Approach to the examination

Published on 21/03/2015 by admin

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Last modified 21/03/2015

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Chapter 1 Approach to the examination

Positive mindset

All paediatric clinical examinations test the following aspects:

1. Clinical skills—history taking, physical examination, interpretation of findings, construction of a diagnosis or differential diagnoses, method of investigation, overall management of the patient.

3. Interpersonal relationships.

Candidates invited to postgraduate clinical examinations have usually satisfied their relevant learned college regarding their factual knowledge. Consequently, their factual knowledge should be at a standard appropriate for making management decisions in the case being examined.

Clinical skills are usually taught adequately to most candidates at the hospitals where they were trained. However, little if any attention is paid to developing proper attitudes and interpersonal relationship skills. Advertisers and sales representatives know the importance of personal contact. They realise that appearance, personality and speech are crucial in successful negotiations. The ‘viva’ is very similar in that candidates have to ‘sell’ themselves and their knowledge to the examiners. Successful candidates usually possess certain characteristics, namely:

1. A positive, confident response to personal confrontation. People with strong personalities have little trouble, but those who are easily embarrassed and shy away from confrontation between equals may do poorly. This response can be changed by methods described in this book.

2. Ability to sort out relevant from irrelevant information. Those who ‘think’, ask questions, seek explanations and try to understand rather than learn by rote do well.

3. Familiarity with the method of examination.

4. Endurance. Candidates who are ‘street-wise’ and naturally confident tend to have little difficulty, whereas their less confident colleagues are left to learn the hard way and eventually succeed or fail.

Preparation for the ‘viva’ requires effective communication skills during physical confrontation. Attitudes, interpersonal skills and projection of a confident, professional consultant image can be learned and developed.

Techniques include:

Body language

Non-verbal communication in the form of a person’s gestures is a very accurate indicator of his or her attitudes, emotions, thoughts and desires.

In order to learn body language, set aside a couple of minutes a day to study and read other people’s gestures. Examine your own body language. Copy the body language of people you admire and respect, such as a consultant who you feel would have no difficulty passing the clinical examination. The model you choose does not necessarily have to be a real person: he or she may be a composite of ideal body language.

There is an old saying: ‘If you would be powerful, pretend to be powerful’. One way to adopt an attitude that helps you achieve any objective is to act ‘as if’ you were already there. If you change your posture, your breathing patterns, your muscle tension, your tone of voice, you instantly change the way you feel. For example, if you feel depressed, consciously stand up straight, throw your shoulders back, breathe deeply and look upward. See if you can feel depressed in that posture. You’ll find yourself feeling alert, vital and confident.

An important component of body language is consistency. If you are giving what you think is a positive message, but your voice is weak, high-pitched and tentative and your gestures reveal poor self-confidence, you will be unconvincing and ineffective. Individuals who consistently succeed are those who can commit all of their resources, mental and physical, towards reaching a goal. One way to develop consistency is to model yourself on individuals who are consistent. Copy the way they stand, sit and move, their key facial expressions and gestures, their tone of voice, their vocabulary, their breathing patterns and so on. You will begin to generate the same attitudes that they experience, and experience the same successful results. Effectiveness comes from delivering one unified message.

When you next attend a place where people meet and interact, study the individuals who have adopted the gestures and postures of the individuals with whom they are talking. This mimicry is how one individual tells another that he or she is in agreement with their thoughts and attitudes. You can use this unconscious mimicry to your advantage. One of the best ways of establishing effective personal communication is through mimicking the breathing patterns, posture, tone of voice, gestures, words and phrases of the person or people with whom you are interacting. Once you establish contact with someone, you create a bond and reach a stage where you begin to initiate change rather than just mimicking the other person, a stage where you have established so much mutual contact that when you change, the other person unconsciously follows you. If, when you try to lead someone, he or she does not follow, it simply means there is insufficient rapport. Mimic, strengthen the mutual contact and try again.

Eye contact

When answering questions or making a point, look the examiner straight in the eye. Powerful individuals have always been characterised by exceptional eyes. If you have difficulty maintaining eye contact, there are a few techniques you can use to develop a more effective gaze.

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