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1). Medical Interview-Questions， Answers and Advice for ST， GP and Consultant Posts■What to Expect in a Medical Interview Plus Sample Interview Questions?■Having worked in recruitment in the Medical sector I am often asked for guidance on how to succeed in Medical Interviews.Of course， most candidates want to know what interview questions to expect and what are the best strategies for answering.■It is no surprise that Medical Interviews are notoriously difficult.For example，competition for ST places is going to be even tougher this year with the Department of Health predicting an exceptionally high ratio of applicants to places.It goes without saying that you should prepare thoroughly and effectively and this applies equally，irrespective of your experience.■This article reflects the up to date MMC Recruitment Process and the information here is designed to help candidates interviewing for Medical posts at all levels， including positions at Specialty Training and GP levels and is also relevant for：■·F1 and F2， Foundation Interviews■·ST，CT and FTSTA Interviews■·GP， ST and GP Salaried Interviews■·Consultant and Senior Medical Appointments■The NHS Medical Interview Structure■Within the NHS today， you will be asked to take part in a Structured Competency Interview in front of a panel of interviewers.For ST interviews these can be part of a interview process which involves moving from one station to another.■The Interview Questions and Topics explored will be in line with the Essential Criteria as detailed on the relevant Person Specification.For example， these might include：■·Eligibility■·Clinical Skills■·Research and Audit■·Personal Skills■·Probity■·Commitment to Specialty■While the format changes regularly， expect 3～4 questions relating to each and as this is a structured interview each candidate will be asked exactly the same questions with no deviation from the script.■Depending on the level of the post， the questions of course will vary but so also will the interview setup.For example， in recent years for ST interviews， some Deaneries have used one of the stations to take candidates through a specific communication exercise which involved describing items on a table.■For GP selection interviews you will be asked to participate in a patient simulation(role play) with an actor taking the part of the patient， colleague or family member.In addition， you will be asked to complete a Written Exercise.■For Salaried GP and Senior Medical Appointments， a presentation is common.You will be given time to prepare for this but do check in advance on the availability of equipment such as projectors etc..■My Advice for Success in Medical Interviews■Surveys suggest that between 80%～90% of candidates fail to prepare adequately for an upcoming Medical Interview.They take the view that their CV， training and experience to date are so good they will sail through the interview.For me， this approach seldom works especially now when more sophisticated interviewing techniques are in use.■Some candidates also believe that it is impossible to anticipate the questions asked and therefore no point in preparing answers.As you will see this is in fact not the case and it is possible to predict the questions with up to 80% accuracy.■How to Approach Your Medical Interview■Medical Interviews and especially ST interviews will continue to follow MMC standards.These will reflect recruitment practices which are fairer and which remove any element of bias from the selection process.Techniques such as Competency Based Interviewing and Structured Interviewing which have been used in large commercial enterprises for a number of years are now the norm in Medical Interviews.■You will be tested on your skills and to succeed you must approach your interview with a professional attitude even if you are being interviewed within your own Department and where you know the interviewing panel.You will be required to present a proficient demeanour at all times and remember all aspects of your appearance，communication， language and attitude will be under scrutiny.■How to Prepare for Your Medical Interview■I know from experience that preparation is key to success and key steps you should take include：■·Review the Person Specification in depth and detail all of the key competencies，personality skills and clinical skills required■·Carry out research into the recruiting hospital， trust or clinic.What is its reputation? How did it perform against its targets? What are the issues it is facing?■·Review your CV and application form and be aware of your skills， your achievements， your strengths and your weaknesses■·Create a list of the most likely questions and prepare answers giving examples where appropriate■·Be prepared for a Structured Panel Interview as this is now commonly used in the Healthcare Sector■·Practice your answers in advance by taking part in a mock interview with a friend or colleague■·Practice with Role Plays and Group Discussions as these are standard at Stage 3GP Selection Centers■Sample Interview Questions for Medical Interviews■Test yourself with these Medical Interview questions.Take a moment to reflect and see how you would answer：■Interview Question 1： Describe for us a time when you used your leadership skills to resolve a difficult patient situation.