Paeds Cases · professional-practice-and-evidence
Goals-of-care conversation OSCE — adolescent oncology and a child with no plan
Observed communication encounter testing a structured goals-of-care conversation using the Serious Illness Conversation Guide, age-appropriate advance care planning, prognostic disclosure, documentation, and management of a family who wants everything.
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Study tools
Target exams
RACP General PaediatricsRACP DCEMRCPCH ClinicalRCPSC Pediatrics
Prompt
Station A is a 15-year-old with relapsed leukaemia and her parents, seen to establish a goals-of-care plan. Station B is the parents of a technology-dependent 7-year-old with severe neurodisability who say they want everything done and have no documented plan.
Station objectives
- Run a structured goals-of-care conversation using the Serious Illness Conversation Guide (set up, assess, share, align, plan). [1] [2]
- Capture a developmentally able adolescent's voice with an age-appropriate tool. [3] [11]
- Share honest prognosis with compassion and respond to emotion. [8]
- Document and disseminate a usable advance care plan. [1] [12]
References8ShowHide
- [1]Rapoport A Goals of care conversations and advance care planning for paediatric patients living with serious illness. Paediatr Child Health, 2024.PMID 39539786
- [2]DeCourcey DD, Bernacki RE, Nava-Coulter B, Lach S, Xiong N, Wolfe J Feasibility of a Serious Illness Communication Program for Pediatric Advance Care Planning. JAMA Netw Open, 2024.PMID 39058485
- [3]Needle JS, Friebert S, Thompkins JD, Grossoehme DH, Baker JN, Jiang J, Wang J, Lyon ME Effect of the Family-Centered Advance Care Planning for Teens with Cancer Intervention on Sustainability of Congruence About End-of-Life Treatment Preferences: A Randomized Clinical Trial. JAMA Netw Open, 2022.PMID 35819787
- [4]Thompkins JD, Needle J, Baker JN, Briggs L, Cheng YI, Wang J, Friebert S, Lyon ME Pediatric Advance Care Planning and Families' Positive Caregiving Appraisals: An RCT. Pediatrics, 2021.PMID 33958436
- [8]Bennett HE, Duke S, Richardson A Paediatric advance care planning in life-limiting conditions: scoping review of parent experiences. BMJ Support Palliat Care, 2023.PMID 37201934
- [9]Loeffen EAH, Tissing WJE, Schuiling-Otten MA, de Kruiff CC, Kremer LCM, Verhagen AAE Individualised advance care planning in children with life-limiting conditions. Arch Dis Child, 2018.PMID 29127099
- [11]Wiener L, Bedoya S, Battles H, Sender L, Zabokrtsky K, Donovan KA, Thompson LMA, Lubrano di Ciccone BB, Babilonia MB, Fasciano K, Malinowski P, Lyon M, Thompkins J, Heath C, Velazquez D, Long-Traynor K, Fry A, Pao M Voicing their choices: Advance care planning with adolescents and young adults with cancer and other serious conditions. Palliat Support Care, 2022.PMID 35876450
- [12]Linane H, Tanjavur B, Sullivan L A scoping review of guidelines and frameworks for advance care planning for adolescents and young adults with life-limiting or life-threatening conditions. Palliat Med, 2024.PMID 38600067