Clinical Governance ( Platinum ) - SBA

1. The effectiveness of MIRENA vs oral progestogens for treatment of heavy menstrual bleeding was carried out in 25 hospitals across UK. A total of 4000 women were recruited for the trial. In each participating hospital, a list with numbers that had been generated by a random programme was put up. If a woman was included in the study, she was allocated to the next available number on the list, which was then crossed off. If the number was even, the patient was treated with MIRENA. If the number was odd, the patient was treated with oral progestogens. At the end of the observation period, it was estimated how many patients in two groups had improvement in menorrhagia.
Which of the following options are correct?

A. The study was non-randomised.
B. The study was double blinded.
C. The study used a concealment allocation.
D. The study was multicentric.

2. Which of the following aspects of randomisation is incorrect?

A. It provides high quality evidence on the effect of an intervention.
B. It ensures adequate distribution of patient characters between treatment and control group.
C. Any unknown factor that could influence the effect of an outcome occurs in the same frequency in the two groups due to randomisation.
D. It cannot be used to determine cause and effect relationship

3. A meta-analysis is a statistical analysis that combines the results of multiple scientific studies. Which of the following reduce the credibility of a meta-analysis?

A. Only randomised studies are included
B. A separate analysis of randomised and non-randomised studies
C. A separate analysis of studies with significant and non-significant results
D. Only publications in English are included.

4. As part of appraisal/ARCP trainee is expected to get a 360degree feedback. Which among the statements below best describes this?

A. Trainee is expected to get feedback from midwives and more senior doctors.
B. Trainee is expected to get feedback from more senior doctors.
C. Trainee is expected to get feedback from nurses,midwives, anaesthetist, junior and senior doctors.
D. It is only necessary that they get feedback from other trainees at the same levels.

5. Which of the following statement is incorrect about appraisal.

A. Encourages open informal dialogue
B. Encourages discussion of Personal development plan.
C. Tests that competencies have been met against a predetermined (minimum) standard
D. Addresses concerns supportively

6. Which of the following is incorrect about Revalidation.

A. Assure patients and public, employers and other health care professionals that licensed doctors are up to date and fit to practice.
B. Tests concordance with principles and values set out in Good Medical Practice
C. Occurs over a five-year cycle.
D. Revalidation is for consultants alone and junior doctors are excluded from this process.

7. Which of the following are not part of GMC framework of providing evidence for structured appraisal?

A. Knowledge skills and performance
B. Safety and quality
C. Communication, partnership and teamwork
D. Leadership

8. Which of the following are not part of Bloom’s taxonomy?

A. Attitude
B. Practise
C. Reflection
D. Knowledge

9. For aWorkplace based assessment to be effective, it should be tested for its validity, in this regard, what does validity mean?

A. The degree to which the test measures what it is supposed to be measuring.
B. Ability to produce the similar results under consistent conditions.
C. Degree to which a test can be done conveniently.
D. Degree to which a test can be accepted by its recipients.

10. The goal of a formative assessment is to gather feedback to guide improvements in the ongoing teaching and learning context. In this regard which of the following statement is untrue?

A. This is used to keep track of a student's progress through a particular course of learning
B. The information given to the student needs to be of a kind that tells the student what they are doing well and what they need to do to improve.
C. It is not used in pass/fail decisions.
D. It is referred to as 'Assessments of Performance' (AoPs)

11. Modified Angoff method is a useful tool of assessing standard setting in examination used to certify or license practitioners. Which of the following options are incorrect regarding Modified Angoff method?

A. Candidates are judged by comparing their performance with regard to other candidates.
B. It involves defining a ‘Minimally competent practitioner’ (MCP) and considering how many of 100 MCPs would answer the question correctly.
C. Reality check is performed, score distribution is reviewed and passing point is selected from 95%confidence interval.
D. Standard is maintained through statistical equating.

12. Which of the following is not a formative assessment.

A. OSATS
B. CbD
C. MiniCEX
D. MRCOG OSCE.

13. With regard to standard setting for assessments there are two approaches to deciding this and they are the ‘norm’-referenced approach and the ‘criterion’-referenced approach. Which of the following options are correct with regard to ‘criterion’ referenced approach?

A. Students are compared to each other.
B. Examinee's ability will influence the standard.
C. Standard is not known in advance.
D. Standards are content and level related.

14. All of the following are components for clinical governance except:

A. Clinical effectiveness
B. Clinical organisation
C. Clinical audit
D. Education and training.

15. With regard to the steps of guideline development which of the following options are incorrect.

A. Identifying and refining the subject area is the first step
B. Convening and running guideline development groups
C. On the basis of systematic reviews, the group assesses the evidence about the clinical question and translates it to recommendation.
D. An internal review of the guideline is done and ratified.

16. The CPD programme is an essential component of appraisal and revalidation processes. It covers all the below learning areas except:

A. Local job-plan related clinical and non-clinical educational activities.
B. Contribution to the national or international agenda
C. Specialty-related activities which derive from a personal interest
D. Complaints and litigations addressed.

17. All of these options are current national level audits undertaken except:

A. RCOG Each Baby Counts
B. MBRRACE
C. UK Obstetric Surveillance System.
D. Saving babies’ lives.

18. All the below options are reasons for a clinical audit failure except:

A. Lack of understanding of hospital/community-based processes
B. Failure to involve stakeholders
C. Lack of financial support
D. Unable to effectively publicise findings.

19. All of the following are components of Risk management except:

A. Risk identification
B. Risk analysis
C. Risk reversal
D. Risk control.

20. With regard to incident reporting in obstetrics, which of the following options do not require reporting?

A. Stillbirth >500grams
B. Blood loss of more than 1000 ml
C. Cord pH <7.05 arterial or <7.1 venous
D. Term baby admitted to neonatal unit.

21. With regard to incident reporting in Gynaecology, which of the following do not require reporting?

A. Unexpected operative blood loss >1000 ml
B. Moderate/severe ovarian hyperstimulation
C. Procedure performed without consent
D. Unplanned return to hospital within 30 days

22. Which of the following are not organisational reasons for incident reporting?

A. Delay following call for assistance
B. Conflict over case management
C. Medication error
D. Admission to ITU.

23. One way of identifying what potentially could go wrong is to use a tool called Failure Mode and Effects Analysis (FMEA). With regard to FMEA tool, which of the following option is incorrect?

A. Examine a process in detail and outline every step and identify ways in which any of the steps might go wrong.
B. Identify what could be the underlying causes (contributory factors).
C. Rate each contributory factor in terms of its frequency or likelihood of occurrence
D. All contributing (risk) factors are important and hence cannot be prioritised over the other.

24. All of the following are sources of identifying ‘Risk’ in Obstetrics and Gynaecology except

A. Incident reporting
B. Complaints and claims
C. Clinical audit
D. Outpatient clinics.

25. With regard to NHS complaint procedure, which of the following option is not true?

A. Local resolution – the patient first lodges a complaint locally. In most cases the matter will be resolved at this stage
B. The Ombudsman undertakes independent investigations into complaints that have not been resolved locally.
C. Judicial review is a procedure that allows a court of law to review decisions made by public bodies.
D. Patients do not have the right to make a claim for judicial review if they think they have been directly affected by an unlawful act unless they are supported by the Ombudsman.

Clinical Governance ( Platinum ) – SBA

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