The Essential Revision Guide to Paediatric Cardiology

Rebecca Casans, Mithilish Lal, Michael Griksaitis

• Publisher: CRC Press
• Year: 2021
• ISBN:
  9781000552591
• Edition: 1
• Topic: Médecine
• Subtopic: Théorie, pratique et référence de la médecine

A unique reference book covering the relevant basic sciences of cardiac anatomy, physiology and pharmacology through to the initial clinical assessment and investigation. It covers the core curricula for paediatricians in training at all levels including the MRCPCH and DCH examinations. This book is relevant to paediatricians in training, general practitioners, emergency department staff and specialist nurses. General staff working in specialist regional cardiac centres and healthcare professionals involved in the care of children and young people will also find this essential resource extremely useful. 'The aim of this handbook is to provide a rapid and reliable reference to congenital and acquired cardiac problems. It is very well organised. provides a more detailed discussion of cardiac physiology and pathophysiology and a comprehensive guide to ECG interpretation. It should be of particular interest to paediatricians in training, including those studying for higher professional examinations, but it also provides a valuable source of reference for paediatricians already in practice.' From the Foreword by Dr Christopher Wren

CHAPTER 1

Royal College of Paediatrics and Child Health examination structure

Part 1 A and B written

Part 2 written

Part 2 clinical examination

RCPCH: EXAMINATION STRUCTURE

This chapter aims to explain the process of paediatric assessment set out by the Royal College of Paediatrics and Child Health (RCPCH). It will be useful to new paediatric trainees in preparation for membership examination and for non-trainees to gain an insight into the college examination process.

The RCPCH has a robust assessment strategy and it is set in the context of paediatric training. The assessment process itself is transparent and uses a range of different assessment methods, including written examinations to test theory and a practical examination to assess practical skills.

FIGURE 1.1 Miller's Pyramid

This concept is nicely demonstrated by Miller’s Pyramid which maps different methods of assessment.

Note: All of the following information has been taken from the RCPCH website with permission and is correct at time of publication, though subject to change. Please see the website www.rcpch.co.uk for further details.

THE INDIVIDUAL PARTS OF MRCPCH

Part 1A

This is a single written paper which aims to test basic clinical knowledge in paediatrics. Trainees should be able to pass this paper having completed at least 4 months of clinical paediatrics and after engagement in self-directed learning from any good, short paediatric textbook. This has a pass rate of 60%–70% among UK trainees.

Part 1A is also taken in the UK by trainees wishing to complete the Diploma in Child Health. This assessment is aimed at those intending a career, including the care of children, but not where this is the main component of their daily work. It is principally taken by general practitioners.

Part 1B

This is a single written paper. It aims principally to test the understanding and science which underpins paediatric practice. This has a pass rate of 25%–30% among UK trainees. Currently, this low pass rate is a matter of concern which is being specifically addressed.

• ➤ Paper 1a focuses on the areas of child health that are relevant to those who will be working with children in their medical careers, not just those entering mainstream hospital-based paediatrics. The areas to be tested will be those conditions likely to be seen in 6 to 12 months of hospital, community or primary care practice. This paper also serves as the written component of the Diploma in Child Health examination.
• ➤ Paper 1b focuses on the more complex paediatric problem-solving skills not tested in Paper 1a, and on the scientific knowledge underpinning paediatrics.

THE NUMBER OF EXAMINATION QUESTIONS

Paper 1a and Paper 1b will consist of the following questions:

• ➤ 2 extended matching questions (EMQ) worth 9 marks each (3 per item)
• ➤ 15 multiple true-false questions worth 5 marks each (1 per item)
• ➤ 48 best of five questions worth 4 marks each

Both Paper 1a and Paper 1b papers will be 2½ hours in duration.

QUESTION TYPES

Multiple true-false questions

Multiple true-false questions are most useful when testing knowledge when there is an absolute Yes/No answer.

The questions test whether a candidate has true knowledge of a fact or thinks that something similar (but wrong) sounds vaguely familiar.

A simple statement or short clinical scenario leads into five items, e.g.

• ➤ ‘The following statements about X condition are true:’
• ➤ ‘X is a complication of’.

Alternatively, they might test whether a candidate has true knowledge of a fact or thinks that something similar (but wrong) sounds vaguely familiar, e.g.

• ➤ ‘Characteristic features of X condition include’

Best of Five questions

Best of Five questions are used to test judgement and experience. A simple statement or short clinical scenario leads into five options. All could be possible, but only one is completely correct or more correct than the others.

They should cover only one aspect of the topic, so stems might be:

• ➤ ‘What is the most likely diagnosis?’
• ➤ ‘Which investigation is most likely to lead to a diagnosis?’
• ➤ ‘What is the best next step?’
• ➤ ‘What is the best advice to give to parents?’
• ➤ ‘What is the most likely pathogenesis of this condition?’
• ➤ ‘What is the most common cause of this?’

Extended matching questions

Extended matching questions are used in much the same way as Best of Five questions. In this case a list of 10 possible answers is offered with three statements or clinical scenarios.

The candidate chooses the best option from the introductory list. Again, all could be possible, but only one is completely correct or more correct than the others.

EMQs are often accompanied by laboratory results that are similar but with differences. They should cover only one aspect of the topic, so suitable questions might be as follows.

• ➤ ‘Choose the most likely diagnosis from the following:’
• ➤ ‘Choose the best treatment for each of these children:’
• ➤ ‘Choose the organism which matches most closely each of the following case scenarios:’

PART 2 WRITTEN

This is an applied knowledge test. It comprises a single examination divided into two papers over a day. Most of the questions are based on clinical scenarios. A child is described, for example, who is admitted with certain symptoms. The findings on examination are given. This is often followed or accompanied by X-rays, investigations or laboratory results.

The candidate is asked to select the most likely diagnosis or the most important steps in management. Other questions may address therapeutics, follow-up or referral to colleagues. Success in this examination demands knowledge and clinical training with experience. This examinati...

Table of contents

• Cover
• Title Page
• Copyright Page
• Table of Contents
• Foreword
• Preface
• Acknowledgements
• Accreditations
• Dedication
• 1 Royal College of Paediatrics and Child Health examination structure
• 2 Basic cardiac anatomy, physiology and pharmacology
• 3 Examination of the cardiovascular system
• 4 Interpretation of the paediatric ECG
• 5 Investigations for suspected cardiac disorders
• 6 A–Z of paediatric cardiac disorders and procedures
• 7 Hot topics: a quick reference guide
• Appendix: reference tables, normal values
• Glossary
• Index