Non-clinical

Question 1

Name the 10 Core RACS competencies

Answer 1

Health advocacy, Professionalism, Communication, Collaboration, Cultural Safety, Judgement and Decision Making, Technical Expertise, Medical Expertise, Leadership, Scholar/Teacher

Question 2

Give three examples of medical expertise

Answer 2

(1) Demonstrate medical skills + expertise;
(2) Monitors + evaluates patient care;
(3) Patient centered approach to quality, safety, and risk

Question 3

Given four examples of judgement and decision making

Answer 3

(1) Recognizes conditions and circumstances where surgery may be indicated
(2) Plans ahead and anticipates consequences
(3) Considers and discusses options
(4) Implements and reviews decisions

Question 4

Give two examples of technical expertise

Answer 4

(1) Maintains technical skills
(2) Operates safely within defined scope of practice

Question 5

Give five examples of professionalism

Answer 5

(1) demonstrates awareness and insight
(2) Observes ethics and probity
(3) Behaves respectfully and culturally safe towards colleagues and team
(4) Maintains personal health and well-being
(5) demonstrates ethical billing practices

Question 6

Give four examples of health advocacy

Answer 6

(1) Cares with compassion and respect for patient’s rights
(2) responds equitably to the social determinants of health
(3) demonstrates sustainability of the healthcare system
(4) cares for the well-being of colleagues

Question 7

Give four examples of communication

Answer 7

(1) gathers and understands information
(2) discusses and communicates options
(3) communicates in a respectful manner
(4) communicates effectively with team members, staff, colleagues

Question 8

Give (five) examples of collaboration and teamwork

Answer 8

(1) play an inclusive role in clinical teams
(2) establishes a shared understanding through appropriate documentation and exchange of information
(3) demonstrate a willingness to seek or offer a second opinion
(4) foster an environment where patient safety measures are the team’s responsibility
(5) supports conflict resolution and manages differences within the team

Question 9

Give four examples of leadership and management

Answer 9

(1) identifies when to lead, manage or take direction as required
(2) leads to inspire others;
(3) sets and maintains standards;
(4) supports others

Question 10

Give (three) examples of scholar and teaching

Answer 10

(1) shows commitment to life long learning
(2) teaches, supervises and participates in assessment
(3) engages in research to improve surgical practice

Question 11

Give (three) examples of cultural safety

Answer 11

(1) Promote cultural competence and safety across the whole health system in order to achieve equitable healthcare
(2) foster a safe and respectful health care environment for all patients, families, and carers
(3) promotes inclusive and safe workplaces for all colleagues and team members

Question 12

How do you assess and maintain your surgical skills and outcomes as a surgeon?

Answer 12

(1) life-long learning - attending conferences and RACS courses and journal club
(2) using and reassessing EBM, willing to change practice to reflect current evidence
(3) participate in training, supervision, and assessment
(4) improving surgical practice via regular audit and research
(5) accessing** available resources and support (MDTs, RACS online CPD)

Question 13

What is a clinical audit?

Answer 13

Process of assessing performance via:
(1) identifying a clinical question
(2) identifying a standard/guideline to compare results to
(3) collecting information
(4) presenting findings
(5) make changes based on outcomes

Question 14

What are some concerns around Complimentary and alternative medicine (CAM)?

Answer 14

Concerns when CAM substitute rather than compliments conventional treatment and may lead to a poor health outcome

Question 15

If you are being bullied or witness bullying describe a graded approach to the situation

Answer 15

After making sure myself (or colleague) is okay (and with consent): (1) discuss with the individual in an informal way; if this does not lead to a change in behavior formal procedures may be necessary via HR +/- RACS

Question 16

Communication - How would you facilitate receiving information?

Answer 16

(1) environment choosing a private location free from distractions and time pressure
(2) shows active and reflective listening
(3) see things from their perspective
(4) use open body language
(5) be friendly, available, and approachable
6) ask open ended questions

Question 17

Communication - How would you best impart information?

Answer 17

(1) environment choose a private location free from distractions and time pressures
(2) ensure adequate communication aids such as interpreters, hearing aids, cultural liaison
(3) tailor the communication to the individual (audience) and avoid jargon
(4) be calm and use open non-verbal communication
(5) know your limitations and ask for help early
(6) be adequately prepared for the conversation

Question 18

How would you approach a critical incident?

