Generic Interview Qs Flashcards

Question

What are the challenges for EM over next 10 years? What priorities would you focus on?

Answer 1

Increasing demand Increasing complexity; frail and comorbid Restricted resources; beds, staffing Results Poor flow, Overcrowding, ambulance waits Reduced productivity Staff retention, reliance on Locum Aim: Community care, increased SDEC: reduce bed occupancy and flow Digital technologies; improve productivity Improve research; evidence to shape policy and future

Answer 2

Clinical governance Audit: against best practise standards - example Risk management: - M+M, DATIX, complaints - important not to change processes based on a single event; build a picture of risk and management plans CQC/HIW report - example

Answer 3

Is this support I would need in starting role or difficulties faced by department?

Answer 4

As EPIC Flow: 4h target (seen, treated, discharged/admitted). Time to be seen 12h waits; exit block, bed occupancy Ambulance waits: overcrowding

Answer 5

Living abroad; - exposed to diversity; importance of inclusivity. Ensuring authentic selves. Benefits of diff POV Dog training - reliable, caring and insightful Using healthcare system as patient or family member - mother perforated appendix - Xmas - understand importance work from the service user aspect. Gratitude for the service provided. What great service feels like as a service user. - Wife and miscarriages Research

Answer 6

Amazing talented and motivated colleagues. Thrive given right circumstances Challenges - shift work and intensity: work life balance. flexible. Much improved since LTFT - stress: work and training; supervisors make way through training, help with new aspects; helped clinical fellow interviews. - service and moral injury. Must continue to improve service for public and staff. Staff retention. Colleagues can thrive if we take on the challenges in EM. Already improvements. Contribute

Answer 7

Vision - what they want to achieve and how to get there Motivation - create work environment; encouraging and thankful. allocate roles appropriately variety and challenge, Communication - clear, focussed, respectful Helen Mansfield; RAT service gloucester - resistance, flexibility, data

Answer 8

Skilled - honest about abilities/ need for help Understand goal - Common purpose: Motivated Communication; - clear, focussed, respectful Example of good team I led; cardiac arrest in car park Shows good team, how I can form and motivate good team work

Answer 9

SHO - provide

Answer 10

Arrange meeting with appropriate person Inform about high referral rates - offer comparison Enquire reasons behind this Offer help and assistance Plan for improvement Continue assessment Arrange further meetings

Answer 11

Poorly defined goals/direction Demotivate team Poor communication - unclear, unfocused, disrespectful Example resuscitation. Unclear what is happening, what roles people have, blameing people, upsetting team member

Answer 12

Analogy: sailing ship leader sets course, manager ensures you get there smoothly Role often overlap. What they do: - leader creates vision - manager sets goals to deliver vision How they achieve - leader focus on people; motivate - managers focus on systems Time frame - leaders long range - managers short range view

Answer 13

Wide experience various management roles: Workplace manager: EPIC - Know team; names, needs - Allocate resources according to need and experience training requirements Clinical supervisor - clinical fellow Project supervisor: QIP: - manage audit team

Answer 14

Explore why they feel that way - no variety? Challenge Discuss solutions to the issue - more resus, procedures Ongoing plan - Advise they speak to their educational supervisor and EPIC

Answer 15

?example NEAD Explore why they disagree Explain your reasoning Explain risks benefits of other management plans ? Shared decision

Answer 16

Acute or chronic, burnout and performance - anxious - less chatty - reduced laughter Tactics High acuity situation; use shared mental model; rely on communication ask help from team

Answer 17

Example Abx wrong patient - notify patient - apologise - truthful account of what happened - how incident can be mitigated - review incident - inform patient of outcomes Important; trust, honesty: risk management Shows; promote open blame free culture and focus on improving service and supporting staff.

Answer 18

Research: process to establish facts and generate hypothesises Basis for EBM - process evaluating evidence; valid; provide best possible care to pt Research in your community ensures that the evidence is relevant Research active hospitals have been shown to provide higher quality care - better engagement with EBM Active in research and EBM;

Answer 19

All hospitals should be involved in research Ideal: Research team working seamlessly alongside clinicians Doctors involved in basic way; eg eligibility and prescriptions Governance and data collection for specialist research team

Answer 20

Management system to ensure high quality, safe, ethical research Examples - ensuring informed consent; DEXACELL; UGI bleed and hyperglycaemia - compliance with regulation; eg GCP certificate - risk management; learning from adverse events; report adverse drug events

Answer 21

Ideally - Audit compares current state of practice with preset standards - understand what needs improving and can demonstrate improvement via QIP - ensure department: safe and high quality care Example EoL QIP Summary audit demonstrates current care against standards and I have demonstrated how I have used this to improve care

