Explain a perplexing presentation and a safety-netted plan to an exhausted family — OSCE

Candidate instructions

You are the paediatric registrar. The parents of a seven-year-old boy — two years of recurrent vomiting, fainting and fatigue, seen at four hospitals, no diagnosis, school attendance under 30% — have ten minutes with you. They are exhausted, frightened and frustrated. They want to understand, in plain language: (1) why you will not arrange a feeding tube today when the previous team was considering one; (2) whether you think their son has a rare disease the other doctors have missed; and (3) what your plan actually is, and who is in charge of it. Explain with empathy and honesty, do not accuse, hold the balanced differential openly, check understanding throughout, and agree a clear, named, dated plan. ^[5]