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Home / Station 17: Adolescent confidentiality and sexual health

NAC OSCE preparation

Station 17: Adolescent confidentiality and sexual health

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

Adolescent confidentiality and sexual health

11 minutes

Discipline: Communication, Ethics & Professionalism
Station type: Ethics + counselling
Setting: Family medicine clinic

Your task

Speak with a 16-year-old asking to see you alone. Explain confidentiality and address the concern.

Information available at entry

Vital signs stable

Coach prompt: Explain confidentiality, assess capacity/safety and provide confidential care.

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 17 of 30

Standardized-patient profile

NameAlex Morgan

Age16

Pronounsthey/them

RoleAdolescent patient

Demeanour: Hesitant until privacy is explained.

Opening statement: “I think I might have an STI, but I don't want my parents to know.”

History and standardized-patient responses

Concern

Candidate explores	Standardized-patient response
Symptoms	Dysuria and urethral discharge for three days.
Sexual history	One new consensual partner; vaginal and oral sex; condoms sometimes.
Pregnancy potential	Patient cannot become pregnant based on anatomy; partner may.
Preference	Wants testing/treatment but fears family portal visibility.

Safety/capacity

Candidate explores	Standardized-patient response
Consent	Partner also 16; relationship consensual.
Exploitation	No threats, payment, age/power imbalance or authority relationship.
Self-harm/substances	No suicidal thoughts; occasional cannabis.
Understanding	Can explain testing, treatment and follow-up.

Support/privacy

Candidate explores	Standardized-patient response
Trusted adult	Older sibling supportive.
Logistics	Family phone/insurance; needs portal, billing and pharmacy privacy plan.

Physical findings

No examination required here; a focused examination may be offered with consent when indicated.

Examiner prompts

Limits of confidentiality?

Private unless serious harm, abuse/exploitation or another legal reporting duty; exact rules vary by province/territory.

Can a 16-year-old consent?

Capacity is decision-specific, not based only on age; this patient shows capacity.

Care needed?

Confidential STI testing/treatment, broader testing by risk, partner management, condoms/vaccination and follow-up.

Differential diagnosis

Gonococcal/chlamydial urethritis
Other urethritis
UTI
Noninfectious irritation

Investigations

Site-specific NAAT
Urinalysis/culture if UTI possible
HIV/syphilis/hepatitis tests by risk and consent
Pregnancy testing only when anatomically/exposure relevant

Management

Empiric treatment when clinically indicated using current local guidance
Partner management/public-health reporting
Prevention and vaccination
Confidential result communication and retesting plan

Communication behaviours

Use correct name/pronouns
Normalize sensitive questions
Do not promise absolute secrecy

Critical safety actions

Screen exploitation and immediate harm
Do not disclose routine care solely because parent asks
Know jurisdictional duties

Model closing summary

I would explain that our discussion is private unless there is serious risk, abuse or a legal reporting duty. Alex demonstrates capacity for routine STI care. I would take an inclusive sexual and safety history, arrange confidential testing and appropriate treatment, discuss partner notification, condoms, vaccination and follow-up, and plan how results and prescriptions can remain private. I would encourage support from a trusted adult without making it a condition of care.

Common pitfalls

Absolute-confidentiality promise
Heteronormative assumptions
No capacity assessment
Ignoring electronic privacy

Reference starting points

Verify current recommendations and local protocols before clinical use.

Continue practising

Choose another complete 11-minute station

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