Test yourself: MCQ and single best answer

  • Adrian Ben Cresswell
    Affiliations
    Adrian Ben Cresswell MD(Res) FRCS (Gen) Consultant HPB & General Surgeon, Hampshire Hospitals NHS Foundation Trust, Basingstoke, Hampshire, UK; Professor of Clinical Surgery, St George's University International Medical School; Clinical Editor, SURGERY
    Search for articles by this author
Published:December 01, 2021DOI:https://doi.org/10.1016/j.mpsur.2021.11.010
      For questions 1–4, select the statements which are true and which are false. The correct answers are given below.

      1. The extended surgical team

      • A
        A surgical care practitioner is a registered UK health professional with 2 years' accredited masters level training
      • B
        Surgical first assistants may undertake surgical procedures autonomously, following appropriate training and with appropriate supervision
      • C
        Physician Associates complete a 2-year degree course, but are unregulated by any professional body
      • D
        Advanced Clinical Practitioners are able to take consent for procedures which they may not be able to perform themselves
      • E
        Almost all patients, when surveyed, suggested that they would be happy to undergo a first hospital consultation with a member of the extended surgical team with indirect consultant supervision

      2. The effect of COVID-19 on surgical training

      • A
        Around 900,000 surgical training cases were lost between the start of the pandemic and May 2021
      • B
        Vascular surgery has been the specialty least affected by COVID
      • C
        Emergency surgical case numbers have been unaffected by COVID
      • D
        Training must be extended when COVID has prevented areas of the curriculum from being achieved
      • E
        A sharp decline in ARCP outcome 10 in the more latter phases of pandemic suggest a restoration of training opportunities

      3. Patient safety for the surgical trainee

      • A
        Up to 25% of all patients accessing healthcare suffer avoidable harm
      • B
        Around 5% of hospital deaths are avoidable
      • C
        Fifty per cent of surgical complications are avoidable
      • D
        The Safety II approach focuses on the recognition and reduction of risk
      • E
        According to NOTSS taxonomy, situational awareness comprises considering, selecting and communicating options

      4. Simulation for early years surgical training

      • A
        With constructive alignment, learning outcomes determine the content of a training intervention
      • B
        Fidelity of a simulator system refers to its realism
      • C
        High quality simulation relies on carefully controlled and consistent levels of difficulty and clinical variation
      • D
        Feedback allows for far more in-depth discussion of performance than that contained in a debrief
      • E
        Mastery learning requires standardized stepwise methods to performing procedures

      5. Patient safety and the surgical trainee

      • Crew resource management theories have led to NHS England's “Five Steps to Safer Surgery”.
      • Which of the following terms is used to describe the confirmation of recording of the procedure performed, the instrument and swab counts and discussion of any equipment issues?

      Single best answer – select one answer only

      • A
        Briefing
      • B
        Sign-in
      • C
        Timeout
      • D
        Sign-out
      • E
        Debrief

      6. Postgraduate surgical examinations in the UK and Ireland: an update

      • The GMC has now approved proposed changes to Section 2 examinations in all 10 specialties. The forward planning of these changes hinged around six factors. Which of these factors will be most positively influenced by a reduction in the number of patients involved in clinical examinations?

      Single best answer – select one answer only

      • A
        Maintenance of the standard
      • B
        Enhanced pre-examination calibration
      • C
        Shared responsibility for summative assessments
      • D
        Harmonization of the number of marking episodes
      • E
        Improved candidate feedback

      Correct answers

      • 1.
        A, C, D
      • 2.
        A, B, E
      • 3.
        A, B, C, D
      • 4.
        A, B, E
      • 5.
        D
      • 6.
        B

      Answers to incorrect statements

       Question 1

      • B
        Whilst surgical care practitioners may undertake some appropriate surgical procedures, surgical first assistants work purely in the operating theatre as an assistant to the operating surgeon
      • E
        Sixty-seven percent of patients stated that they would be happy to undergo first hospital consultation with a member of the extended surgical team under indirect supervision

       Question 2

      • C
        Even emergency surgical case numbers reduced to 85% of baseline during the pandemic
      • D
        Despite significant effects on elective training opportunities in many specialties, relatively few outcome ARCP 10.2 have been issued, with most trainees progressing without delay

       Question 3

      • E
        Considering, selecting and communicating options comprises decision making. Situational awareness relates to the gathering and understanding of information in order to project and anticipate future states

       Question 4

      • C
        Issenberg's ten features of high fidelity simulation encourage practice with increasing levels of difficulty and with clinical variation
      • D
        Feedback usually comprises quick and efficient comments from expert to novice, whereas a debrief is a much more in-depth exercise, often in groups, developing shared understanding or cognitive skills