interview prep - general questions Flashcards
what have you done outside your scope of work to demonstrate commitment to speciality?
Clinically working in fields that gives me exposure to the skills and attributes that would futher my career in anesthetics, working in ED and actively seeking out resus and leaderhsip opportunities. Also putting myself forwards for eductaional opportunities learning US skills and learning to place arterial lines.
organised taster week and developed positive and ongoing relationships with team members of the anaesthetcis department. We have worked closely on a QIP that integrates into the maternal medicine PROMPT course created a series of educational resources, including a series of videos that were not only well revieved locally, gaining a GREATIX and also feedback from other consultants that they would like that sort of video in their area of education but also more regionally at the PROMPT conferece - as such ongoing work to develop forther clinical material with this team.
Further from this attended courses such as ATLS, prehospital medicine course and the prompt course which provided me with both clinical and simulated practice on acutely unwell individuals in different setting/environments.
Ive also immersed myself in teaching experiance currently doing a PGCERT and being a team lead in postgraduate simulations. I know within anaesthetics there is much scope for teaching, especially simulation teaching so having this educational and leadership background is of use.
I’ve also immersed myself within the working environment by taking on leadership roles such as running the the ED educational blog and in by F2 year been on the foundation school committee.
outside of the direct links to the speciality I have lead multiple QIPs that have delivered an actual impact, have experiance leading and being 1st author in the field of research having presented at international and national conferences and having a paper published in a peer reviewed jounral - BIDA. I am currently working on a further two manuscripts which will hopefully get published in due course.
How would you describe your communication style?
One of my main strengths in communicating is that I always approach a situation with empathy and patience.
Working in ED currently means that there are high work pressures on everyone, I pride myself in being a supportive team-member, someone who people feel comfortable engaging with in discussion regarding advice/questions or, for nurses especially, escalating a concern to.
If being handed over some information ensuring I am being attentive and asking relevent probing questions in a way which is still open and supportive.
I make it a point never to interrupt unless strictly necessary as that has been shown to have a massive detrimental impact in communication and mental workload.
Indeed, on my MSF I have had this reflected back at me that poeple enjoy having meon their team, that I am dilligent and nurses feel happy to have to escalate to me.
Ultimately having this open, and supportive communication style makes for a much more positve work environment but also means that patient safety is improved.
In terms of patient communication I pride myself in being patient, and understanding, taking a little extra time per person to ensure they have a good understanding of what has happened and have left feeling that they have been listened to and valued. Oftentimes Ive had to deal with angry or frustrated patients and having an empathetic approach opens discussion to allow for better shared decision making and patient outcomes. Similarly having had to deliver bad news in ED, whichc is often a less than ideal setting, for ex (pan Ca) my communication style has meant that I was able to engage with this patient, give them some time to process, reassess theyre understanding and answer any questions possible whilst still highlighting the unknown and allowing the discussion to be as positive and productive as possible.
supportive team-member, positive working environment and feeling as though people can ask you for advice/questions, boots rapport and work relationships but untilmately shared decision making leads to batter patient care
Never interruptine unless stricly necessary and asking probing questions in a way which isnt intimidating
I have broken bad news, sometimes in not ideal enviornments, a few months ago finding a metastatic pancreatc cancer in oatient ct and informing the patient of this, and have felt as if those discussions were clear but empathetic
In ED there are a lot of angry patients and showing understanding, asking them about why theyre feeling a certain way and coming to a shared understanding/plan is something I have found easy to navigate
From MSF collegeues have said that I am someone they enjoy working with, nurses have commented they are never worried about asking me for something
What skills do you want to improve what is your weakness
Overall I feel like my training so far has given me a well rounded experiance and I have strived to make the most out of every rotation getting involved in multiple project - mention here.
However, reflecting back on experiances so far I feel an area I want to improve on is being more assertive communicating my decisions and having the confidence to speak up for my clinical decisions and my patients.
In ED where I am working currently you meet a lot of specialities and although that MDT work and discussions is something I do enjoy and find eciting and oftentimes rewarding, I find that when faced with an opposing or potentially dismissive oppinion I struggle to negotiate a way to a shared understanding or decision.
I have spoken about this with my senior collegues and other trainees to find internal strategies that can help navigate that better and frameworks to help do so under pressure. I have started implementing in my day to day practice and ask to be put in majors or resus (where more of this MDT working under pressure occurs) to practice these dicussions. Only recently having had an experiance of a pt with severely reduced GCS arriving to ED and asking the consultant if they wouldnt mind coming and reviewing how I led the resus call and obtrained valuable feedback from that.
