Paeds Cases · adolescent-and-young-adult-medicine
Inclusive care OSCE — the affirming consultation and the mother's direct question
Observed communication station testing an affirming adolescent consultation: establishing confidentiality, asking attraction, identity and behaviour separately, behaviour-based screening, responding to a parent's direct question without breaching confidentiality, and acute risk management.
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Target exams
RACP General PaediatricsRACP DCEMRCPCH ClinicalRCPSC Pediatrics
Prompt
Station A is a 15-year-old girl attending with her mother for a check-up who discloses, once alone, a girlfriend, months of bullying and fleeting suicidal thoughts; the candidate must run an affirming consultation. Station B is the same young person's mother asking the candidate directly whether her daughter is gay; the candidate must hold confidentiality and respond appropriately.
Station objectives
- Run an affirming adolescent consultation that establishes confidentiality before any sexuality history. [4] [8]
- Take a sexual orientation history asking attraction, identity and behaviour separately. [2]
- Screen mood, suicide risk and safety, and plan behaviour-based sexual health. [6]
- Respond to a parent's direct question about the young person's orientation without breaching confidentiality. [8]
References7ShowHide
- [1]Meyer IH Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. Psychological Bulletin, 2003.PMID 12956539
- [2]Bradford J, Mustanski B Health disparities among sexual minority youth: the value of population data. American Journal of Public Health, 2014.PMID 24328630
- [3]Baams L, Grossman AH, Russell ST Minority stress and mechanisms of risk for depression and suicidal ideation among lesbian, gay, and bisexual youth. Developmental Psychology, 2015.PMID 25751098
- [4]Cahill S, Singal R, Grasso C, King D, Mayer K, Baker K, Makadon H Do ask, do tell: high levels of acceptability by patients of routine collection of sexual orientation and gender identity data in four diverse American community health centers. PLoS One, 2014.PMID 25198577
- [6]Luk JW, Goldstein RB, Yu J, et al. Sexual Minority Status and Age of Onset of Adolescent Suicide Ideation and Behavior. Pediatrics, 2021.PMID 34580171
- [8]Diana P, Esposito S LGBTQ+ Youth Health: An Unmet Need in Pediatrics. Children, 2022.PMID 35884011
- [9]Ream GL Minority Stress and Intersectionality in LGBTQIA+ Youth Mental Health Disparities. American Journal of Public Health, 2024.PMID 38662974