Answer 18

Firstly, identify that one has occurred. Consider patient safety; open disclosure and good communication; appropriate escalation; documentation; prevention (risk management system, audit, M&M)

Question 19

What is evidence based medicine?

Answer 19

Integration of best evidence and research knowledge , clinical expertise and judgement, and patient values to treat patients, with the aim of producing the best possible patient outcomes

Question 20

What are examples of critical incidents

Answer 20

1. Operating on the wrong side or wrong patient
2. inpatient suicide
3. retained procedural instruments
4. intravascular gas embolus
5. ABO incompatibility blood transfusion reactions
6. medication error causing patient death
7. maternal death

Question 21

What is informed consent?

Answer 21

The process of obtaining permission to provide treatment which has four components: (1) competence, (2) information, (3) voluntariness, (4) ability to communicate

Question 22

How do you assess for capacity/competence?

Answer 22

Patients are competent if they demonstrate:
(1) comprehension - understands the reasoning behind accepting/refusing intervention
(2) appreciation - can weigh up risks + benefits,
(3) reasoning - forsee consequences of consenting or refusing,
(4) can communicate their decision

Question 23

When is written consent indicated?

Answer 23

(1) to participate in research
(2) for experimental procedures
(3) for procedures that require GA
(4) interventions that have significant risk of adverse effects to the patient

Question 24

When is informed consent not necessary?

Answer 24

In an emergency situation, treatment can be provided to an incompetent individual where the treatment is necessary to preserve the patient’s life, health, and well-being.

Question 25

What are the qualities of a good leader?

Answer 25

(1) leads by example,
(2) motivates and inspires other,
(3) approachable,
(4) good communicator,
(5) good collaborator,
(6) aware of their limitations,
(7) encourages and practices development of skill + knowledge

Question 26

What is open disclosure?

Answer 26

A discussion that should occur with patients when incidents have resulted in harm to that patient while receiving health care. This involves:
1. Timely discussion in an appropriate environment with appropriate personnel
2. Factual explanation of what has happened
3. Acknowledge and apology for the harm caused. Validate emotions/frustrations, show empathy
4. **Answer question ** and let them know of their rights to place a formal complaint
5. Explain you will ensure this won’t happen again
6. Document
7. Incident reporting
8. Audit/MDM

Question 27

What are the principles of open disclosure?

Answer 27

(1) Open + timely communication with factual explanation of what happened, explanation of potential consequences or outcomes;
(2) acknowledgement of harm;
(3) apology and expression of regret,
(4) discussion of next steps,
(5) documentation,
(6) necessary reporting,
(7) utilizing clinical governance tools to avoid this happening again - audit/MDM/trigger of review if necessary

Question 28

What is graded assertiveness?

Answer 28

A communication tool used to overcome the phenomenon of “authority gradients” that impede the ability of someone with less authority to challenge someone with more authority. Demonstrated by the mneunomic CUSS. Curious, uncertain, seriously concerned, STOP.

Question 29

What can healthcare workers with blood-bourne viruses (Hep B, Hep C, HIV) perform and not perform

Answer 29

HCW with BBV cannot perform exposure prone procedures (major surgery or where a person’s hands come into contact with sharp instruments inside a patient’s body). They can however, perform endoscopy, laparoscopy, minor surgery.

Question 30

What is constructive criticism?

Answer 30

A form of feedback that focuses on delivering critique and negative feedback constructively and positively to improve performance or behavior

Question 31

Domestic violence - What are the situations where mandatory reporting to police obligated?

Answer 31

(1) immediate risk of homicide, (2) reasonable belief that a child is at risk

Question 32

How would you consent a patient for a procedure? (9 steps)

Answer 32

Chart review of patients notes, clinical review of the patient, and/or imaging to establish the correct procedure is indicated.
(1) explain the pathology/diagnosis, natural history and level of confidence
(2) discuss why the procedure is warranted
(3) discuss nature of the procedure
(4) describe the procedure in detail, use visual aids
(5) discuss reasonable alternatives
(6) explain risks, benefits, and uncertainties. General risks, Material risks, Significant risks
(7) expected post-operative course
(8) allow for questions
(9) document discussion and sign consent form

Question 33

What are the seven pillars of clinical governance?

Answer 33

1. Clinical effectiveness
2. Risk management
3. Patient + Public Involvement
4. Audit
5. Staff management
6. Education + training
7. Patient information