What is your biggest achievement
Consent form QIP and what followed on from that
Creating these costomisable consent forms for emergancy general surgery as an f1/2 required a lot of time and deadication. As I was lead in the project coordingating the general surgey team to help provide feedback on our mock drafts and finalising the forms, passing them through the igorous caldicott and approval processes and getting them printed and having them implemented in day to day practice took a lot of leadership, coordination and time. It was a great satisfaction knowing that this project started in F1 was now making real life changes and had helped improve the consenting process for bath patient and clinician
Subsiquently from this the QIP project my abstract was accepted at the ASiT conference and I delivered a national poster presentation .
What do you like most about this speciality?
I realised over the course of my foundation years that anaesthetics is the speciality in which I see myself.
Clinically speaking, when I look back to the best days I have had at work its because I’ve been dealing with acutely unwell individuals, so for me that experience has been largely in Resus. Taking the lead role in resus calls has allowed me to develop my ability to keep calm under pressure and think ahead, and I have realised that this aspect of work gives me a real buzz. Thinking back to a recent clinical exampl having had a patient who presented in resus in severe DKA ho I realised would likely need ITU, I enjoyed the ability to lead the team and those interactions with other specialities gives a huge amount of variety to the day which I enjoy.
On my anaesthetics taster week I saw how much scope and variety there is with anaesthetics which is a very exciting prospect. I enjoyed seeing the ebb and flow of acuity and the close working relationships not only between anaesthetics dpt but also other specialities.
I also particularly enjoy practical procedures and learning those hands on skills, often asking for the opportunity to learn a new skill or for supervision when practicing skills I am not yet familiar with. Getting that satisfaction of a procedure well done and seeing its immediate effects like with FIBs in ED.
I have also seen how many opportunities there are within anaesthetics to get involved in other projects for which you have a passion in, for me that is education and MDT simulations which is an exciting prospect.
Lastly speaking to anaesthetics trainees of all grades and consultants there is a palpable happiness surrounding the work they do and the training pathway which is always a pleasure to see and is inspiring to see.
What is your greatest achievement?
choose one of either
MSc Cancer reseach poster with masters, poster primer video used by different trusts in UK and Yorkshire cancer charity. also resulting in oral presentation at international conference and ongoing work and relationship with the neurosurigal and cancer research team at sheffield teaching hospitals currently working on a manuscript together for submission.
or
consent form project coordinating the effort with surgical and consultant body, passing through the process of getting them approved, printed and implemented into daily practice. Making positive change to consenting process as a whole and completeing a second cycle audit plus presentation at national conference.
Talk me through your CV
Clinical
FY1/2 in a busy DGH in the north west. Lots of hand on experiance early and lots of responsibility
Currently am working in the south west as a clinical educatio fellow 5050 ED education
I realised quickly I liked hands on and practical procedures and skills - best part of my day. US skills and learning to place things like arterial lines or do blocks.
I liked leading MET calls and dealing with acutely unwell patients
In F2 I did my ED rotation and asked to be put in resus often
Did my taster week, consolidated I loved anaesetics, the team and envronmant the type of patient contact
Academic
MBCHB Sheffield
MSc SciComm, award given
Currently doing PGCERT
Authored one paper
Presented x1 conference internationally and one nationally
ATLS BASICS and PROMPT courses
Management
2nd cycle audit implementing prefiled consent forms which allowed for personalisation, significant change
qip in art line - videos being iused by whiston for prompt and they were included as part of a presentation for regional prompt courses and recieved excellent feedback, will be involved in producing more general ones.
on mess committee organising large scale events
currently helping organise conference for EDI in ED
Education fellow and organised 3 month ED undergrad sims in f2
Personal
main attributes is supportive and caring individual who people have commented enjoy working with and having around
art
top time 2 min 30
where do you see yourself in 10 years time
hopefully nearing CCT, within anesthetics theres so many areas that you han sub specialise which is an exciting prospect in the field, I particularly enjoy proceduaral work and found that regional block anaesthetia was interesting as well as pain management.
I see myself having ongoing impact in teaching, I would like to have taken further time to progress and obtain further qualifications and readily implement that in my clinical life.
I particularly like MDT simulations and communications aspects of those which have a huge role in anaesthetics so that is an area I see myself going into and hopsylly leading some research in that field - qith AI and VR the field on simulation education is expanding and I think that could play a hge role.
Give an example where you showed empathy towards a patient?
Breaking bad news in ED - new diagnosis of pancreatic cancer. But actually taking a more empathetic approach with patients that don’t ‘pull on your heartstrings’
Reattendance in ED for 14yo girl with a variety of what sounded like vasculitic symptoms, absconded for ed yesterday with parental consent. Unclear why, taking empathetic approach I figured out it was because she was severely needle phobic.
