Some of the most common questions that BDI get asked when discussing any sort of medical examination include, ‘What Preparation do I need?’, ‘‘How do I revise?’ and ‘What courses should I take?’.
In this Blog we discuss Preparation for the Part 1 EDAIC Examination, which can be done in a number of ways – by reading, discussion, local tutorials, formal lectures and courses and practicing examination technique.
Although there are no specific requirements in terms of duration of training, the level of
knowledge is appropriate to that of a trainee at the end of year 3 of their training
The ESAIC have responded to this question on their own feeds, stating ‘The examination is designed to test more than just learning hundreds of disjointed facts, and involves reasoning and decision making too’ – for this reason, they do not publish such banks of questions. However, there are many books of sample questions available for you to read through and practice but be sure to use ones which are in the correct, multiple true/false format.
At the outset it is essential to understand the question format of a stem followed by a response. The questions are designed to be read as stem, response A, stem, response B, etc. In other words, response A has no bearing on response B and response B only makes sense if preceded by the stem. Reading them in this way is crucial to avoid double negatives, etc. Questions are of the multiple true/false variety.
It is important to note that there is no longer negative marking of incorrect answers. In light of this, we always say to every Doctor taking the EDAIC, that they should answer ALL the questions as there is no longer a penalty for getting an answer incorrect.
There are two things that a Doctor must do to pass the examinations for the European Diploma:
1) Reach a certain level of knowledge
2) How to present it to the examiners
There are many Books of test questions available to help a candidate assess their level of knowledge, however it’s important to note that they should not be treated as sources of knowledge.
The standard textbooks are the best source books of basic knowledge for the EDAIC. The more specialised texts, reviews in the journals, and discussion with others should be used to build upon this knowledge, to update it, and to find faults in it. The more clinically orientated is the exam, then the more importance must be placed on gaining wide experience in clinical anaesthesia.
Many Doctors ask BDI Resourcing whether they should attend a preparation course for their upcoming exams. Whilst there is no doubt that courses can be extremely useful, it’s important to note that a course is not the key to passing the exam. Preparation courses should be thought of as means of aiming your studies in the right direction, rather than the singular form of revision. To properly benefit from your preparation course, you must have already done your own revision.
This is a waste of time. To get the most out of a course, one should have covered some of the groundwork beforehand. Having acquired what one hopes to be sufficient knowledge, then is the time that these books should be of help.
The format of the MCQ’s in the EDAIC examination is a stem and five responses. The stem may be short (“Opiates are:”), or may be a few lines, for example when presenting a clinical problem. Each of the five responses that follow may be true or false. The candidate scores one mark for each correct answer.
Once again, it’s important to remember that there is no penalty for incorrect answers or those left blank so you should answer all the questions as there is no advantage to leaving questions unanswered.
The actual answer sheets are marked by computer, and so the candidate must put their answers onto those answer sheets that are supplied separately. These answer sheets have the question numbers printed on them and the preferred answer is indicated by filling in a “true” or a “false” box in pencil.
The candidate should also think very carefully if they think a response (or a stem) is ambiguous. Each stem should be read very carefully, watching out for qualifying words such as “commonly”, “rarely”, “always”, etc. because they can turn what would otherwise be a “false” into a “true” answer and vice versa. Re-read the stem with each response, as it is all too easy to forget the emphasis and exact wording of the stem as one works down the five responses.
Watch out for negative words - in the heat of the moment it is easy to fail to see “not” in a response. “May” is an awkward word; one can argue that anything “may” cause anything else.
Try to give the answer relevant to clinical practice. For instance, it is “true” that atropine may cause bradycardia, but not that propranolol may relieve bronchospasm.
There are some subjects about which questions tend to be particularly confusing. The oxyhaemoglobin dissociation curve is one and the ionic dissociation of drugs is another. These are both subjects in which the wording of stem and response are crucial. If an option states, “The saturated vapour pressure of halothane is 243 mm Hg”, then the answer is clear (if the candidate happens to know!), but the concept and consequences of “The oxyhaemoglobin dissociation curve is shifted to the left by hypercarbia” can be expressed in a number of different ways and, even then, the wording of the stem may alter the answer.
Questions tend to fall into two basic types: the straightforward factual type, and the deductive type. Many pharmacology questions present facts, for example a drug and five effects that may or may not be properties of that drug. A false response must appear to some candidates to be true or else the question will not discriminate between the good and poor candidate. The false responses are likely to be: the exact opposite of the true answer (e.g. hyperkalaemia for hypokalaemia), an association with another similar or similar-sounding drug (e.g. a property of chlorpropamide appended to a question on chlorpromazine), or a complete red herring. These last can be very difficult to answer, and the candidate may not be able to find the correct answer in the literature because the connection does not exist. False answers in the deductive type of question include these types, although they may not be so obvious, but also include answers of false logic.
It’s important to have should have a general strategy for answering an MCQ paper. For those who do not, one is suggested below (which has been published on the ESAIC website). While it is certainly not the only one, it should allow efficient use of the time spent answering the paper.
First, read through all of the questions from the first to the last - answering quickly any questions that you are absolutely certain of the answers.
If you cannot answer a question immediately on this first read-through, put a question mark by it if you will need to think about it (and also by any answers that you do make, but about which you are still a little uncertain). Similarly put across against those that you think you will probably not be able to answer at all. It is very important not to dwell on doubtful questions at all, in you first read-through or you may find yourself short of time before you have answered all the questions that you DO know.
On the second read-through, tackle those that you marked with a question mark.
After this second read-through, it is worth going back and rechecking the answers, but don’t dwell on those that you answered on the first read-through or you will find yourself doubting yourself! At this stage, transfer the answers that you have made so far, to the computer cards and make sure that you mark the cards correctly – it is easy to get out of phase between the question numbers and answer numbers. You should now regard these answers as final and unchangeable: don’t look at the questions again and get on with answering those that you marked with a cross. You can transfer your answers to these questions to the computer marking cards right away because you will have had plenty of time to think around the subject.
When you have answered all you can, check that you have written your name in every place that you should have done, and then it may be better to leave the examination hall. With essay questions, you should always be able to add more to your answers, and you should stay for every precious minute; staying and staring at MCQ answers encourages you to question your answers!
The format of each of the two EDAIC MCQ papers in the exam is 60 questions in 2 hours and the best way to test yourself is to try a whole “paper” from an appropriate book of questions, under examination conditions, unseen, in under two hours (say 1 hour 45 mins).
If you take longer than this you may run out of time in the actual exam when transferring your answers to the computer cards. It’s important to remember, that you will not gain anything if you look at the answer sheets without trying the question and similarly there is little to gain from trying a question if you have not done the work on the subject.
For each response, score + 1 if you marked correctly True or False, and 0 if you marked incorrectly True or False or for any response for which you gave no answer. The maximum for each question is thus + 5, and the minimum is 0.
Your overall score on a paper will give some idea of your general level of knowledge.
Of course, once you have marked your paper, you should look very carefully at those individual questions at which you scored badly. These questions should form a basis for further revision.
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