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PAPER TWO MCQ – Multiple Choice Questionnaire. What do you want from MCQ preparation? Table as a group (get to know your neighbour) Table as a group (get.

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Presentation on theme: "PAPER TWO MCQ – Multiple Choice Questionnaire. What do you want from MCQ preparation? Table as a group (get to know your neighbour) Table as a group (get."— Presentation transcript:

1 PAPER TWO MCQ – Multiple Choice Questionnaire

2 What do you want from MCQ preparation? Table as a group (get to know your neighbour) Table as a group (get to know your neighbour) Person nearest the aisle is spokesperson Person nearest the aisle is spokesperson Just FOUR items required Just FOUR items required Only takes a minute or two Only takes a minute or two

3 TUTORS Aims of MCQ preparation Review format/content of exam Review format/content of exam Flavour of questions Flavour of questions Practice (difficult to do under exam conditions) Practice (difficult to do under exam conditions) Identify areas of weakness (go home and check answers) Identify areas of weakness (go home and check answers) Some comparison with peer group (need to mark the paper here and now) Some comparison with peer group (need to mark the paper here and now)

4 Plan for short seminar Overview Overview Content Content Revision Revision Format Format

5 Overview MCQ May 2005 May candidates 1622 candidates High reliability of the exam (comparable to any equivalent test worldwide) High reliability of the exam (comparable to any equivalent test worldwide)

6 Overview MCQ Mean74% Mean74% Standard Deviation9% Standard Deviation9% Pass mark67% Pass mark67% Merit81% Merit81% 79% of candidates passed 79% of candidates passed 23% of candidates given merit 23% of candidates given merit

7 Overview MCQ Just a few extra marks makes a large difference in your ranking compared to your peers Just a few extra marks makes a large difference in your ranking compared to your peers

8 Overview MCQ Questionnaire – (60% response rate – 90% passed) Questionnaire – (60% response rate – 90% passed) Difficult!! (yet nearly 80% passed) Difficult!! (yet nearly 80% passed) Appropriate questions Appropriate questions Extended matching items most difficult (and Summary Completion) Extended matching items most difficult (and Summary Completion) Time a problem Time a problem NOW more Single Best Answer questions NOW more Single Best Answer questions

9 Overview MCQ Overview MCQ 3 hours and offered in May and October 3 hours and offered in May and October Tests established and recently discovered KNOWLEDGE of relevance to general practice Tests established and recently discovered KNOWLEDGE of relevance to general practice (newer questions involve more and more APPLICATION of knowledge) (newer questions involve more and more APPLICATION of knowledge)

10 CONTENT

11 Content clinician clinician family physician family physician patient's advocate patient's advocate gatekeeper gatekeeper resource allocator resource allocator handler of information handler of information team member team member team leader team leader partner partner colleague colleague The Gatekeeper

12 Content employer employer manager manager business-person business-person learner learner teacher teacher reflective practitioner reflective practitioner researcher researcher agent and shaper of policy agent and shaper of policy member of a profession member of a profession person and individual person and individual

13 Content Syllabus 32 pages long Syllabus 32 pages long 17 pages of general concepts for each defined area 17 pages of general concepts for each defined area 13 pages of appendices - checklist 13 pages of appendices - checklist 2 pages of references 2 pages of references

14 Content - syllabus 1. Good medical practice and care 2. Generalist skills 3. The doctor-patient relationship, communication and consulting skills 4. Professional, ethical and legal obligations 5. Population, preventive and societal issues 6. Information management and technology

15 Content - syllabus 7. Risk management 8. Monitoring of quality of performance, audit and clinical governance 9. Continuing Professional Development, learning, teaching and training 10. Working with colleagues 11. Organisational administrative and regulatory framework 12. Financial probity and business management

16 Content (example from syllabus appendix) Serious communicable diseases Particularly, but not limited to, infections such as Human Immunodeficiency Virus (HIV), tuberculosis and hepatitis B and C Particularly, but not limited to, infections such as Human Immunodeficiency Virus (HIV), tuberculosis and hepatitis B and C Means and control of transmission, awareness of diagnosis, investigation, management, consent for testing, issues of confidentiality and the implications to the patient of a positive result Means and control of transmission, awareness of diagnosis, investigation, management, consent for testing, issues of confidentiality and the implications to the patient of a positive result Role of Public Health Services Role of Public Health Services

