QBase Anaesthesia 2: MCQs for the Final FRCA

549 Pages·1997·1.17 MB·English

by  Mark Blunt

Qbase Anaesthesia. Vol. 2, MCQs for the
title:
Final FRCA
Blunt, Mark.; Hammond, Edward.;
author:
McIndoe, Andrew.
publisher: Greenwich Medical Media Limited
isbn10 | asin: 1900151324
print isbn13: 9781900151320
ebook isbn13: 9780511043550
language: English
subject Anesthesia--Examinations, questions, etc.
publication date: 1997
lcc: RD82.3.Q23 1997eb
ddc: 617.9/6/076
subject: Anesthesia--Examinations, questions, etc.
Page iii
QBase Anaesthesia:
2
MCQs for the Final FRCA
Edited by
Edward Hammond MA BM BCh MRCP FRCA
Shackleton Department of Anaesthetics
Southampton University Hospital NHS Trust
Andrew McIndoe MB ChB FRCA
Sir Humphry Davy Department of Anaesthesia
Bristol Royal Infirmary
Contributors
Mark Blunt
John Isaac
Ravi Gill
Mike Herbertson
Sundeep Karadia
Elfyn Thomas
Gareth Wrathall
Page iv
Disclaimer:
This netLibrary eBook does not include the ancillary media that was
packaged with the original printed version of the book.
© 1997
Greenwich Medical Media Ltd.
219 The Linen Hall
162-168 Regent Street
London
W1R 5TB
ISBN 1 900151 324
First Published 1997
Apart from any fair dealing for the purposes of research or private
study, or criticism or review, as permitted under the UK Copyright
Designs and Patents Act, 1988, this publication may not be
reproduced, stored, or transmitted, in any form or by any means,
without the prior permission in writing of the publishers, or in the case
of reprographic reproduction only in accordance with the terms of the
licences issued by the Copyright Licensing Agency in the UK, or in
accordance with the terms of the licences issued by the appropriate
Reproduction Rights Organization outside the UK. Enquiries
concerning reproduction outside the terms stated here should be sent
to the publishers at the London address printed above.
The right of Edward Hammond and Andrew McIndoe to be identified
as authors of this Work has been asserted by them in accordance with
the Copyright, Design and Patents Act 1988.
The publisher makes no representation, express or implied, with
regard to the accuracy of the information contained in this book and
cannot accept any legal responsibility or liability for any errors or
omissions that may be made.
A catalogue record for this book is available from the British Library
Distributed worldwide by
Oxford University Press
Produced and Designed by
Derek Virtue, DataNet
Printed in Great Britain
Page v
Contents
Foreword vii
Introduction ix
Exam 1 1
Answers 21
Exam 2 49
Answers 71
Exam 3 99
Answers 121
Exam 4 149
Answers 171
Exam 5 199
Answers 221
QBase Anaesthesia on CD-ROM
CD-ROM System Requirements and Installation 249
Instructions
Page vii
Foreword
What do we know? We know that organisations responsible for setting
standards who are accountable to the general public must be able to
assess their trainees formally. One method is by the FRCA
examination which provides, from 1996, two (primary and final)
opportunities for summative assessment to complete local appraisal
and assessment. These examinations may present significant hurdles
in the shortened training programme as only four attempts at each are
allowed.
We also know that candidates may be unprepared for these hurdles.
There is currently little excuse for this predicament and many sources
of help and advice are available from College Tutors, viva practice
and writing questions under examination conditions. More difficult
perhaps is practice at MCQ papers which can be a threatening test of
breadth of knowledge.
First the candidate needs to learn and then test his knowledge and
MCQ technique ideally in a way which provides feedback leading to
improved performance. Prospective candidates are fortunate. This
book by Dr. Andrew McIndoe and Dr. Edward Hammond supplies 5
well constructed MCQ examinations of 90 questions covering the
syllabus required for the Final FRCA examination. Not only that,
explanations of the answers are provided with references so the
candidates can identify their areas of weakness and whether their
guesswork is a benefit or not. The accompanying interactive CD-
ROM allows detailed structured analysis of performance and exam
technique targeted to identify gaps in knowledge which should be
addressed.
I congratulate the authors. This book complements their earlier
publication on the primary examination and both provide a valuable
learning experience for trainees. They should be used repeatedly to
improve exam technique in answering MCQ papers in order to ensure
a good ma k in this part of the examination.
Practice makes perfect; we do at least know that practice with
feedback will improve outcome.
SHEILA M. WILLATTS
CONSULTANT IN CHARGE ITU,
BRISTOL ROYAL INFIRMARY
VICE PRESIDENT
ROYAL COLLEGE OF ANAESTHETISTS
JUNE 1997
Page ix
Introduction
The Examination
