let’s talk about the exam… - oiiq · let’s talk about the exam… chantal lemay and anik...
TRANSCRIPT
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Let’s talk about the exam…
Chantal Lemay and Anik Desrochers | 08.11.16
Espace étudiant -
Congrès 2016
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Why a professional exam?
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Why a professional exam?
3
> Public protection
> Assess aptitude to practice
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Aptitude to practice
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> Functional component
> Professional component
> Contextual component
5
Aptitude to practice
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> Scientific field
> Communication field
> Moral and prof. ethics field
> Legal field
> Organizational field
> Operational field
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Functional component
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> Clinical assessment (30%)
> Clinical interventions (60%)
> Continuity of care (5-10%)
7
Professional component
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Contextual component
40 to 44 clinical situations:
> Mother-baby and pediatric care
> Medical care
> Surgery care
> Geronto-geriatric care
> Psychiatry and mental health care
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Demonstrate:
> Knowledge
> Skills
> Clinical judgment
9
Aptitude to practice
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> Name the clinical manifestations of a flu-like
syndrome?
> Knowledge recall
> What is your assessment finding?
> Analysis and interpretation
10
Aptitude to practice
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How do you prepare for the exam?
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Preparing… it’s already done!
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Strategies to better answer questions
Scenario:
> Identify key information
> Analyze and interpret data
Question:
> Identify the objective of the question
Answer:
> Answer accurately and with discernment
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> Consider all the scenarios
> Do not extrapolate
> Highlight significant information
> Use visual cues***
Identify key information
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> Age
> Timing of events
> Health history
> Particularities
> Follow the sequence of events
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Identify key information
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Analyze and interpret clinical data
> Explain the meaning of relevant and critical
data
> Make connections
> Between clinical data
> With acquired knowledge
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> Identify key words
> Find the meaning of the key words
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Identify the objective of the question
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Determine the best answer
The answer must reflect clinical
judgment and demonstrate the ability
to exercise.
The answer must contain the
appropriate vocabulary.
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> Establish the
conclusion of the
analysis and
interpretation of clinical
data.
> Formulate the answer
based on this finding and
the objective of the
question.
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Identify data: Example – Ms. Gascon
Ms. Gascon, age 48, was admitted for cellulitis in her left forearm.
Her medical history is: type 2 diabetes, hypertension, dyslipidemia.
Her BMI is 25 and she is not a smoker.
…
Ms. Gascon eats a piece of cheese and two crackers at 21:00.
….
Question: Will you agree to do as she asks?
Give the rationale for your answer.
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Identify data: Example – Ms. Gascon
At 5:00 the following day, you see that Ms. Gascon is trembling and
that her skin is clammy. She tells you that she is having palpitations.
You check her blood glucose with a glucometer and it is 3.0 mmol/L.
Ms. Gascon drinks 175 ml of orange juice.
Fifteen minutes later, Ms. Gascon’s blood glucose is 3.6 mmol/L.
She says to you: “Can you get me a cracker with peanut butter?
That’s what I take to get my blood sugar level back to normal when
I’m at home.”
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Analyze and interprete data: Example – Ms. Gascon
21
3,0 mmol/L
175ml orange juice
15 minutes later
3,6 mmol/L
Cracker with peanut butter? Proteins slow down absorption
Hypoglycemia
15g of simple carbohydrates
Expected increase in blood sugar
Hypoglycemia (< 4,0 mmol/L)
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Question 1
Will you agree to do as she asks? Give the rationale for your answer.
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Identify the objective of the question: Example – Ms. Gascon
The answer must indicate a CLINICAL DECISION.
The answer must GIVE THE RATIONALE or EXPLAIN the decision
to agree or refuse to do as Ms. Gascon asks.
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Determine the answer: Example – Ms. Gascon
Conclusion drawn from the analysis and interpretation of the
information
Do not give Ms. Gascon the food that she asks because her blood
glucose is still below 4,0 mmol/L, 15 minutes after she was given a
first serving of 15 g of simple carbohydrates.
Giving foods that contain protein would slow the body’s absorption
of carbohydrates.
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Determine the answer: Example – Ms. Gascon
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> The answer must indicate a
CLINICAL DECISION.
> The answer must GIVE THE
RATIONALE or EXPLAIN the
decision to agree or refuse to
do as Ms. Gascon asks.
> Giving food that contain protein would
slow down the body’s absorption of
carbohydrates.
> Ms. Gascon must receive another 15 g
of simple carbohydrates.
> After a serving of 15 g of simple
carbohydrates, Ms. Gascon blood
glucose is only 3.6 mmol/L.
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Determine the answer: Example – Ms. Gascon
Question 1
Will you agree to do as she asks? Give the rationale to your answer.