17 Syllabus – help or hindrance First direction for revision from College First direction for revision from College A little vague in places but a useful starting point A little vague in places but a useful starting point Certainly worth a read to help identify areas of weakness Certainly worth a read to help identify areas of weakness

18 Content Medicine - 65% Medicine - 65% Admin. & Management - 15% Admin. & Management - 15% Research, Epidemiol. Stats - 20% Research, Epidemiol. Stats - 20%

19 Medicine (65% of marks) Cardiovascular Cardiovascular Dermatology / ENT / ophthalmology Dermatology / ENT / ophthalmology Endocrinology / metabolic Endocrinology / metabolic Gastroenterology / nutrition Gastroenterology / nutrition Infectious diseases / haematology / immunology / allergies / genetics Infectious diseases / haematology / immunology / allergies / genetics Musculo-skeletal Musculo-skeletal Paediatrics Paediatrics Pharmaco-therapeutics Pharmaco-therapeutics Psychiatry / neurology Psychiatry / neurology Reproductive / renal Reproductive / renal Respiratory Respiratory all equal - 6% !! all equal - 6% !!

20 Implications for revision DERMATOL / ENT / EYES – 6% of exam DERMATOL / ENT / EYES – 6% of exam

21 Research/epidemiol./stats – 20% Assessing the quality of care Assessing the quality of care Principles of audit Principles of audit Understanding and application of the terms used in inferential statistics and evidence- based medicine Understanding and application of the terms used in inferential statistics and evidence- based medicine Knowledge of statistics and research methodology, sufficient for the critical appraisal of published papers. Knowledge of statistics and research methodology, sufficient for the critical appraisal of published papers.

22 Content - Revision Clinical areas fairly limitless Clinical areas fairly limitless Research, epidemiology, administration and management more defined in this exam. Research, epidemiology, administration and management more defined in this exam.

23 Revision Considerable amount of work to be done (sorry) Considerable amount of work to be done (sorry) Need a good general background Need a good general background Identify areas of weakness Identify areas of weakness Prioritise these areas Prioritise these areas Dont spend time needlessly Dont spend time needlessly Make use of review articles and publications such as Clinical Evidence Make use of review articles and publications such as Clinical Evidence

24 Revision

25 Revision

26 Revision

27 Revision

28 FORMAT

29 MCQ FORMAT – why change? Congruence with education Congruence with education Mainly PBL Mainly PBL Flaws in multiple T/F format Flaws in multiple T/F format Rote memory vs problem solving Rote memory vs problem solving Benefits of newer formats Benefits of newer formats ?integration of factual knowledge / personal care ?integration of factual knowledge / personal care

30 Format <250 questions <250 questions EMQ - extended matching item questions EMQ - extended matching item questions SBA - single best answers SBA - single best answers MBA - multiple best answers MBA - multiple best answers TAQ – table / algorithm completion TAQ – table / algorithm completion SCQ- summary completion questions (???) SCQ- summary completion questions (???) Items per question will vary between 3 and 6 Items per question will vary between 3 and 6 Trial questions = different papers Trial questions = different papers

31 Format Pictorial data - charts, photos (on the INCREASE) Pictorial data - charts, photos (on the INCREASE) NO NEGATIVE MARKING NO NEGATIVE MARKING

32 Question Examples SINGLE BEST ANSWER SINGLE BEST ANSWER MULTIPLE BEST ANSWER MULTIPLE BEST ANSWER SUMMARY COMPLETION SUMMARY COMPLETION EXTENDED MATCHING ITEM EXTENDED MATCHING ITEM TABLE / ALGORITHM COMPLETION TABLE / ALGORITHM COMPLETION

33 SBA- Single Best Answer, from May 98 In the management of croup in a 2y old child, which single treatment has been shown in clinical trials to shorten the course of the condition? X place the child in a steam filled bathroom administer inhaled budesonide administer inhaled budesonide X prescribe amoxycillin 125mg tds for 5/7 X administer inhaled salbutamol X prescribe paediatric codeine cough suppressant X administer inhaled tribavirin

