Risk-sensitive interviewing — exploring distress safely and respectfully
1 of 6 debrief stages revealed
Fictional OSCE teaching station. A deterministic station with a rubric for learning and self-assessment — it is not auto-graded, produces no score, and is not a diagnosis exam. Not a real patient.
Candidate instructions
Type H · Risk-sensitive interviewing · time limit 10 min
You are a trainee seeing a 46-year-old whose GP is worried after a recent bereavement and job loss. In 10 minutes, explore mood and safety sensitively. Elicit risk-relevant findings and describe appropriate escalation PRINCIPLES; do NOT devise a treatment plan or make crisis-disposition decisions — that is beyond this teaching station.
Task: Explore mood and safety with warmth and directness, elicit the risk-relevant findings, and state the escalation principles — without turning safety into an interrogation or a diagnosis.
Simulated patient role (reveal when practising with a partner)
Role (simulated patient): You feel low and hopeless since your losses, sleep poorly and have withdrawn. If asked gently and directly, you disclose fleeting thoughts that life is not worth living, but no plan, no intent, and protective reasons (your children). You shut down if the questions feel like a checklist or are rushed; you open up to unhurried, warm, direct enquiry.
Fictional teaching station. Risk enquiry here is educational. When discussing safety planning or means, the module teaches recognition and escalation principles only and never names specific methods; a real disclosure would require immediate, locally-governed clinical action.
Attempt the station (10 min)
Run the station, ideally aloud with a peer. Reveal the debrief only after attempting it.
Consider: How will you ask about safety directly while keeping the person engaged and respected?