Taking the time to hear what she needed to say. Explaining everything we can do to make the procedure as quick and comfortable for her. Assuring her she was in control of the situation. Obtaining consent and performing the test meant that we could spot some abnormalities which prompted discussion, initiation of treatment and OP referral to paeds.
Discribe a time you had to advocate for your beliefs for a patient?
Either:
foundation years, surgical rotation spent a lot on time on ward care. patient with a lot of complec medical needs, saw her deteriorating as days went on, then on calls and saw how quickly and progressively she was deteriorating. A lot of distress for the patient. I called my consultant and registrar for a meeting regarding the patient and explained what I had experianced and that I felt that she needed a care plan in place and ultimately a respect form with ceilings of care and DNAR.
They listened and went over the notes of the patient, agreeing with my assessment had a disussion with the mum. Who was obviously sad butagreed with the plan that it had been a thought she had had. Within a couple of days she deteriorated more and because of the involvement with palliative care now she was moved to hospice where she ultimately died but surrounded with her family and in a much better environment.
Describe a situation where I failed to communicate appropriately ????
In GP patient mid 30s came in with new diagnosis diabetes and ketosis but otherwise well. I was unsure regarding what the best course of action was for him from a community persective as I was suspecting he had t1dm.
Went to discuss with a senior GP but when confronted by his plan which delt with the issue by starting on metformin and discharge w follow up mane with diabetic nurses. I did not emphasise my concerns regarding the patent, that I suspecting an alt diagnosis seeing how busy he was I didn’t follow on the discussion. I safety netted the patient closely on symptoms of DKA.
This lead to the patient attending the practice the next day and subsiquently referred immediately to ED for insulin and endocrine review. Although no harm came to the patient it did result in the patient loosing confidence in the practice and a delay in his care.
When I followed the patient up the following week this obviously had to be addressed and apologised to the patient.
I learned from this personally but also discussed it with my ed supervisor and the diabetes nurse who was involved with the patient and it lead to implementing of diabetes training at the practice for rotating juniors at induction and also for thesenioqs at the practice
Tell us about a situation where you had to obtain informed consent?????
probably the bloods one again or safeguarding one
what makes you a good team player
Good at being accountable and reliable getting my jobs done on time and having good organisational skills:
for example QIP consent forms
Good at coming to compromises and navigating discussions where issues or disagreements are met:
for example whiten jr dr committee
Proactive in helping others and sharing workload
For example on the wards/at work
Generally having good time
what is a recent example of you playing an important role in a team????
situation education.
Currently doing CEF role organising F1-IMT3 teaching. As a team we were briefed on how trainee satisfaction with education was poor within the last GMC survey.
I took an active approach to this suggesting to each of the fellows we see what is and inst working within our departments and see what cold be implemented, setting up the following initial meeting.
Talking to trainees within ED it transpired that they felt that hand on or simulation experience was what was lacking in the department. However, many aspects such as 1:1 sessions with seniors and some teaching at handover was useful.
Feeding this back to our team meeting and hearing where difficulties also lay in other departments we set out some initial aims to help implement ongoing changes within departments.
For ED, and for me it involved setting up some practical simulations for the department, I set up a meeting with the educational lead and we outlined a plan on how to implement these monthly ED .
We have completed two months/ or sims sessions so far which have been a great success.
With the GMC trainee survey no longer being fed back further work is going to involve seeing how we can assess trainee satisfaction in departments and how to ensure further development and continuation of education not only whilst I’m there but ongoing, as this job role was only created this year for ED.
OR
consent form project
Describe a time where you failed to act as a good team player
stressful clinical situations
strategies implemented to not be rude
seen an improvement
ongoing work on this
do you work better alone or as part of a team
I think ultimately I am able and happy to work in both capacities but in my own personal experience the two often go hand in hand and that I see a cohesive and well run team as one that can work on their own roles and tasks well independently but with close communication and working between all members.
For example,
In the consent form project that I was lead in, there were many aspects of the project that needed tacking simultaneously in order to push the project forwards. I reconised this and suggested as a team split up responsibilities. For example initially I was in close communication with consultants and caldicott lead etc to figure out the logistics whereas my colleague set about collecting patient hospital numbers and gathered the data. Subsequently I analysed this data and we kept in close communication with each other as well as giving my seniors regular updates and asking for advice when needed.
A recent clinical example would be when I was in resus and had very unwell patient with DKA and reduced GCS, asking for support from a colleague. Asking nurses to get access and my colleague to ring ITU as I knew their support would be needed and if that conversation could happen as I initially assessed and stabilised the patient the outcomes could be smoother and quicker for the patient.
