Oriel Pre-Reg Pharmacy Overview: Multiple Choice Three of Eight

Advice & Insight From Pre-Registration Recruitment Exam Specialists

Along with ranking questions, in which you must rank five possible courses of action, you will be faced with multiple choice ‘three of eight’ questions as part  these are the multiple choice ‘three of eight’ questions as part of the Oriel Pharmacy SJT. This guide looks at how the multiple choice questions work, how they are marked, and how to succeed in them.

Question Format

The multiple choice questions allow you to select from eight possible choices. Overall, a multiple choice question is worth 12 marks – less than the 20 marks available for a ranking question. However, multiple choice questions are more ‘binary’ – you either select the answers correctly, or you don’t receive marks. For each correct answer, you receive 4 marks. In other words, you won’t receive 1,2 or 3 marks for a ‘near miss’ option, like you would in a ranking scenario. However, it is important to note that there is no negative marking – you won’t lose marks for choosing incorrect options. As such, you must always select three options for any given scenario, even if you are not confident on more than one or two of those options.

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Example Question Explained

Let’s look at an official question from a past paper, edited for brevity:

You are working on a respiratory ward as a Pre-reg Pharmacist. You are asked to visit a patient who needs counselling on her choice of Nicotine Replacement Therapy. The patient, Mrs MacDonald, has a chronic lung condition. The patches were prescribed by her GP. However, she tells you that they have not helped her stop smoking. She explains that she often forgets to put the patches on. She adds that she doesn’t truly want to stop smoking.

Choose the THREE most appropriate options to take in this situation:

A Provide Mrs MacDonald with the mortality rates of those with COPD who also smoke
B Ask Mrs MacDonald to explain why she might be forgetting to use the patches
C Explore with Mrs MacDonald if any of the other Nicotine Replacement Therapy products might be easier for her to remember to use
D Advise Mrs MacDonald that if she wants to stop smoking then she needs to try using the patches properly
E Suggest that Mrs Macdonald make a follow-up appointment with her GP to discuss this further
F Explain to Mrs Macdonald that it is her responsibility to persevere with any option she chooses, if she wants to really stop smoking
G Suggest to Mrs Macdonald that she comes back when she is ready to stop smoking
H Provide Mrs Macdonald with leaflets on the options for stopping smoking

The answer is BCD. Let’s think about why these three options are superior to all others. First of all, we need to realise that this is a consultation-style question. In a consultation question, you must listen to what the patient has to say in order to act on it – and you also must work through any consultation – be it with a difficult patient or a charming one – in a logical and professional manner. Therefore, we need to hear what the patient has to say in order to know how to act. Option C ought to stand out immediately simply because of the word ‘explore’ which is something of a cheat-sheet tip; exploring issues is always a positive choice. If you read through the rest of C, it’s clear that it’s a sensible option that makes a great deal of sense in the context. Moving back to the start of the options, we now need to find two others that work with option C – that’s the goal of the multiple choice questions, to find three options that work together to create a sensible approach. A is entirely lacking in empathy and likely only to scare Mrs MacDonald – no doubt she is already aware of the severity of her condition. B is a good option, as it allows the patient to speak to you, and it’s an open-ended question. As such, we’d likely select B as well. We now need to find a third option that fits with asking the patient about the problem, and exploring solutions. D sounds like a good approach, as it provides an efficient solution to her problem. However, it’s not clear enough for us to move on – instead, read the other options too. E should be discounted as she already has spoken to her GP, and you’re on a respiratory ward – so she is in a specialist care environment where she ought to be getting advice without the need for re-referral backwards. F puts the responsibility solely on the patient rather than seeking to position yourself as the patient’s helper and partner in their fight against illness. G is rude and dismissive and lacks empathy. H is a good option as it provides additional information. You would therefore be choosing between D and H. As the options are phrased, choosing H over D would be understandable – if D was phrased ‘Advise Mrs MacDonald that if she wants to stop smoking then she needs to try using the patches properly, and provide clear advice on how to do so’ then D would be clearly the better option. As it is, this question illustrates the importance of reading every option, and the fact that sometimes you might find two clear answers, but hesitate over the third. Just remember to choose an option, and that the more patient-centred option (here, speaking to them rather than giving leaflets) is likely to be correct.

Oriel Pre-Reg Pharmacy Overview: Multiple Choice Three of Eight

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