Question:

What do you know about problem-based learning (PBL) or team-based learning (TBL)? How does it
compare to traditional teaching methods?

Test Question – Learn About School

Follow Up Question:

- What are some advantages to PBLs/TBLs?

- What are some disadvantages?
- What is your preferred learning style?
- How do you learn?

Points to hit:

- Able to describe TBLs and PBLs

- Able to explain that TBLs and PBLs require more independent learning
- Able to explain that TBLs and PBLs are more interactive compared to didactic situation in
traditional learning
- Able to list advantages
o Practical view of medicine
o Good for those with initiative
o Smaller group teaching
o Develops teamwork
o Independent learning and personal research will allow students to remember fine
details better
o Early exposure to real-life issues
- Able to list disadvantages
o Quality of learning depends on quality of problem ie. Bad programme can be useless
o Some topics need to be taught formally
o Gaps in knowledge will affect performance
o Relies on good facilitator
o Students who prefer academic way of learning may struggle
o Requires team to work together efficiently, poor teamwork can result in everyone
suffering
- Able to describe learning style and able to reflect on what works and what does not
Question:

You are a junior doctor on a general medical ward. A patient has a fluid overload from heart failure
and your consultant asks you to give Lasix (a diuretic) to assist in removing some of the fluid. You
accidentally prescribe Losec (a drug for gastritis) instead without recognising your error. The next
day, you find out that the patient was admitted to intensive care overnight with worsening fluid
overload because you prescribed Losec instead of Lasix. You identify your error although no one else
has noticed what occurred. What are the issues here?

I Fucked Up Question

Follow up questions:

What would you do in this scenario?

Points to hit:

- Immediate fail if you would say nothing or if you attempt to cover up your error
- Admits error may have been the cause of the patient’s deterioration
- Tells supervising consultant what happened
- Does not pass blame to someone else ie. Nurse who administered the
medication/pharmacist who gave the wrong one
- Notifies the hospital and mentions that hospitals have a system to prevent things like this
from happening
- Self reflects to identify what caused this error and makes an effort to avoid having this occur
again
- Tells the ICU team who is now taking care of the patient about the error to make sure it isn’t
exacerbated
- Discusses the importance of letting the patient know what happened

Remember AARR – admit, apologize, rectify, reflect

Question:

You are a pharmacy student doing a clinical rotation on the surgical floor at a community hospital. It
is early in the morning and after rounding, the surgical team members have departed for the
operating room. You are about to go into a room to speak with Ms. Carol about her diabetes
medication when her shift nurse pulls you aside and informs you she gave Ms. Carol 5 times the
regular ordered dose of her blood pressure medication 20 minutes ago. The nurse has tried to page
the surgery team twice but has been unsuccessful. No prescribed changes were made to Ms. Carol’s
medication record over the past 24 hours. You are the first person to be notified of this new
information and the nurse tells you that Ms. Carol is currently stable and comfortable. What are the
issues present here?

I Fucked Up Question

Follow up questions:

What would you do in this scenario?

Points to hit:

- Red flag: Ignoring or attempting to cover up this mistake results in immediate 0

- Checks patient to make sure they are stable
- Mentions patient should be monitored
- Tells supervising consultant what happened
- Makes sure the surgical team knows about the error to make sure it isn’t exacerbated
- Discusses the importance of letting the patient know what happened
- Mentions the importance of trust
- Apologises to patient
- Mentions need to reflect on why error occurred
Question:

Two deaf women, with masters degrees in psychology want to have a baby. They decide to choose
an embryo that has a genetic cause of deafness by carefully selecting their donor. Their rationale was
that they wanted a deaf child who would participate more fully in the community that these two
women belonged to. Discuss all the ethical issues here, outlining and defending your views.

Ethical Question
Points to hit:

- No right or wrong answer, at least one point will be given for having any opinion at all
- Couples should have the right to procreate with whomever they want (issue of selecting donor)
- Deafness is only a disability from an outside viewpoint
- Genetic tests should be offered for couples looking to have children, in order to allow them to select
the child who will start life with the best opportunity of having the best life
- Couples should be free to refuse genetic testing of themselves or their offspring
- Freedom of choice includes freedom to do what others disapprove of or judge wrong, provided the
exercise of freedom does not harm others
- Lesbian couples have the right to have children

This question is designed to test your ability to think empathetically

Question:

You are an intern on a children’s ward. You were on the morning ward round and your consultant
prescribes a hepatitis B vaccine. The vaccine was written on the medical chart to be given later in the
day. The mother arrives at the hospital to see the nurse about to administer the vaccine. After being
informed it is a hepatitis B vaccine, the mother refuses and starts arguing with the nurse. The mother
has researched vaccines on the internet and believes they are linked to autism. What would you do
as the child’s doctor in the scenario?