What qualifications and skills/experiance do you have that makes you suitable to be an anesthetist?
- resus experiance
- practical skills including USS, keeping calm under pressure, working within an MDT
- taster week
- ATLS / PHEC / PROMP mat medicine
???try and ground it in an example
more broadly speaking
- lead a QIP working with anaesthetics and attended their montlhly audit meetings so have good understanding
- education experience organising and running teaching, especially sims and doing PGCERT
Talk to me about a time you demonstrated leadership
implementing sims teaching or QIP
- leading by example
- motivated
-listening to others
What makes a good leader and how do you demonstrate that?
lead by example
get stuck in
be a point of contact for advice
make everyone feel engaged and involved
creating a positive environment
educational sims is great example of this
How do you manage stress
describe an instance where you had to take a holistic approach with a patient
describe a time where you had to deal with a sceptical patient
what personal attributes do you possess that suit you to this speciality
- ebb and flow and remain calm
- communicate well and be supportive
- diligent and organised
clinically speaking I am someone who enjoys an ebb and flow of acuity so for example being in Resus and dealing with those acutely unwell individuals I have realised that I remain level headed and can navigate the situation presented to me as well as lead the team and think a few steps ahead.
This is an area which over the last year I’ve actively taken the opportunity to improve upon as anaesthetics is what I want to go into and I saw that these skills were imperative to trainees of all levels.
The attribute which I am most prod of myself for developing and refining is my ability work well with a team, to communicate clearly and openly and to be a point of reference for, Thats been developed both clinically but also non clinically for example when I was part of the doctors mess committee, instigating conversations to navigate and come to a shared decision regarding conflicting opinions. communicating in a manner that’s open and empathetic. Ive had it fed back to me both verbally but also in things like my TAB forms that collegues are always happy to turn to me for help or advice and nurses feel comfortable and confident in escalating an issue to myself which I think is so important. And its also meant that I am not only viewed as a diligent colleague but actually as someone who is a positive presence in the workplace and enjoyable to be around.
Lastly I would say that I am a dependable and organised person. This allows to me to tackle high pressure situations at work but also to take on more opportunities othside of basic clinical practice and develop as a person and follow those passion projects, for me thats simulation teaching, which I know there is huge scope for in anaesthetics in future.
Tell me about a mistake you have made?
ST / A / R
diabetic patient
not handing over and escalating efficiently
followed up patent and saw had been referred to ED
discussed with GP cons and diabetic nurse
outcomes were personal changes and systemic changed in that practice
describe a situation where you showed professional integrity?
diabetic patient
not handing over and escalating efficiently
followed up patent and saw had been referred to ED
discussed with GP cons and diabetic nurse - by owning up to this mistake discussing with my peers what they’re awareness of this practice was and then feeding back to the senior GP team systemic changes where made in that practice to ensure safer practice
how do you handle stress
organising tasks
discussions with colleagues and escalation to seniors
using personal development time effectively
unwinding
what is a stressful situation you have been part of
dealing with difficult patient who was abusive to staff, refusing treatment but also wanting to be treated
I remained calm in my engagement with this patient not rising to their comments, I maintained a firm tone and approach.
I escalated appropriately to the consultant and also sought the input from one of our experienced HIU nurses, although this patient wasn’t HIU they were exhibiting behavioural patterns which I knew she had a great deal of experiance with.
I regularly reconvened with all my team ensuring we were all on the same page, to the more junior nurses who where having to take a lot of the brunt of the abusive behaviour I regularly checked in on and ensured they felt confident and comfortable escalating to myself. Having a cohesive team really reduced the stress load.
With this approach the patient deescalated and we were able to navigate a discussion surrounding next steps coming to a shared decision which meant that the patient was agreeable to what we were offering and got the treatment she needed.
After that as a team I asked the consultant if we could hold a group debrief together so that we could all move forwards with our shift with a clearer head.
what are your main strengths
- being able to stay calm under pressure make quick decisions and also think a few steps ahead about possible trajectories even in a relatively well patient
- communicate empathetically
- work well within a team both as lead and more generally
- stays organised and allows Time for other projects which are beneficial eg teaching/ QIPs
what is your weakness
I am someone who likes to be juggling a few different projects and however because of this in the past I have had quite strict timelines and I guess high standards of what I am expecting from others.
Realistically everyone has their own pace, working style and responsibilities so those standards are unrealistic and when not met have caused me undue stress.
What I have learnt over the last year has been to be more flexible with these projects, to regularly check in with everyone and when we do ask about realistic timescales and come to a shared goal, by easing up a bit and giving over more responsibilities to others I have found people are motivated to do more.
OR being snappy when stressed. Now its one of my strengths.
