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EXPLORING THE DIFFERENT TYPES OF EXAM

• written examinations e.g. MCQ, SBA’s, short answer
• making the best use of question banks
• oral examinations e.g. CSA Vivas

As mentioned previously the aim of examinations is to confirm that you have the knowledge to do your job. All formats are designed to test knowledge, what you know and how you can apply it: the application and synthesis of that knowledge. There are different types of questions, which aim to test different types of information. Some questions are scenario based (testing differential diagnosis or clinical reasoning), while others are looking for information and the understanding of processes. So, it helps to recognise how the questions are structured, what is behind the type of question, what language is commonly used, which bits of information are key for a relevant answer. Be sure to know what is being asked for in the question.

Different disciplines use different formats. The written exams include

• Multiple choice questions (MCQs)
• Extended matching (EMQs), 
• Single best answer (SBAs),

The three formats above are often trying to test differential diagnosis, clinical reasoning skills as well as knowledge

• Short answer - the information being tested requires more than one word.
• Long answer (one question per hour of the examination). This tests theoretical as well as clinical knowledge

Practising exam questions is clearly important as a form of preparation for the exam itself. It really helps to be familiar with the format, so you know what to do on the day. If your exam is a mixture of these question types, try to work out which ones you like the best and think why. If you really find the MCQ format hard, think why. Is it knowledge, or reading and interpreting the question, or trusting your judgement to find the correct answer?

Exam questions can also be used as a revision aid. Below is an activity that can broaden your revision subject matter and develop familiarity with the questions particularly in relation to MCQs.

 

A revision exam question strategy

1. Read the question sentence first as indicated above (i.e. the sentence that has the question mark after it). What is it asking for: information, diagnosis, management treatment?
2. Cover the answers if possible and do not read them.
3. If it is a factual question, try and come up with a potential answer. Check this against the list of answers to find the one that matches.
4. If it is scenario-based, then read the scenario with the question sentence in mind. Look for the key variables which affect potential answers: age, gender, environment, symptoms, previous history. Construct a mental image of a patient.
5. Answer the question without looking at the answers. 
6. See if your answer is right. If it is, look to see why. Tick, circle, highlight the elements of the scenario that gave you that correct answer. If it is wrong, look at the question again. Identify the bits of information in the scenario you missed that were key for the correct answer. 
7. THEN: Look at all the other potential answers. Ask yourself: Why are they wrong? When would they be right (e.g. if the patient were a different gender, age etc)? 
8. Create new questions to match the other potential answers.

This can seem laborious, but it is more effective as a tool for learning and revision, than just marking exam questions.

NB this strategy can be adapted to suit you – some people do like to look at the answers at point 2 - it guides their reading – for others it confuses them – work out what is best for you.

 

ACTIVITY 5: Find a question from one of the question banks relevant for you and try this strategy. It is a much more interactive and ultimately productive way of using the question banks 

 

Reading blocks of text

If you find it hard to locate the relevant information in a scenario, it can help to break the text down into sections.

ACTIVITY 6: Go to the additional resources section Page 21 and look at the example. Try working it through it - then practice using your own question banks and gain a better understanding of the way the questions are structured

 

Oral examinations

Oral examinations obviously make different demands on people. They are testing knowledge but also how you perform in a clinical setting. And you are being observed.  Exams such as the CSA are assessing data gathering skills, i.e. history taking; interpersonal skills how you interact with your patients; and management skills, how you manage the patient’s illness.

Vivas assess knowledge and how you make a clinical judgement, how you use evidence-based practice and how you can defend your decision - they are meant to be challenging.

Both types of examination are also assessing your confidence in yourself and your ability, and very importantly, they are assessing what you do when you do not know the answer! Be confident in your knowledge and confident to say you do not know!

Many of the suggestions mentioned for the written exams work for this type of assessment too. But in this instance practice with others definitely helps. If you are taking the CSA/ RCA, or a Viva practice as much as you can in your daily clinic – use your clinical experience and practice / rehearse with others – colleagues, clinical supervisors and even family  

 

A note on on-line examinations

In recent months there have been many rapid changes in the examination system due to Covid. Some exams such as the AKT the format is the same, others have switched from paper and pencil to an on-line format and are now conducted in people’s homes or place of work. This can present new challenges as techniques people have practiced and used when taking exams are no longer available; for example, annotating the question, or making quick notes or diagrams on the question paper. It is even more advisable in these changing times to get as much information as possible in advance of the examination date, and then practice the new or different exam formats as much as you can.

 

Remember! Planning and preparation promotes improved performance