Paeds Cases · adolescent-and-young-adult-medicine
Chronic disease self-management OSCE — adolescent adherence and motivational interviewing
Observed structured encounter testing objective adherence assessment, motivational interviewing, shared goal-setting and transition planning with an adolescent living with a chronic condition.
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Target exams
RACP General PaediatricsRACP DCEMRCPCH ClinicalRCPSC Pediatrics
Prompt
A 16-year-old with type 1 diabetes whose HbA1c has risen after two DKA admissions. The candidate must assess adherence objectively, use motivational interviewing, set a shared goal, and plan the transition.
Candidate brief
You are the paediatric registrar in the adolescent diabetes clinic. Liam is 16 and has had type 1 diabetes for five years. He has been admitted twice in six months with diabetic ketoacidosis. His HbA1c has risen. His pump download shows wide gaps in bolus insulin. He and his mother both say he takes everything. You have 12 minutes. [1] [4]
References6ShowHide
- [1]Osterberg L, Blaschke T. Adherence to medication. N Engl J Med, 2005.PMID 16079372
- [2]Schaefer MR, Kavookjian J. The impact of motivational interviewing on adherence and symptom severity in adolescents and young adults with chronic illness: A systematic review. Patient Educ Couns, 2017.PMID 28619271
- [3]Wood DL, Sawicki GS, Miller MD, et al. The Transition Readiness Assessment Questionnaire (TRAQ): its factor structure, reliability, and validity. Acad Pediatr, 2014.PMID 24976354
- [4]Leocadio P, et al. Adolescents' Experiences of Transition to Self-Management of Type 1 Diabetes: Systematic Review and Future Directions. Sci Diabetes Self Manag Care, 2023.PMID 37927049
- [5]Yi-Frazier JP, Hilliard ME, O'Donnell MB, et al. Promoting Resilience in Stress Management for Adolescents With Type 1 Diabetes: A Randomized Clinical Trial. JAMA Netw Open, 2024.PMID 39158914
- [6]Campbell F, Biggs K, Aldiss SK, et al. Transition of care for adolescents from paediatric services to adult health services. Cochrane Database Syst Rev, 2016.PMID 27128768