GP ST Stage 3 : Hot Topics for 2010 Assessments
All of these tasks cover potential areas for Stage 3 assessments this year.
GP Stage 3 Assessment : Written Prioritisation , Practice Task 1 :
You have 5 minutes to read an 25 minutes to complete the answers
You are a GP Trainee in surgery, about to finish your morning surgery. Rank the following in order of importance, giving reasons, and discussing the issues for each one. You have 5 minutes to read this information, and then 20 minutes to write your answers.
A. You are asked by one of the receptionists to move your car from a position that it is blocking the car belonging to the duty doctor this morning who is about to set off for an emergency visit to see a terminally ill patient.
B. You are about to finish surgery this morning, but the nurse in the adjascent room calls you to help out - her patient suddenly developed SOB just after he was given the flu jab by the nurse. He said he was allergic to egg after he developed a rash.
C. You need to finish off you application for your next job online and the deadline is 1800 hrs today.
D. The mum of a 6 yr old boy you went to visit yesterday has called to speak to you because he has very high temperature again. She is wondering whether you could prescribe some tamiflu for him as one of his friends has just been diagnosed ti have swineflu.
E. Your educational supervisor is waiting to see you to discuss the cases you saw yesterday.
Which of the above did you find the hardest to rank and why?
What have you learnt from this exercise?
GP Stage 3 Assessment : Written Prioritisation , Practice Task 2 :
You have 5 minutes to read an 25 minutes to complete the answers
You are an FY2 in a busy surgical ward. You have just come back from lunch.
A. Your registrar has set aside some time to complete one of your assessment forms on the computer this afternoon. You are aware that he is waiting for you to page him.
B. The charge nurse tells you that the patient who you reviewed 2 hours back post cholecystectomy, has a very high temperature and become breathless.
C. You brother just leaves gives you a missed call on you mobile.
D. You find that your consultant has just come back from theatre to see a new patient with RIF pains. He wants him to be clerked as soon as possible while he organises emergency surgery.
E. You are paged by the mortuary to come and do a cremation form. They have been waiting for you since this morning and the relatives are getting impatient.
Which issues did you find the hardest to rank and why?
What have you learnt from this exercise?
GP Stage 3 Assessment : Written Prioritisation , Practice Task 3 :
You have 5 minutes to read an 25 minutes to complete the answers
You are an FY2 doig a 3 month placement in a GP surgery. You are about to start your afternoon surgery.
A. The Coroner's Office leaves you a message to call them back as soon as possible regarding the death of a patient you had last seen 2 weeks back.
B. You realise that you have a lot of blood results in you folder on the computer that you need to action. You were planning to do them before starting your surgery.
C. You have received an urgent fax from the hospital advising you to prescribe treatment for a 64 year old woman diagnosed to have paroxysmal atrial fibrillation. You had referred her yesterday when she came to see you complaining of palpitations.
D. Your trainer wants to qiuckly discuss a patient's management with you just before you start your surgery.
E. You are asked to see an extra emergency patient at the beginning of your surgery. The receptionist calls you up to make this request but also informs you that the patient had been waiting for 2 hours to see the emergency GP who is tied up with a patient with chest pains.
This patient is threatening to make a complaint and is very angry.
Which was the most difficult task to prioritise and why?
What have you learnt from this exercise?
GP Stage 3 Assessment : Written Prioritisation , Practice Task 4 (GP ST Stage 3 Course):
You have 5 minutes to read an 20 minutes to complete the answers
You are a GP at the beginning of your surgery on a Monday afternoon. Rank the problems:
A. There is a patient in the waiting room who has been waiting for over 2 hours. The reception staff inform you that he is clammy and out of breath. The on call doctor is still tied up with a complicated house call.
B. There is a 40 yr old patient on the phone asking to speak to you. He has a cough and fever for the past 2 days. Thinks he might have swine flu.
C. One of the partners wants to see you in the next 15 mins to finalise the duty rota for next week before he leaves in 30 mins.
D. You have a referral letter to dictate from the morning surgery for a patient needing a routine endoscopy.
E. There is a large pile of blood results in your tray for you to check.
GP Stage 3 Assessment : Clinical Meeting, Practice Task 1
You have just become aware of the outbreak of pandemic flu. The government has not thought of a help line as yet to offer advice to patients with flu- like symptoms and fever. You are getting huge numbers of calls from your patients every day and this has become very difficult to handle. A lot of them have simple viral infections but are worried that it could possibly be the deadly flu that can kill. For this reason, it has become incredibly difficult to cope with appointments - you simply dont have enough slots to offer your patients. Many patients are being seen with very simple viral illness whereas others with very serious problems are not getting appointments.
An emergency clinical meeting is called to discuss the problem and how to best solve it.
GP Stage 3 Assessment : Clinical Meeting,Practice Task 2
Your surgery has been very busy triaging hundreds of patients with flulike symptoms on the phone, after the recent outbreak of swine flu. You don't want everyone to come over to the surgery as they would then potentially infect everyone else in the waiting room. Last week, one of your colleagues spoke to the mum of a 3 yr old boy who had a very high temperature. The mum stated that he was burning up but was alert and playful. This patient later became drowsy and an ambulance had to be called. He has diagnosed to have meningitis and resuscitated by the paediatric team at the hospital. Fortunately he survived but is still admitted. The parents felt angry that your practice has let them down.
GP Stage 3 Assessment : Clinical Meeting, Practice Task 3
Your surgery is located very close to the local hospital. You have done an audit that shows that a lot of your patients are going straight to AE with their minor ailments rather that coming to see one of you. You also realise that you are not being able to provide appointments which are early enough for your patients. There is particular shortage of daily emergency appointments. This results in patients going to the hospital rather than come to you.
This is costing the PCT a lot of money and they have advised you to look into ways of improving this problem.
GP Stage 3 Assessment : Clinical Meeting,Practice Task 4
During the recent adverse weather, a lot of your staff have not been able to turn up at work on some of the days due to severe snow. This includes some GPs as well as clerical and administrative staff. As a result it had become extremely difficult to cope with the pressures, even after the advrse weather had settled. A lot of your patients asked for home visits during the snow and there were just not enough doctors. Many were not able to attend surgery and missed appointments. These appointments had to be made in the following weeks on top of your fully booked surgeries.
This is a meeting to come up with an adverse weather policy for your surgery that could help in addressing the potential problems when it happens again.
GP Stage 3 Assessment : Clinical Meeting,Practice Task 5
You see a patient who was prescribed prednisolone 30mg daily from the hospital for polymyalgia rheumatica 1 year back. After the discharge letter was received, one of your staff put it on his repeat prescription without noticing what it said with regards to tapering this off over the following 6 months. The patient kept asking for repeat prescriptions every month without seeing a doctor. These were being signed and dispensed (all of you might have contributed to this) until the patient came to see one of you with weight gain and heartburns.
GP Stage 3 Assessment : Simulated patient encounter :
A 35 yr old man comes in CO generalised aches and pains and a mild fever and sore throat. He has had this for the past 2 days. He has just been assessed and examined by the nurse practitioner who is convinced that he has a simple viral infection. His temperature was 37.2, chest clear, throat slightly red. He wants to see a doctor to discuss whether it could be swine flu. He is otherwise fit and healthy and smokes 15 cigarettes every day. The nurse passed him on to you as an emergency appointment to discuss viral infections and swine flu.