Example Ranking Question

Whilst working in the Medical Assessment Unit (see also AAU), you treated a patient for an asthma attack. The patient made a good recovery and was discharged from hospital last week. Today, you receive a short complimentary message from the patient through social media, thanking you for your care. The patient also sends you a friend request on social media.

Rank in order the following actions in response to this situation (1= Most appropriate; 5= Least appropriate)

A. Ignore the message and friend request on social media

B. Print an anonymised copy of the complimentary message for your development portfolio

C. Respond through social media, asking how the patient's asthma has been since discharge

D. Talk to your educational supervisor* to reflect on the situation

E. Decline the friend request, politely explain via social media that any further contact would be inappropriate

Answer: ADBEC

Rationale: This question is about understanding the boundaries of patient contact via social media in the context of GMC social media guidance. The most appropriate response would be to simply ignore the request (A). If unsure what to do, the next most appropriate choice would be to seek senior advice (D). Whilst it would be nice to place the comment in a portfolio (B), this is less appropriate than the first two options and may require consent. Finally, entering into discussion may lead to further interaction (E) and discussing medical conditions via social media (C) is inappropriate.

 

Example Multiple Choice Question

You are attending to a seven year old child, Aidan, whose mother has brought him to hospital because he has a high temperature. Aidan is very agitated, and is screaming and crying very loudly. As you attempt to examine him, Aidan becomes physically aggressive and tries to kick you.

Choose the THREE most appropriate actions to take in this situation

A. Explain to Aidan why you need to examine him

B. Ask Aidan's mother to help you to examine him

C. Advise Aidan's mother to bring Aidan back later when he has calmed down

D. Ask one of the nursing staff to help Aidan's mother to restrain him

E. Ask Aidan why he is upset

F. Continue to examine Aidan as best as you can

G. Tell Aidan that you will give him a sticker if he calms down

H. Tell Aidan that his behaviour is unacceptable

Answer: ABE

Rationale: This scenario describes an unwell child, who despite agitated behaviour, requires assessment. The best approach to management would be calm and engaging both mother and child. Hence, the best option would be to explain to Aiden that you need to examine him (A), and to ask his mother to help with this (B). Asking Aiden why he is upset may also be helpful and allow you to address specific concerns (E).

Aiden is agitated and pyrexial and he requires urgent assessment. To send him away until he has calmed down would be inappropriate and potentially dangerous (C). Asking the nursing staff to restrain Aiden is likely to upset him more and make the situation more challenging (D). Without trying to calm Aiden down, you are unlikely to be able to examine him successfully (F). Offering stickers or treats for good behaviour may not be appropriate as it may not be a treatment style that his parents and carers appreciate (G). While the patient is unwell and upset telling him that his behaviour is unacceptable is slightly harsh, and unlikely to be productive in this situation (H).

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