Answer 22

Use EoL QIP example Choose topic Define standards:, patient centred - ?national Data on current practice Compare data against standards Identify area of improvement Implement changes Review data post change

Answer 23

Audit aims to improve practice by checking current practice against established standards. QIP to improve - EoL QIP Research aims to gain new evidence to better understand what practice is and generate new hypothesise. - DEXACELL

Answer 24

Process gathering and evaluating evidence to make informed decisions about patient care. Evidence from research Lots research; podcasts; read papers Example EVM in practice NoPAC; multicentre RCT; TxA vs placebo epistaxis. Changed management. Effective and cost effective Enrolled patients on trial Shows engage research, EBM. Bring skills to grange train trainees curriculum. Set example continuous development - courses - skills, halo - conferences; expert opinions Summary; what EBM, how I practice and how that continually makes me a better Dr

Answer 25

Develop team, self, system - Team: Up skill individuals; ALS Better care and staff retention - As a teacher Improve leadership. Up to date, explaining reasoning and assessing team - Test systems; in situ simulation Tested new transfer protocol for patient s to CT. As closest CT being repaired and long transfer time. Identified issue gaining emergency porter. Contact info added to transfer bag

Answer 26

Nicky Moore PRU Experience; pt centred, clinical acumen, MDT Grange; friendly, proactive, experienced Motivated to attempt bigger projects; EPR Shows approachable, inspiring to colleagues to help each other improve

Answer 27

Reflection on own practice and practice within department Reflected after M+M Target training: HALO procedures courses, theatres; worked well - Halo procedures Create awareness - Podcasts, conferences Shows reflective, identify needs, continually develop: set example train our trainees

Answer 28

National institute for health and care excellence Independent body provide - evidence based guidance - develops standards - assess new medications technologies for cost effectiveness NICE guidelines; assess for symptoms and use EoL as appropriate.

Answer 29

NRLS aims to improve patient safety - monitors incidents - promotes reporting - develop interventions to reduce risk All incident reports now uploaded to NRLS National reporting and learning service

Answer 30

Appraisals - professional development - Broad focus ; entire scope of practice - annual review Assessment - evaluate specific aspect performance - narrow focus - triggered sporadically; exam I target training for assessments but continually reflect on my practice to improve care

Answer 31

Overall Benefit but there can be challenges to this model. Benefits: - experienced staff, diverse skill mix - improve retention, up skill workforce - permanent staff; continuity of departmental care. Challenges: - supervision, training and credentialing ; less widely understood than doctor in training. Importance of consultant training. Something I would be keen on as I know we are expanding our ACP roles

Answer 32

NHS deaneries are regional organizations responsible for coordinating and overseeing postgraduate medical training. Ensure training standards meet GMC requirements - performance, safety, communication, trust Appraisal; CPD, audit, issues, targeted improvements

Answer 33

Protocol mandatory procedures to be followed, Eg research protocol to enrol patient on DEXACELL Guideline general recommendation to guide action, allowing for flexibility and judgment HTN emergency guideline Stakeholders, CG

Answer 34

Not all some better to focus on service provision Consultants: well placed to make management and leadership decisions - Understand how it will effect care - Ownership of decision making; responsible and responsive to needs - represent department to other leaders Example EPR; - use EPR everyday. Understand how improve productivity by streamlining data capture - owned project. Iteratively change issues/snags given by team. - able to make a business case for this change. Provided the funds to proceed Shows

Answer 35

Departmental job plan made to cover service objectives. Individual job plans Should be ongoing basis to allow flexibility - collaborative agreement amongst colleagues to ensure team job plan complete Keyskills: team work, communication, time management Personal job plans Full time 10 PAs (8:2), usually 7:3 Working time: 4 components - Direct clinical care (DCC); plan sites, PRU, pre hospital streaming, weekends, on calls - Supporting professional activities (SPA); teaching (1PA), CPD (1PA), education support (1PA, 0.25 per trainee) Additional NHS responsibilities; lead clinician; audit, CG, teaching, research External duties: university roles, college work

Answer 36

Opportunities and challenges Pro: variety in practice opportunities to learn from different sites Patient centred; sites close to pt Cons: Complexity, more to learn, potential for missed opportunities Not always convenient for staff, Shows: opportunities for providing care close to home. Importance of getting patient to correct site first time. Flow centre and PRU

Answer 37

Over regulation - time consuming and reduced productivity Poor stakeholder engagement - failure to enact change Focus on procedures rather than pt experience Show pitfalls to consider. My changes from clinical governance try to make it easier for clinicians to provide safe effective care. Adrenaline autoinjector

Answer 38

Excellent leadership Open and honest about mistakes - learn lessons Investigate systems not individuals Respectful, encourage psychological safety Example Duty of candour Shows; I maintain blame free culture, learn lessons, staff welfare

