Explaining a negative malaria film and the plan to repeat it — OSCE

Candidate instructions (8-minute station)

You are the paediatric registrar in the emergency department. An eight-year-old girl has been assessed for two days of fever and headache, one week after returning from visiting family in Papua New Guinea. She did not take malaria prophylaxis. Her first malaria blood film has come back negative. She is currently well-looking, febrile but alert, with no signs of severe disease, and the plan is to observe and repeat the film. ^[6]

Your tasks are: ^[11]

1. Explain to her parents what a negative film means and why one negative film does not rule out malaria, in plain language that neither alarms them nor underplays the need to repeat the test. ^[6]
2. Set out the safety-net plan clearly — when the film will be repeated, and what warning signs must bring them straight back. ^[11]
3. Acknowledge the family's anxiety and hold their trust, while being honest that the possibility of malaria has not yet been excluded. ^[2]

You are not expected to give a detailed pre-travel counselling session, to discuss antimalarial drug dosing, or to manage severe disease. ^[11]