■Interview Question 2： Describe a recent patient interaction which shows your ability to create trust and what steps would you take to develop an effective relationship with your patient.■Interview Question 3： Tell me about a time when your communication skills played a key role in achieving a successful outcome.What was involved and what part did you play?■Interview Question 4： Describe a time when you felt frustrated during an interaction with a patient.How did you deal with this emotion both during the interaction and afterwards?■Interview Question 5： How would you go about ensuring that you improve the quality of the care you give to your patients?■Interview Question 6： Can you please detail a time when a new and different approach to your patient proved beneficial.What did you do and what was the outcome?■Interview Question 7： Describe a time when you felt you gave optimum care to your patient， what did you do that made the experience so good for your patient.■Interview Question 8： Now tell us about a time when you did not provide the level of care you wanted， perhaps a time when you made a mistake or would have handled a situation differently.■Interview Question 9： Describe a recent patient interaction which shows your ability to create trust and what steps would you take to develop an effective relationship with your patient.■Interview Question 10： Describe a situation when you were able to empathise with a patient or their families and which resulted in an enhanced level of care for the patient.■* Questions taken from the InterviewGOLD Interview System.■How to Succeed in Your Medical Interview■Don′t miss out on the job offer by not preparing properly for your Medical interview.■Preparation really is the secret to success and I am pleased to recommend InterviewGold， a professional Internet for Medical Interviews.It has been recommended by top recruiters such as reed.co.uk and the Telegraph Jobs and has been featured in Personnel Today， the Guardian and on the BBC.■With InterviewGold you will know what to expect and you will learn how to answer tough Competency Based and traditional Medical Interview Questions confidently and successfully.■About InterviewGold■Online Medical Interview Skills Course■For ST， CT and GP and Senior Posts■Medical Interview Questions & Answers■All Questions with Expert Answer Guides■Excel in front of an NHS panel■Communicate fluidly and easily■Sell yourself effectively■Proven success in any Medical InterviewThis article is designed to help candidates who have interviews for Medical posts at all levels， and also includes up-to-date MMC Recruitment Process.( )
A.True
B.False
C.Not mentioned

正確答案：A
2). Nurse Prescription■We started the week with a new proposal by the Grattan Institute to shake up the hospital workforce and allow nurses to take on more roles traditionally performed by doctors.But should registered nurses′ roles extend even further， to prescribing medication?■As the population ages and has a higher rate of chronic conditions such as diabetes，heart disease and arthritis， primary care needs will continue to grow.And as a previous Grattan report noted， more than one in four Australians already feel they have to wait too long for an appointment with a general practitioner.■But extending registered nurses′ roles to prescribing， as the Nursing and Midwifery Board of Australia has proposed， isn′t the answer.Australia already has a category of nurse specialists who can prescribe some medicines一nurse practitioners.■International prescription■In the United Kingdom， suitably trained nurses have been able to act as independent prescribers since 2006， and some nurses had limited prescribing rights before that date.The UK government implemented the change in a bid to improve patient choice，provide better access to care and enhance multidisciplinary team care.■Evidence from the UK suggests that overall， nurse prescribing is currently of a high quality： it′s safe， clinically appropriate and educational programs adequately prepare nurses for this role.Patients are also accepting of nurse prescribing.■Nevertheless， a re recent UK study found that patients generally preferred to see their own doctor for minor illnesses； however， those who had previously seen a nurse were happy to consult a nurse.■The cost of drugs prescribed and assessment and diagnostic skills are seen as areas where nurse prescribers need to improve.International evidence suggests that nurse practitioners in primary care tend to order more investigations than doctors.They also spend more time with patients and achieve better patient compliance to medication regimes.■Nurse practitioners■To become a nurse practitioner， Australian nurses must undergo extended education at masters level， then complete a long and rigorous process of endorsement to prove their clinical competency in a specified area such as emergency care， wound management，palliative care， and so on.