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Home / Station 10: Consent for lumbar puncture

NAC OSCE preparation

Station 10: Consent for lumbar puncture

Complete the task in 11 minutes. Reveal the full standardized-patient script, examiner prompts and structured debrief only after your attempt.

Station time

11:00

Ready for an 11-minute attempt.

Candidate instructions

Consent for lumbar puncture

11 minutes

Discipline: Communication, Ethics & Professionalism
Station type: Informed-consent counselling
Setting: Emergency department procedure room

Your task

Explain a recommended lumbar puncture for possible meningitis and obtain informed consent. Do not perform the procedure.

Information available at entry

Stable after initial assessment and treatmentNo focal deficit or scenario-specific reason to defer LP is provided

Coach prompt: Demonstrate valid consent and balanced risk discussion.

In Exam Mode, coaching cues are hidden. Ask a partner to use the standardized-patient script after you start the timer.

Finished your attempt?Reveal the full station only after completing or stopping the timer.

Complete station package

Standardized-patient script and structured debrief

Station 10 of 30

Standardized-patient profile

NameMs. Laura Grant

Age35

Pronounsshe/her

RolePatient

Demeanour: Anxious but capable and engaged.

Opening statement: “I'm scared. Why do you need a needle in my back, and could it paralyze me?”

History and standardized-patient responses

Understanding/values

Candidate explores	Standardized-patient response
Current understanding	Knows infection around the brain is possible but not what the test does.
Main fear	Paralysis and severe pain.
Preference	Wants plain language and time for questions.

Safety

Candidate explores	Standardized-patient response
Bleeding	No anticoagulant or bleeding disorder.
Allergy	No local-anesthetic allergy.
Experience	No prior LP.

Physical findings

No procedure is performed in this station.

Examiner prompts

Elements of valid consent?

Capacity, adequate disclosure, understanding, voluntariness, clear choice and opportunity to ask or withdraw.

Alternatives?

Empiric treatment and other tests may proceed, but no alternative gives the same CSF information; a capable refusal must be respected.

Differential diagnosis

Not applicable—communication station

Investigations

Confirm platelet/coagulation status and imaging need based on clinical assessment

Management

Proceed only after safety checks and valid consent
Use aseptic technique/local anesthetic
Do not delay time-critical empiric meningitis treatment for LP logistics

Communication behaviours

Name the emotion
Avoid jargon and risk-free claims
Use teach-back rather than 'Do you understand?'

Critical safety actions

Do not delay antimicrobials
Confirm capacity and lack of coercion
Discuss patient-specific material risks

Model closing summary

I would explain that a lumbar puncture samples fluid around the brain and spinal cord to diagnose meningitis and guide treatment. I would describe positioning, local anesthetic and placement below the end of the spinal cord; common discomfort/headache; and uncommon bleeding, infection, failed attempt or nerve irritation. I would discuss alternatives and consequences, address the paralysis fear honestly, check understanding with teach-back, confirm voluntariness and obtain a clear decision.

Common pitfalls

Memorized complication monologue
Over/understating paralysis risk
Pressuring patient
Treating a form as consent

Reference starting points

Verify current recommendations and local protocols before clinical use.

Continue practising

Choose another complete 11-minute station

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