NO
Giving foods that contain protein would slow the body’s
absorption of carbohydrates.
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Identify the objective of each question - examples
What is your assessment findings?
______________________________
Give a rationale of your answer using
two specific clinical manifestations.
_______________________________________
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> Data must be obtained from
the clinical scenario.
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What signs and symptoms would
indicate a complication?
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The answer must specify the
characteristic that would indicate
the abnormality
> Capillary refill time
> Increase in capillary refill time
Identify the objective of each question - examples
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What will you check…
Name three elements…
List your three interventions in the
execution order…
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The answer should always
reflect what is most important in
the situation:
> Bruise at the venous
puncture site
> State of consciousness
Identify the objective of each question - examples
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Identify a sign that would indicate that
your interventions have been
effective.
What do you do?
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The answer must be specific:
> Peristalsis
> Return of peristalsis
> Assess the wound
> Assess the bleeding by
marking the dressing
Identify the objective of each question - examples
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What is your assessment finding?
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> The answer must identify
the problem which is the
most probable in the
situation
Identify the objective of each question - examples
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Give a rationale for your answer.
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The answer must be based on
clinical, scientific, ethical or legal
considerations
> Restraints should be
avoided.
> The family is at bedside
and can monitor patient.
Identify the objective of each question - examples
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Objective: Identify an actual problem or a potential problem
Actual
problem
Potential
problem
Suspected
Confirmed
Manifestation(s) Wording
Present
Present
Absent
Possible hypoglycemia
Hypoglycemia
Risk of hypoglycemia
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Enter a nursing directive in the TNP.
> The directive must include, if appropriate:
> the frequency or duration (e.g. : q 2 h, for 24 h)
> if the activity is reserved for the nurse (e.g. : Nurse to assess)
> to whom the directive is given (e.g. : client/family/PA)
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Objective: Determine or adjust TNP
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Answer accurately and with discernment
Expected answers: Uterine contractions
> Contractions of the uterus
> Contractions
> Uterine cramping
> Muscle cramping
> Spasm of the uterus
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> Transmit a clear message
> Write legibly
> Avoid acronyms
> Use a professional vocabulary
> Be concise
> Beware of inaccuracies
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Answer accurately and with discernment
> Physical examination of
the urinary track system
vs palpation of the
bladder.
> She has hypotension
because her blood
pressure is high.
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New items format - S2017
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Change in items format
> Cohort size
> Correction activity
> Duration
> Time
> Cost
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> Gradual introduction of MCQ:
> September 2017 = 1/3
> March 2018 = 2/3
> September 2018 = 3/3
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Change in items format
> No change:
> Evaluative approach
> Scenarios
> Questions
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> Preparation Guide for the
Professional Examination
> Supplement 1 (Scenarios)
> Supplement 2 (Questions)
> Supplement 3 (Answers)
> Complement (MCQ)
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Determine the answer: Example – Ms. Gascon
Question 1
Will you agree to do as she asks and why? Choose only ONE answer.
NO
Giving foods that contain protein would slow the body’s
absorption of carbohydrates.
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Determine the answer: Example – Ms. Gascon
Question 1
Will you agree to do as she asks and why? Choose only ONE answer
A. Yes, because carbohydrates have increased blood sugar and reduce
symptoms
B. Yes, because protein intake helps prolong the effect of carbohydrates
C. No, because this snack would slow the absorption of carbohydrates
D. No, because her blood sugar is still below 4,0 mmol/L
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Change in iterms format
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> Multiple choice question (best answer) :
> 4 to 5 answers options
> More than one answer option possible
> No true or false
> No negative choice
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Correction of the exam
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> Expected answers predetermined
by the committees
> Supervision of correctors by the
members of the committees
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Correction of the exam
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One answer per line
Answer: 3 points
1. Frequency at which Tylenol is taken
2. Time of last dose
3. Number of pills taken
Answer: 2 points
1. Frequency at which Tylenol is taken and time of last dose
2. Number of pills taken
3. Reason why he takes only Tylenol
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The answer fits on the line provided
1. Pulmonary auscultation
1. I will very quickly do a pulmonary
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1
1
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Day of the exam
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> All personal items under the chair
> No headgear (hats, caps, etc.)
> No watch
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Day of the exam
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Day of the exam
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> 2 booklets = one exam
> 130 to 135 open-ended short
answer questions
> 40 to 44 clinical situations
> 1 situation = 100 points
> Q = weighting / 100 points
49
Day of the exam
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> Registration confirmation
> Place
> Time
> Etc.
> Two exam periods of
2 h 45
50
Day of the exam
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Exam results
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> Nine weeks delay
> Report card:
> Result: Pass / Fail
> Score: %
> Passing score: 55%
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Results
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53
Questions?