Paeds Vivas · professional-practice-and-evidence
Communicating risk and uncertainty to families — branching viva
Viva on evidence-based risk and uncertainty communication with families in paediatrics.
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Study tools
Target exams
RACP DCEMRCPCH ClinicalRCPSC Pediatrics
Prompt
Clinic: parents of an 8-year-old are deciding whether to start a daily preventive medication for a chronic illness; they have read online that it 'reduces harm by 50%' and that it carries a rare serious side effect; the family speaks limited English.
Opening (candidate)
I would treat this as a structured risk-communication conversation, not a result handover. First I would assess what the family already understands, what they have read, and their numeracy and language needs, and arrange a trained interpreter. Then I would reframe the 50% figure with absolute numbers and a pictograph, present the rare harm in a balanced drug-facts box, confirm understanding with teach-back, and arrange follow-up. [1] [14]
References6ShowHide
- [1]Gigerenzer G Helping Doctors and Patients Make Sense of Health Statistics. Psychological science in the public interest, 2007.PMID 26161749
- [4]Zipkin DA Evidence-based risk communication: a systematic review. Annals of internal medicine, 2014.PMID 25133362
- [6]Schwartz LM Using a drug facts box to communicate drug benefits and harms: two randomized trials. Annals of internal medicine, 2009.PMID 19221371
- [10]Moxey A Describing treatment effects to patients. Journal of general internal medicine, 2003.PMID 14687282
- [13]Peters E Communicating Numeric Risk Information to Patients. Journal of general internal medicine, 2025.PMID 40301218
- [14]Levetown M Communicating with children and families: from everyday interactions to skill in conveying distressing information. Pediatrics, 2008.PMID 18450887