AKT AKT Guidance from trainees who’ve done it.

AIMSAIMSWhat is the AKT?Why do I need to do it?When do I need to do it?Where do I need to do it?How do I need to do it?How much does it cost?How do I prepare for it??any other burning questions

Why do I need to do the Why do I need to do the AKT?AKT?

Essential requirement for completion of MRCGP.

NO OTHER CHOICE REALLY!

What is the AKT?What is the AKT?Summative Assessment

APPLIED KNOWLEDGE TESTThe AKT is designed to test the

application of knowledge and interpretation of information.

Each question is intended to explore a topic of which an ordinary GP could be expected to have a working knowledge.

What is the AKT What is the AKT cont…cont…◦ 200 item Multiple Choice Test.

Core clinical medicine and its application to problem solving in a general practice context - 80% of items

Critical appraisal and evidence based clinical practice - 10% of items

Ethical and legal issues as well as the organisational structures that support UK general practice - 10% of items

What is the AKT? What is the AKT? Question Question writing…writing…Scenarios derived from clinical workPractice issuesTopical

All questions are referenced and the draft questions are then carefully scrutinised by a panel of experienced question writers.

Remember that all question writers are working GPs

What is the AKT What is the AKT Question Question format….format….

Single Best Answer (SBA)Extended Matching Questions (EMQ)Table/AlgorithmPicture/Video FormatData interpretationFree textNew types of questions!! – AKT

now involves some written (typed one word) answers – there was only 3 in the AKT in OCT 2010.

Example questionsExample questions 1. Management of chest pain A 55-year-old man has a two hour history of

severe central chest pain radiating into his left arm. He has no previous significant medical history. His BP is 150/85, his chest is clear and his pulse is regular 90/min.

In addition to aspirin, which is the SINGLE MOST appropriate NEXT drug for this patient? Select ONE option only.

A Amiodarone B Carvedilol C Diamorphine D Furosemide E Ramipril

What is the AKTWhat is the AKTResearch, epidemiology and stats!Research, epidemiology and stats!

Understanding the principles of audit and its application in assessing the quality of care.

Understanding the application of critical appraisal skills which will be tested in a number of formats e.g. the interpretation of research data

What is the AKT What is the AKT example example questionsquestions Risk of hip fracture A cohort study is conducted to evaluate the relationship between dietary calcium

supplementation and the occurrence of hip fractures in post-menopausal women. The study examines the hip fracture rate in 100 women taking calcium

supplements and 100 women taking placebo over three years. Over the three year period, five women have hip fractures in the calcium group and

ten women have hip fractures in the placebo group. The 95% confidence interval is 0.18 to 1.4.

8. In calculating the RISK of a hip fracture in the TREATED group, which is the SINGLE CORRECT answer? Select ONE option only.

A 0.01 B 0.05 C 0.1 D 0.5 E 1.0 9. In calculating the RISK RATIO for this study, which is the SINGLE

CORRECT answer? Select ONE option only. A 0.01 B 0.05 C 0.1 D 0.5 E 1.0

Administrative and Administrative and ManagementManagementRegulatory frameworks, e.g. PCOsLegal aspects, e.g. DVLASocial services, e.g. CertificationProfessional regulation, e.g. GMCBusiness aspects, e.g. GP contractPrescribing, e.g. Controlled drugsAppropriate use of resources, e.g.

drugsHealth & Safety, e.g. needlestick

injuryEthical, e.g. Mental capacity,

consent

What is the AKT What is the AKT example example questionquestion25. Medical standards of fitness to drive

A 65-year-old retired man had a routine coronary arteryangioplasty and stent insertion one week ago. He is nowWell and asymptomatic. He asks you for advice aboutdriving. According to DVLA guidance, which is the SINGLEMOST appropriate advice with regard to driving?Select ONE option only. A He may resume drive immediately B He may resume driving after a further week C He may resume driving one month after the

angioplasty D He may resume driving six months after the

angioplasty E He must inform the DVLA and await their decision

before resuming driving

What is the AKT What is the AKT ScoringScoring

All question formats have equal weighting

Each correct answer-1 markTotal score is the number of correct

answers given.No negative marking - ‘Fear factor’ If a question performs poorly across

the whole exam it will be removed from the scores of ALL candidates.

When do I take the AKT?When do I take the AKT?

Number of attemptsFrom 1 August 2010, a maximum

of 4 attempts!Those who commenced specialist

training before this date will be permitted to unlimited number of attempts at the AKT while they retain a national training number

When do I take the AKT?When do I take the AKT?Time limit of AKT validity:AKT passes obtained after 1 August

2010 -no longer three year validity limit.

Passes obtained between 1 August 2007 and 31 July 2010 by trainees in a specialist training programme will remain valid pending the award of a Certificate of Completion of Training (or Certificate of Eligibility for GP Registration)

When do I take the AKT? When do I take the AKT? Offered three times a year- Oct/Nov, Jan/Feb,

April/May

Rams website tips; Do not consider doing in your first year on a 3

year scheme (even though you are allowed to by the regulations)

Nobody is recommending that you should take until you have done at last 6m in General Practice.