34 Multiple Best Answer (MBA) A statement is followed by a variable number of items a specified number of which are correct A statement is followed by a variable number of items a specified number of which are correct

35 Multiple Best Answer (MBA) A 65-year-old male smoker presents with a gradual onset of breathlessness on moderate exertion, and a cough with clear sputum. Chest examination reveals general reduction breath sounds and the presence of a few rhonchi bilaterally. Spirometry reveals an FEV 1 of 50% of predicted. Identify the three most appropriate therapeutic interventions to be considered following the British Thoracic Society COPD guidelines. Give THREE answers. ASalbutamol inhaler BBeclomethasone inhaler CIpratropium inhaler DSalmeterol inhaler ESodium cromoglycate inhaler FOral theophylline GOral steroid trial HNebulised ipratropium IReferral for long term oxygen therapy

36 Summary Completion Questions - possible fill in the gap words (given in College instructions) association association exclusion exclusion sensitivity sensitivity bias bias precision precision success success difficult difficult safety safety validity validity error error selection selection variables variables blinded questioned typical cohort randomised undertaken demonstrated reliability unrepresentative

37 Extending Matching Questions Extending Matching Questions (EMQ) in which a scenario has to be matched to an answer from a list of options. You may feel that there are several possible answers but you must choose only the MOST LIKELY from the option list. Extending Matching Questions (EMQ) in which a scenario has to be matched to an answer from a list of options. You may feel that there are several possible answers but you must choose only the MOST LIKELY from the option list.

38 THEME: Reduced Vision Option list: (A) Basilar migraine(F) Occlusion of the central retinal vein (B) Cerebral tumour(G) Optic neuritis (C) Cranial arteritis(H) Retinal detachment (D) Macular degeneration(I) Tobacco optic neuropathy (E) Occlusion of the central retinal artery Instruction: For each patient with reduced vision, select the single most likely diagnosis. Each option may be used once, more than once, or not at all. Items: 1A 75-year-old man, who is a heavy smoker, with blood pressure of 170/105, complains of floaters in the right eye for many months and flashing lights in bright sunshine. He has now noticed a curtain across the vision of his right eye.

39 Table/Algorithm Completion Format often found in guidelines to advise on management decisions. Format often found in guidelines to advise on management decisions. You are asked to select the correct answer to complete the table or algorithm box. You are asked to select the correct answer to complete the table or algorithm box.

40 Not requiring contraception Requiring contraception Combined oral contraceptive pill For each of the numbered gaps above, select ONE option from the list below to complete the algorithm, based on current evidence. Select ONE option only Medical management of menorrhagia:

41 ACopper intra-uterine device ACopper intra-uterine device BCyclical medroxyprogesterone acetate BCyclical medroxyprogesterone acetate CCyclical norethisterone CCyclical norethisterone DInert intra-uterine device DInert intra-uterine device ELevonorgestrel releasing intra-uterine system ELevonorgestrel releasing intra-uterine system FMefenamic acid FMefenamic acid GNonoxinol 9 GNonoxinol 9 HTibolone HTibolone ITranexamic acid ITranexamic acid

42 OPSCAN SHEET

43 Use only the pencil provided Use only the pencil provided Potential pitfalls Potential pitfalls Wrong ID number Wrong ID number Skip a question? Skip a question?

44 MCQ Summary Time is more important Time is more important 250 questions in 180 mins 250 questions in 180 mins 43 seconds per question 43 seconds per question Answer everything – no negative marking Answer everything – no negative marking Practice, practice, practice (go over weak areas) Practice, practice, practice (go over weak areas)

45 Practice A composite paper giving examples of multiple choice questions is published from time to time, and is available from the RCGP Sales Office A composite paper giving examples of multiple choice questions is published from time to time, and is available from the RCGP Sales Office Does not include many newer questions? Does not include many newer questions? Also, Also, PEP, PEP, Pastest Pastest

46 The End!!!!


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