Patient Interaction Question

Points to hit:

- Acts as patient advocate, discussing benefits of vaccination

- Admits there are risks but they are exceedingly small compared to overall benefit to the child
and the community
- Discusses communication techniques to calm mother and educate the mother about the
vaccine
- Recognises that the mother should have been informed prior to the administration of the
vaccine
- Recognises the autonomy of the parent as the child’s decision maker
- Demonstrates appropriate respect for the patient’s point of view on vaccination (is not overly
judgemental or condescending of the parent’s view on vaccination)
Question:

You are a paediatrician who is looking after a child who has come in for vaccinations. The nurses tell
you that the mother is quite pedantic and is constantly fretting over every little change in her child’s
appearance. You go to look at the child’s charts and notice that the nurse had administered an extra
vaccine that was not planned. The administration of this vaccine will have no serious effect on the
child’s health. What do you do? Outline your actions.

Someone Else Fucked Up Question

Follow up questions:

Would you tell the mother of this error at risk of causing the already anxious mother further distress?

Points to hit:

- Immediate 0 if attempts to hide error

- Tells mother that mistake was made
- Apologizes to mother
- Attempts to explain to mother that mistake will do no harm to her child to comfort her
- Admits responsibility
- Does not attempt to blame nurse
- Makes effort to understand why error was made and suggests how to prevent future
recurrence
Question:

You are a junior doctor on a medical ward. You hear a patient arguing with a nurse in one of the
bays. The patient accuses the nurse of taking his pain medication away from him. The nurse
maintains there was no pain medication in his bag and doesn’t know what he is talking about. What
would you do in this situation?

Dealing With Patients – Unique situations that you should know (Conflict Management)

Points to hit:

- Effectively diffuses the situation by suggesting that the nurse leave the patient bay to allow
the patient some time to calm down
- Discuss the events with both the patient and the nurse to obtain both points of view
- Does not make any false accusations about either patient or the nurse
- Reports the situation to supervisor for further investigation
- Ensures that a different nurse looks after the patient as there is now established conflict
between nurse and patient
- Suggests review of hospital policy for the storage of patient medications especially
controlled drugs
Question:

An African man is brought into hospital unconscious, following a high speed truck accident. During
routine blood tests, it is discovered that he has a highly infectious and deadly disease. You and the
team rush to the patient’s bedside. The nurse prepares to inject the cure when the patient suddenly
wakes up. He expresses that he does not wish to receive the injection and is adamantly demanding to
return home to his village of 50,000 people. The nurse looks at you expectantly, as if waiting for the
signal to give the injection. What do you do?

What About Now Question

Follow up questions:

What if it was a village of only 500 people?

What if it was not a deadly disease?

Points to hit:

- Acknowledges ethical principle of autonomy is violated if injection is given against consent

- Acknowledges that letting man go infect a village is unethical
- Acknowledges ethical dilemma of two apparent choices being poor
- Comes to best conclusion possible
- Acknowledges that regardless of lethality of disease, there is still an ethical dilemma present
with allowing someone to go on to infect innocents (draw link to husband with AIDS who
doesn’t tell wife)
- Does not change mind when there is only 500 people
- Able to explain ethical issues with allowing person to leave with disease
Question:

You are a GP and a woman comes into your practice for a medical examination for work. As you
perform the examination, the woman mentions that she has depression and takes medication for it.
On the form you have to fill for her workplace, it requests that you comment on her medical history.
What do you do?

Ethical Dilemma/What About Now

Follow up questions:

What are the ethical issues here? – Use if participant hasn’t mentioned it in answer

The woman explains to you that she is a single parent and that she needs this job to sustain her 3
children. What do you do?

Points to hit:

- Able to acknowledge that patient confidentiality is important

- Able to acknowledge that as a medical professional, you cannot lie on a form or sign your
name on false records
- Acknowledge the conflict between the two ethical issues
- Explains to patient that it is unethical to lie on the form
- Tactfully refuses to lie on her behalf
- Refuses to compromise ethics and morals
- Acknowledges the patient’s frustration
- Acknowledges that patients are paying for your service, but you have refused to provide it
Question:

A patient has low haemoglobin and requires a blood transfusion for anaemia. He is a Jehovah’s
Witness and refuses to have a blood transfusion. What will you do in this scenario?