■Most nurse practitioners in Australia work within hospitals， but some work in areas of need such as aged care， palliative care and primary care (in collaboration with a doctor，though in some isolated communities， doctors only visit periodically).■Once endorsed， nurse practitioners can diagnose and treat conditions within their scope of practice.And， since November 2010， nurse practitioners have had limited prescribing rights.■A nurse practitioner working in an aged care facility， for example， is able to diagnose conditions such as urinary tract infections and prescribe antibiotics in a timely manner.This means that the patient doesn′t have to wait for a doctor to visit and risk becoming more unwell or be transferred to hospital.■Studies show that nurse practitioners can address the needs of an ageing population with chronic and complex conditions.And they may be able to provide the most cost-effective care， if they can reduce the time they spend with patients and reduce their return consultation rate (which increase the cost of care).■There is obviously scope for nurse practitioners to provide more care in areas of geographic isolation， where it is hard to recruit doctors and in areas such as aged care，where patients have complex and high needs.■They are also able to provide effective care to patients with chronic and complex conditions.Such activities could include broadening the range of medications these nurses can prescribe and enabling them to review a patient′s medication.■Proposal for nurse prescribing■The Nursing and Midwifery Board of Australia， the body responsible for registering nurses and developing professional standards， released a draft proposal in October to allow registered nurses and midwives to “supply and administer” scheduled medicines.■This applies to registered nurses and registered midwives but not to nurse practitioners whose rights rest in legislation.■The proposal would see nurses administer a range of medicines：■·Schedule 2 and 3 medicines which are available from the pharmacy without prescription such as aspirin， paracetamol， ibuprofen， and cold and fu tablets■·Schedule 4 medicines that are available by prescription only， such as contraceptives and antibiotics■·Schedule 8 drugs， which doctors need a special permit to prescribe such as Fentanyl， morphine， oxycodone， which are highly addictive.■To be eligible for endorsement， the registered nurse or midwife would need to Have “completed a program of study in medicines management， clinical assessment and differential diagnosis.”■The draft standards state that the endorsement of registered nurses and midwives to supply and administer medication is “intended to provide safe and timely health care when a medical practitioner or nurse practitioner is not immediately available.” But it′s not clear from the draft standards how “immediately available” is defined.■Nurses working in rural and isolated areas currently have certain rights to supply and administer scheduled medicines.These are recognised areas of medical workforce shortages.■Unanswered questions■Nurse practitioners are a relatively new professional group in Australia and， in particular， in primary care.The public and even other health professionals often have little knowledge of their skills and scope of practice.Adding another level of prescriber may bring opposition from medical groups and confusion among the public.■While the proposals make it clear that nurses should be properly trained to administer medication， there is also a need for them to have skills in diagnostics， history taking and recognizing adverse drug reactions.As we learnt from the UK experience， this is required for best practice.■There is also a concern that broader nurse prescribing rights would lead to fragmentation of care and an increase in the number of people seeking out different health professionals for the supply of medication.Unlike the UK， Australians aren′t registered with a particular GP practice and can seek primary care anywhere.■There is also the question of insurance.Nurses endorsed to supply medication would likely face higher insurance premiums.Nurses working in health services would be covered by their employer.But those working for private business， such as a general .practice， would need to get their own insurance or the practice would need to agree to provide insurance cover under its policy.Although nurse prescribing has been extended in the UK， the Australian health system is different enough for us to think carefully before following this lead.How can Austrian nurses become nurse practitioners?( )
A.They must have a master′s degree
B.They must work with an experienced GP for several years
C.They need to finish a long process of endorsement
D.They must have higher insurance premium

正確答案：C
