Paeds Cases · adolescent-and-young-adult-medicine
Youth violence, risky behaviour and injury prevention OSCE — private screening, tiering, lethal-means counselling and the safety override
Observed structured encounter testing a private violence and safety screen, prevention-tiered brief advice, lethal-means counselling, and an immediate-safety override.
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Target exams
RACP General PaediatricsRACP DCEMRCPCH ClinicalRCPSC Pediatrics
Prompt
Station A is a private prevention assessment with a 15-year-old who has been bullied, vapes, and has a firearm in the home. Station B is a post-overdose adolescent with firearm access requiring lethal-means counselling and disposition.
Station objectives
- Secure time alone and state conditional confidentiality with its limits. [9] [3]
- Complete a private, developmentally framed violence and safety screen woven into HEeADSSS. [9]
- Stratify the young person into a prevention tier and match the intervention to the evidence. [4] [8]
- Perform lethal-means counselling and recognise the immediate-safety override. [6] [7]
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- [1]Krug EG, Mercy JA, Dahlberg LL, et al. The world report on violence and health. Lancet, 2002.PMID 12384003
- [3]Duke NN Youth Violence Prevention and Safety: Opportunities for Health Care Providers. Pediatric Clinics of North America, 2015.PMID 26318944
- [4]Santaella-Tenorio J, Tarantola D Youth Violence: Prevention and Control. American Journal of Public Health, 2021.PMID 34038157
- [6]Gastineau KAB, McKay S Firearm Injury Prevention. Pediatric Clinics of North America, 2023.PMID 37865435
- [7]Krass P Lethal Means Counseling in Emergency Care: A Critical Opportunity for Adolescent Suicide Prevention. Journal of Adolescent Health, 2026.PMID 42331501
- [8]Taylor RD, Oberle E, Durlak JA, Weissberg RP Promoting Positive Youth Development Through School-Based Social and Emotional Learning Interventions: A Meta-Analysis of Follow-Up Effects. Child Development, 2017.PMID 28685826
- [9]Cohen E, Mackenzie RG, Yates GL HEADSS, a psychosocial risk assessment instrument: implications for designing effective intervention programs for runaway youth. Journal of Adolescent Health, 1991.PMID 1772892
- [11]Tozzo P, Cuman O, Moratto E, et al. Family and Educational Strategies for Cyberbullying Prevention: A Systematic Review. International Journal of Environmental Research and Public Health, 2022.PMID 36012084
- [13]Vivolo-Kantor AM, Niolon PH, Estefan LF, et al. Middle School Effects of the Dating Matters Comprehensive Teen Dating Violence Prevention Model on Physical Violence, Bullying, and Sexual Harassment: A Cluster-Randomized Controlled Trial. Prevention Science, 2021.PMID 31833020