Follow up questions:

Consider a 2nd case. What would you do if a known Jehovah’s Witness presented to hospital
unconscious from a severe motor vehicle accident and needed a blood transfusion to live?

Consider a 3rd case. A child needs a transfusion to save the child’s life but the parents refuse.

Ethics/Cultural Competency/What About Now

Points to hit:

- Patient has right to decide provided he understands implications of decision (ethical

principle of autonomy)
- Discusses concept of capacity – patient needs to understand implications of his decision
- 2nd case: Patient is unconscious and can’t make decisions. They might not be a strict
Jehovah’s Witness either. If you can’t get hold of a next of kin (surrogate decision maker)
then transfuse immediately (emergency situations require no consent)
- 3rd case: The child should be transfused regardless as this is in the best interest of the child
- Recognise the difficult situation in 3rd case and acknowledge that good communication skills
is required
- Discusses parents patriae powers and rights of the state to overturn a decision by a parent in
the best interests of the child
Question:

What are your opinions on the legalisation of medical marijuana?

Random Question To Mix Things Up

Follow up questions:

What are the potential advantages and disadvantages of this legislation?

Points to hit:

- Candidate demonstrates a consistent opinion of the use of medicinal marijuana

- Acknowledges the problems of illicit drug use in society
- Candidate discusses the potential benefits including effectiveness in the treatment of
chronic pain
- Candidate discusses potential use as an adjunct in chronic pain, perhaps as an alternative to,
or to reduce the dose of opioid analgesia
- Recognises the potential risks including long term risks of dependence and deficits in verbal
learning, memory and attention
- Discusses the implications of policy changes that may make the use of illicit drugs seem
acceptable to the community

https://www.canstar.com.au/health-insurance/victoria-legalises-medicinal-marijuana/
Question:

You are a cardiologist working in a public hospital. A patient of yours who has previously had a heart
attack but who has now made a full recovery has come to see you today about getting a disability
pension. He works as a manager of a local supermarket and not only does office duties not physical
work. You believe he should be able to return to work. He has no medical signs or symptoms of
ongoing illness.

Interviewer – Goal is to obtain a full disability pension from the cardiologist (candidate student). You
plan on doing so by manipulation, intimidation, or whatever means necessary to get your disability
pension paperwork signed by the cardiologist. Your main underlying motive is a fear of further heart
attacks from stress at work but you do not wish to discuss this fear with your doctor, unless the
doctor is able to appropriately elicit this history

Points to hit:

- Maintains professional behaviour throughout the interview

- Recognises and vocalises that it is wrong to issue a disability pension without an appropriate
clinical reason
- Demonstrates empathy with the patient
- Effectively diffuses conflict with the patient
- Establishes underlying motive of fear of further heart attacks from stress at work
- Comes up with an effective plan for patient to manage stress at work
Question

Mr. Smith is a 65 year old male with a history of chronic liver disease secondary to excessive alcohol
consumption. He states that he is no longer drinking. His condition is severe and he is on the liver
transplant list. He is admitted to hospital when a donor becomes available. You are asked to assist
with the admission paperwork. Upon taking his medical history, he asks you to get his paperwork
from his bag. On opening the bag you see a bottle of vodka. What do you do?

Ethical Question/Patient Interaction Question

Follow up:

What are the ethical implications of withholding transplantation from non-reformed alcoholics?

Points to hit:

- Recognise and express that if a patient is continuing to drink alcohol, then a liver transplant
is not justifiable
- Approaches patient about the vodka in a non-confrontational manner
- Information is conveyed to superiors
- Discuss principle of justice – not a lot of livers to go around and so you should give them to
those who have the best chance of long term survival, has compliance with medications and
abstains from alcohol
- Discuss discrimination and how it relates here and how the principle of justice outweighs
this discrimination based on patient’s choices
Question:

Studying for medicine is a long and stressful process. What makes you think you can cope with it?

Follow Up Questions:

How do you typically deal with stress?

Have you ever had to juggle multiple projects at one time?

What do you do when you struggle to complete all the tasks you are given?
What techniques have you developed to handle stress?

Points to hit:

- Demonstrates motivation for medicine

- Demonstrates good work ethic
- Demonstrates ability to handle stress and work well under pressure
- Demonstrates ability to organise and multitask
- Demonstrates ability to seek help when necessary
- Demonstrates ability to work in teams and sociability
- Demonstrates ability to balance life and work