3). Patient Access to Physician Notes Is Gaining Momentum■Family physician Richard Martin， MD， sees many patients with chronic conditions.Among them is a man in his 80s who arrives prepped by Martin′s notes from his last visit.Martin was one of the first physicians at Geisinger Health System， headquartered in Danville， Pennsylvania， to volunteer in 2010 for an OpenNotes pilot program making physician notes readily available through a secure online portal，( ).■Sharing medical notes with patients is a trend more health institutions are adopting they foster transparency in medical records.OpenNotes is an initiative to promote medical note sharing that was launched in 2010 by clinicians and researchers at Beth Israel Deaconess Medical Center in Boston.Funded by the Robert Wood Johnson Foundation and other charitable groups， OpenNotes has developed copyrighted materials that it shares for free with health systems to introduce simple patient access to medical notes.■“My patient contends that reading his medical notes motivated him to maintain his health，” said Martin.( ) According to a recent study， patients who frequently read their physician′s notes reported they better understood their health condition， took better care of their health， and had a better relationship with their physician.■For decades， patients could legally access their medical notes as part of the Health Insurance Portability and Accountability Act of 1996.( )What sets OpenNotes apart is the ease and speed with which patients can access notes.■The OpenNotes initiative was the brainchild of Tom Delbanco， MD， a professor of general medicine and primary care at Harvard Medical School， and Jan Walker， RN，an assistant professor of medicine， also at Harvard.Throughout his 40 years of practice，Delbanco freely shared his notes with patients.When patent portals were introduced，Delbanco realized that patients could email their physicians and schedule appointments，but physician notes were hidden.He and Walker decided to investigate the consequences of inviting patients to view physician notes via online patient portals by setting up a 1-year research and demonstration project， funded by the Robert Wood Johnson Foundation and 2 other organizations.■The project involved 105 primary care physicians and 13，564 patients at 3 sites：Beth Israel， Geisinger， and Harborview Medical Center in Seattle.Both participating patients and participating and nonparticipating physicians completed an online survey at the beginning of the study assessing their attitudes toward medical note sharing.( )At the study′s conclusion， after a year of access to physician notes，participating patients and physicians completed a follow-up online survey， which asked the same questions as the baseline survey， but with the verb tense changed to reflect that patient access to medical notes had been established.The results showed that 99% of responding patients supported continued access to medical notes online， and the majority of responding physicians at each of the 3 sites， ranging from 85% at Beth Israel to 91%at Geisinger， agreed that access was a good idea.■Some physicians were skeptical at first， expressing concerns that giving patients access to medical notes might add to their workload if patients called and emailed with questions based on what they read， Delbanco said.For the most part， those fears were unfounded， he noted.( )■Since the pilot study， other health systems have adopted the OpenNotes concept.Delbanco estimates that about 100 health care institutions are at some stage， from planning to implementation， of sharing medical notes with patients.Some have used the OpenNotes resources， and others have not， Delbanco said.■The medical notes that the patients read are the physician′s notes一the patient′s story - Delbanco emphasized， and not simply the after-visit laundry list of medications and instructions that patients customarily receive.■Despite OpenNotes′ benefits， some concerns remain.One is that patients might find the information they read upsetting.To cushion a potential blow， MD Anderson Cancer Center holds laboratory， radiology， and pathology results for 7 days and Mayo Clinic delays patient access to radiology and pathology results for 3 days so physicians can first speak with patients.■In addition， OpenNotes raises issues of access and fairness for patients who don′t have a computer or have a limited knowledge of English， noted Nancy Berlinger， PhD， a Hastings Center research scholar.■( ) The OpenNotes pilot study found that 28% of participating physicians at Beth Israel， 9% at Geisinger， and 11% at Harborview reported in the poststudy survey that they were less candid in their notes knowing patients could read them， suggesting the concern may be valid.■Steven Malkin， MD， an internist who practices in Arlington Heights， Illinois， is concerned that if his patients routinely read his notes， he would be less forthcoming.“My notes are for me，” Malkin said.“If I knew a patient was going to read them， I would write them differently.′”■Although Geisinger′s Martin said he has not changed the way he writes notes， he has learned that patients may， interpret a word differently than anticipated， citing a patient who took offense to being described as obese.( ).■Despite lingering apprehension， Milliner thinks sharing notes with patients is a good tool for improving communication between patients and physicians.“It is one more way they become part of decision making，” Milliner said.“I view that as a very positive thing.”O(jiān)penNotes shares copyrighted materials for free with health systems.( )
A.True
B.False
C.Not mentioned

正確答案：A

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