Do not take it until you have had time to look at GP related medical knowledge as well as management and research.

Do not take it after you have had a period away from work (e.g. pregnancy), as you need to have kept up to date on NICE and SIGN guidelines and how these are implemented in practice

Revising with others helps

When to take AKT ?When to take AKT ?earlierearlier

Preparing for the exam helps keep a focus on learning knowledge when in hospital posts.

More opportunities for retakes

Will help you work out your weak areas if you do not pass and prepare for a second attempt.

Lots to do in ST3 without adding AKT prep to the list/Getting it out of the way

Taking it when others are taking it-helps with preparation.

Leaving it late and failing is a high risk strategy

When to take AKT ?later

College advice most appropriate point, and highest chance of success, will be whilst working as a GPStR in the final year of their specialty-training programme (ST3).

Taking once is cheaper than taking it twice

Everybody else on my scheme is taking at the very start of ST3 so it is easier to prepare together

Knowledge base for AKT helps with CSA so take together

Success rates-Jan 2011Success rates-Jan 2011Pass mark = 136/200 (68.0%)

Overall pass rate = 74.9%ST3 first time takers pass rate = 81.0%ST2 first time takers pass rate = 79.2%

(This ratio varies in different diets of the AKT taken at different times throughout the training year)

Cumulative pass rate for all those in ST3 after 3 attempts is approximately 94%

How do I take it?How do I take it?Book test via RCGP website-

instructions to follow.Morning/afternoon sessions at local

Pearson Vue Centre.Done on computer work station

(like driving theory test)-with tutorial (CBT)

Dates available on rcgp website\results via eportfolio-1st come/1st served.

How/Where do I take it?How/Where do I take it?Familarise yourself with demonstration tutorial on the

PearsonVue website

https://www.pearsonvue.com/rcgp/

The AKT also begins with a short tutorial to remindcandidates how to mark the answers.

Security at each centre will be robust!!!!!◦ Identity checks -2 forms of ID-one photograph ID◦ Invigilated◦ Video monitoring

Separate morning and afternoon sittings with a quarantine period at lunchtime.

Morning candidates will not be allowed to leave before the end of the test.

How to take it?How to take it?Time management – this is everything

Keep watching the countdown clock on the computer

200 questions in 3 hours = average of 54 seconds per question

Skip difficult questions rather than waste time (electronically highlight the ones you have left out)

How to take it? How to take it? Exam tipsExam tips

Cover test – can you answer the question with the option list covered? It’s probably the correct answer

Mark answer spot carefully

Go through unanswered questions 2nd time round using electronic review

Do not leave any questions unanswered – educated guessing is worthwhile

Check for silly mistakes if you still have time

How to prepare?-How to prepare?-resources used to resources used to

devise AKTdevise AKT

GP Curriculum (IOLs)BNFGMC Good Medical PracticeRCGP Essential Knowledge

UpdatesCochraneNICESIGNBMJ Review articles & original

papersBJGP

How to prepare?How to prepare?Give yourself enough time.Familarise yourself with GP curriculum-

particularly 3 domains.Learn from your clinical experience – check

the guidelines and references of cases you come across

Exam website feedback, sample material.Other resources to guide learning/practise

questions?prepare with peers.

How to prepare How to prepare ResourcesResources

Oxford Handbook of General Practice by Chantal Simon and Hazel Everitt

(1st few chapters for primary care & admin)

Innovait magazine (matches to GP curriculum-also has sample questions)

Can register and set up account if AIT member who receives Innovait magazine. Need unique mailing subscriber ID on Innovait magazine.

https://access.oxfordjournals.org/oup/registration/customerDetail.do?commandview

.

Medical Statistics made easy. Michael Harris, Gordon Taylor. How to Read a Paper: The Basics of Evidence-Based Medicine by Trisha

Greenhalgh.

Other books nMRCGP Practice Papers: Applied Knowledge Test. by Rob Daniels NMRCGP Applied Knowledge Test Study Guide: Sample Questions

and Explanatory Answers by Aalia Khan, Ramsey Jabbour, and Almas Rehman

How to prepare How to prepare online online resourcesresourceswww.passmedicine.com offers 1000s of

MCQs at little cost (£20 for 4 months)

On examination from the BMJ group www.onexamination.com/Exam-Revision/MRCGP.aspx is more expensive (£60 for 3 months) but some have found that it reflected the type and standard of MCQ in the AKT better than above.

 Past test- http://www.pastest.co.uk(~£39 for 2 months £59 for 3 months). Plus

there is an app for the phone.

How to prepare? How to prepare? CoursesCourses

Don’t feel it is needed-save your money for CSA!.

But if you really want to ,,

GP update course, NB medical course, Emedica course, Local courses- Nick Price may know about!

Feedback-difficulties 2011Feedback-difficulties 2011Diagnosis and management of acutely

unwell patients – common injuries, acute abdominal pain

Eye problems – identifying patients who require urgent specialist assessment

Personal and professional responsibilities – patient/practice interface, GMC guidance, certification

Remember that, as in real life, the “do nothing” option may be correct