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Paeds Caseschild-safety-and-social-paediatrics

Paeds Cases · child-safety-and-social-paediatrics

Trauma-informed examination and forensic documentation OSCE — the threat response and the court-admissible record

Observed structured encounter testing the trauma-informed response to a freeze during examination, the single trained forensic interview, the documentation standard that separates fact from opinion, and the safeguarding, reporting and disposition duties.

osce communication and clinical station3 min readVerification in progress

Target exams

RACP General PaediatricsRACP DCEMRCPCH ClinicalRCPSC Pediatrics
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Target exams

RACP General PaediatricsRACP DCEMRCPCH ClinicalRCPSC Pediatrics
Prompt
Station A is a non-acute child who freezes during examination, testing the interpretation of the threat response and the trauma-informed adjustment. Station B is an acute presentation testing the documentation standard, photo-documentation consent, and the disposition bundle.

Station objectives

  1. Recognise the freeze response during examination and respond in a trauma-informed way rather than proceeding. [1]
  2. Run or support a single trained forensic interview and state the clinician's constrained role within it. [3]
  3. Produce documentation that separates observed fact from clinical opinion and is contemporaneous, verbatim and complete. [2]
  4. Obtain explicit and separate consent for photo-documentation and maintain the chain of custody. [2]
  5. Discharge the safeguarding, reporting and follow-up duties with a safety plan in place. [1] [4]
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References4ShowHide
  1. [1]Forkey H, Szilagyi M, Kelly ET, Duffee J Trauma-Informed Care. Pediatrics, 2021.PMID 34312292
  2. [2]Cross TP, Schmitt T Forensic medical results and law enforcement actions following sexual assault: A comparison of child, adolescent and adult cases. Child Abuse & Neglect, 2019.PMID 31075572
  3. [3]Lamb ME, Orbach Y, Hershkowitz I, Esplin PW, Horowitz D A structured forensic interview protocol improves the quality and informativeness of investigative interviews with children: a review of research using the NICHD Investigative Interview Protocol. Child Abuse & Neglect, 2007.PMID 18023872
  4. [4]Adams JA, Kellogg ND, Farst KJ, Harper NS, Palusci VJ, Frasier LD Updated Guidelines for the Medical Assessment and Care of Children Who May Have Been Sexually Abused. Journal of Pediatric and Adolescent Gynecology, 2016.PMID 26220352
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