Answer 39

Pros and cons to any intervention Reactionary Over regulation - never events; anaphylaxis Focus on process rather than patient experience in totality (time spent logging on to different systems (4) to check allergy) - resistance to change - poor adherence and failure of initiatives Understand potential issues with governance so that I consider any interventions I make

Answer 40

Reliable; time management, task management, responsible, team player. Caring: Approachable encourage , act as a role model and Insightful; experience, critical thinking, awareness Role as clinical supervisor Reliable: time management; task management - completing portfolio items Caring; approachable and understanding of clinical fellows needs; international student struggling with interviews. Insightful; multiple practice interview sessions. Constructive feedback Now has training job Shows how; manage staff, role models and work towards inclusive workplace by considering individuals needs.

Answer 41

Understand - check welfare, why is this happening? State the issue and why it is a problem - make plan on how to resolve issue and cause of issue Ongoing monitoring - educational supervisor Shows manage underperforming colleague, ensuring welfare, managing staff

Answer 42

Feedback from multiple sources Self Assesment - reflection Supervisor feedback - reliable Colleague feedback; junior, senior, nursing - approachable, trusted Patient feedback - listen and explains Capture entire scope of practice

Answer 43

AI Digital solutions Extra staff or training

Answer 44

Processes designed to assess and mitigate risk M+M Critical incidents DATIX Complaints Example of a complaint I responded to Resulted in creation PSP

Answer 45

Variety; - work; DCC, EPIC, RAT, PRU, teaching, research, EPR project Challenge - partly from variety, new projects Appreciation - staff friendly, approachable, helpful. Having worked here knew this is where I wanted to work long term

Answer 46

Patient safety. Context specific Understand what happened Were protocols followed Sensitive discussion with trainee What lessons did they learn What lessons can the system learn Never just an individuals fault Consultant takes responsibility for department Ensure duty of candour, apology Shows; compassionate responsible leadership and desire to improve

Answer 47

Context specific; example Resolve patient safety issues Calmly listen to concerns Re focus on shared goal (pt centred) Seek common ground Consider 3rd party (Cons) Reflect

Answer 48

Structured Handover - A to E any risks to department Patient safety; sickest seen, plans Department; resus space, pressures in department, walk around, proactive about issues; incivility, challenge inappropriate Staff; breaks, opportunistic training Shows responsible leadership, people first

Answer 49

Issues Population and funding Strategy; healthier wales Community management Digital tech - data driven Research Shows responsible leadership, continually improve service

Answer 50

I work well as either a leader or a follower And I act in according to what is appropriate. My preference is to lead I have a passion for improvement, expertise and ideas I would like to execute. Examples include EPR; dashboard, national KPIs, expand PRU, bring more middle grade trainees to the grange, develop QI project, publish research. Shows; flexibility, passion for leading and developing service

Answer 51

Many things Encourage reflective practice Praise good work Offer Constructive criticism - how to improve Sensitive, Open and honest Ongoing plan; resources, offer another session

Answer 52

Approachable and empathetic Respectful: I would like to see milk provided free to staff; work hard and deserve hot drinks MDT in situ training - fosters team work, comfortable with equipment and high acuity scenarios - trained, self improvement, valued

Answer 53

Lots of advantages Create tech to suit your needs Low maintenance once stable Evidence for effectiveness of service, business plans, QI, research Example EPR

Answer 54

Many ways Create culture friendly, approachable, trust Training; invested in developing team and people TRIM service; peer support post trauma; advertised and accessible. Debrief Important for staff retention, development

Answer 55

COSTED study RCT Smoking intervention; vape and video Improved smoking cessation Public health intervention ED Teachable moment Hard to reach groups Equitable A healthier and wales; national strategy from

Answer 56

Patient safe: immediate actions Department safe; epic role; NIC, cons History; inconsistent story? Document Known social services Others in household Parents access to other children Full exam of child; document Call social services or EDT ?Call police Sensitive, honest discussion Deescalate Frame issue as doing best for child Duty of care ?underlying medical issue Admit under Paeds; discuss Complete safeguarding form

Answer 57

Informed consent; risks, benefits, alternatives Persuade Under 16 ?Gillick competent 16-18: mental capacity act (presumed competent) Not competent; Parental consent Fathers may not have parental responsibility Hospital Legal team; other consultants; ED and Paeds Best interests

Answer 58

Patient safety Departmental safety Context specific; wellfare Immediate plan; safe to work; other patients ?go home, how, safe, who is at home Next on shift, locum Ongoing plan Educational supervisor, deanery (HoS) Own support; number, check up Handover Document in eportfolio ? GMC; professional standards