There are four sections to the Final FRCA examination: a 90 question
MCQ paper; a three hour SAQ paper; a fifty minute 'Clinical
Anaesthesia' Viva and a thirty minute 'Clinical Science' Viva. Each is
evaluated using a four point close-marking system. 2+ is awarded for
a good pass; 2 for a pass; 1+ a fail; and 1 is a poor fail. In order to
pass overall, a candidate must score 2,2,2,1+ or better and must
attempt all the short questions. Thus, relative success is required in all
parts of the examination.
The MCQ
Three hours are allowed for the multiple choice paper. This equates to
approximately two minutes per question. An enormous amount of
mystique surrounds the MCQ, partly because the College does not
release past examples of questions. So what is the best strategy to
ensure success? First and foremost it is a test of breadth of knowledge.
Each paper poses 450 individual problems in the form of 90 questions
with 5 parts. No other form of examination is able to cover such
ground within the time constraints of a three hour sitting. Thus, the
primary aim must be to cover the syllabus which is freely available
from the College and forms the basis of this book. Arguments against
an MCQ examination system are that it fails to differentiate between
rote learning and conceptual appreciation. It has been claimed that the
MCQ assessment itself generates cohorts of candidates who have
learned to perform well in that particular style of examination, failing
in its intended role of assessing competence. Whilst it is true that an
examination should transparently reflect the abilities of the candidate
without prejudicing those not versed with the system of examination,
the reality of the situation is that practice of the technique
undoubtedly improves performance. On the other hand the College
claims to make every effort to validate each portion of the
examination by retrospectively streaming each year group and
examining the performance of each band on every question. Those
questions that have poor discriminating power or a tendency to invert
the groupings are withdrawn. Consistency between year groups is
maintained by the use of tried and tested moderator questions that
allow inter-year comparisons to be made before defining the cut-off
point between success and failure within an exam group. Thus, it is
hoped that each candidates performance is assessed objectively,
independently and without bias. So what does this mean in terms of
technique? Firstly there can be no predetermined pass mark, or for
that matter a predetermined pass ratio, since each year group is
examined against past year groups. This means that a calculated
approach based on number of questions answered correctly is
fundamentally flawed. One should attempt as many questions as
possible to ensure the maximum chance of success. But what of
guessing? The College employs a negative marking system which
reduces the potential benefits of guessing. Thus if
Page x
the examination were presented in Ancient Greek, the majority of
candidates would score zero overall. But it is not presented in a
foreign language and the dilemma of uncertainty is therefore difficult
to negotiate successfully. Few candidates are truly aware of the
influences exerted by their own personalities on their examination
performance. The world is made up from wild gamblers, play safers
and every shade of grey in between these two extremes. It is perhaps
surprising that few candidates attempt any form of self assessment
prior to tackling a negatively marked paper.
The CD-ROM
The unique interactive CD-ROM enclosed with this book allows
detailed analyses of exam performance and technique to be achieved
at the push of a button. Examinations have been constructed in the
College style using material that covers the entire published syllabus.
The 500 questions (each with 5 parts) on the CD can be shuffled and
reassembled in an infinite number of exam combinations allowing you
to concentrate on specific subjects or to create new exams in the
College style. Each question is accompanied by explanatory notes and
a reference to an accepted and accessible revision source. When you
have completed an exam, the paper is marked before your eyes and
your performance objectively assessed, with the option to jump
straight to the notes accompanying those questions you may have
answered badly. Any exam can be saved to your hard disk or you may
simply print a report detailing your performance. The intention has
been to construct a versatile interactive safety net that can rapidly
identify holes in knowledge that require further revision. Try not to
concentrate on the overall mark scored, it is the areas of weakness that
matter more. Use of the unique confidence option automates the time-
honoured process of labelling answers with different coloured pens to
assess MCQ examination technique. Some will be surprised by their