Poverty, food insecurity and social prescribing — OSCE communication and social-prescribing station

OSCE — Communication and social-prescribing station

Candidate instructions

You are the paediatric registrar. You have 8 minutes per station. ^[2]

Station A (screening and co-design). A four-year-old girl is brought for routine immunisation by her mother, who has recently lost her casual job. The mother asks quietly whether you know anywhere that gives food. Screen the family for food insecurity and broader material hardship using validated tools, frame the questions destigmatisingly, co-design a social prescription with the mother, and outline the follow-up plan. ^{[3] [5]}

Station B (investigation and safeguarding). On growth measurement you find the child's weight has fallen across two centiles since her last visit. Investigate the organic differential alongside the social response, make a diagnostic-overshadowing-aware assessment, and decide whether this presentation also requires a safeguarding response. ^{[1] [4]}

Examiner brief and marking domains

Domain 1 — Destigmatised, universal screening (Station A). Greets the mother and child warmly; frames the social questions as routine and universal — "we ask all families these questions because they matter for children's health" — to reduce shame; uses neutral, non-judgemental language; offers privacy and a trained interpreter if needed; and demonstrates that the answers will change the plan, not the respect shown to the family. ^{[3] [5]}

Domain 2 — Validated screening tools (Station A). Uses the two-item Hunger Vital Sign for food insecurity — whether the family worried food would run out, and whether the food bought did not last — and identifies a positive screen correctly; adds a validated multi-domain social-needs instrument covering housing, income, utilities, transport and safety; and records the findings as clinical data. ^[3]