madden T, Zhao Q, Peipert JF Acceptance of long-acting reversible contraceptive methods by adolescent participants in the Contraceptive CHOICE Project. Contraception, 2011.PMID 22018123
- [3]American College of Obstetricians and Gynecologists Committee Opinion No. 710: Counseling Adolescents About Contraception. Obstet Gynecol, 2017.PMID 28742675
- [4]Tepper NK, Krashin JW, Curtis KM, Cox S, Whiteman MK Update to CDC's U.S. Medical Eligibility Criteria for Contraceptive Use, 2016: Revised Recommendations for the Use of Hormonal Contraception Among Women at High Risk for HIV Infection. MMWR Morb Mortal Wkly Rep, 2017.PMID 28934178
- [5]Rome ES, Issac V Sometimes You Do Get a Second Chance: Emergency Contraception for Adolescents. Pediatr Clin North Am, 2017.PMID 28292452
- [6]Davidson KW, Barry MJ, Mangione CM, et al. Screening for Chlamydia and Gonorrhea: US Preventive Services Task Force Recommendation Statement. JAMA, 2021.PMID 34519796
- [7]Hood JE, Hogben M, Chartier M, Bolan G, Bauer H Dual contraceptive use among adolescents and young adults: correlates and implications for condom use and sexually transmitted infection outcomes. J Fam Plann Reprod Health Care, 2014.PMID 24293508
- [8]Whitfield B Vizcarra E, Dane'el A, Palomares L, D'Amore G, Maslowsky J, White K Minors' Experiences Accessing Confidential Contraception in Texas. J Adolesc Health, 2023.PMID 36604208