Physician Associate University Interview Questions and Answers
Advice & Insight From PA Application Specialists
Below are five Physician Associate Interview Scenarios which are based on Interview cases that have been used at PA Universities as part of the interview selection process. We would recommend that you practice the scenarios before reviewing the answers, comparing your performance with that of an ‘average’ and ‘excellent’ Physician Associate applicant.
Physician Associate Interview Scenario 1
You are a physician associate on a consultant ward round and by accident you wrote the entry in the wrong patient’s notes. At the end of the ward round, the charge nurse advised you regarding the potential error and you subsequently removed the page from the notes and threw it into the bin.
Outline the main issues raised.
Average Candidate Response:
The main issue raised is that of documenting in the wrong patient’s notes which could lead to the wrong management plan being initiated for the wrong patient. It is reassuring to note that this error was noticed by the charge nurse.
Excellent Candidate Response: ‘Correcting Errors – BlackStone Tutors 3 Step Approach’
- Managing the immediate risk/harm and escalating if required
- Preventing further short term consequences
- Investigating to prevent long term recurrences
There are a number of issues raised in this case ranging from the initial error, to the removal of documentation from patient notes and finally the manner in which the notes were disposed.
The initial error of documenting in the wrong patient’s notes is potentially dangerous as it may lead to the wrong management/investigation for the wrong patient. Removing a page from notes is a contentious issue, as whilst it may help to prevent incorrect management/investigations being initiated, it is possible that on the reverse of the sheet, there may have been documentation from other MDT professionals which should not be tampered with. Hence, crossing out the incorrect documentation may be a more appropriate response.
Additionally, any patient sensitive information such as patient notes should not be disposed of in ‘a bin’ and instead should be inserted into a ‘confidential waste bin’ if required, thus preventing the disclosure of confidential information. In order to prevent further similar occurrences, it would be useful to investigate how initially it was possible to document in the wrong patient’s notes.
Physician Associate Interview Scenario 2
Review the graph enclosed and explain your findings:
Content modified from www.diabetesdaily.com
Average Candidate Response
- This graph shows that diabetic individuals have higher blood sugars than non-diabetic individuals at baseline and after meals.
Excellent Candidate Response
Excellent candidates will use the ‘BlackStone Tutors Six Point Approach for MMI Data Analysis’
- Data Title (if present)
- ‘x’ axis and ‘y’ axis
- Graphical/tabular progression shown
- Physiological correlation (How can this pattern be explained biologically?)
- Anomolies/additional information of note
- Critical analysis of data/data source
‘This is a graph comparing mealtime blood sugars in a diabetic and non-diabetic individual. On the ‘x’ axis is the time in hours with blood sugars represented on the ‘y’ axis. The time ‘0’ is likely to signify the commencement of mealtime. The graph shows that at baseline, diabetic individuals, represented by the red line have higher blood sugars than non-diabetic individuals, who are represented by the blue line. Additionally, in response to food, diabetic individuals demonstrate a greater rise in blood sugar compared to non-diabetic individuals with peaks of 215 and 140 respectively. Thereafter the normalisation of blood sugars in non-diabetic individuals takes a maximum of two hours to return to baseline, compared to almost six hours in diabetic individuals.
The higher baseline blood sugar and slower return to normal levels in diabetics can be explained by an absolute deficiency of insulin in Type 1 Diabetics and a relative insensitivity to insulin in Type 2 Diabetics. With insulin’s important role in lowering blood sugars through transport of sugars into storage organs and conversion of glucose to glycogen, an absolute or relative lack of insulin will result in generally higher blood sugars.
There are no anomalies demonstrated, and the data is from a reputable source (Diabetes Daily), however it would be beneficial to note the units used to measure blood sugars on the ‘y’ axis.’
Physician Associate Interview Scenario 3
As a physician associate, how would you go about treating a patient who is in pain?
- In this case, it would be important to swiftly administer pain relief as it is unethical for patients to be in pain for longer than necessary.
- It would also be important to review the underlying cause of the pain and how this can be best managed to prevent further patient discomfort.
Excellent Candidate Response:
When treating a patient who is in pain, I would firstly introduce myself and my role, so would describe how I am a physician associate who is here to help them. I would also reassure the patient, and tell them that I will try my best to alleviate the pain as soon as possible. If the patient is able to speak, I would ask about their presenting complaint, i.e. why they are in hospital, however if this is not possible I would talk to the attending doctor and ask them about the patient’s medical history. It is then important to establish the character of the pain. For example, how strong it is from one to ten, what type of pain it is (a sharp versus a dull pain), and the location.
When talking to or interacting with the patient, I would ensure that I treat them with respect and compassion, as they could potentially be in significant distress. After identifying the details of the pain, I would discuss with my team what method of pain management should be administered, and after making a decision would return to the patient and notify them of the plan. It is vital that the patient provides consent to this treatment – the patient should be able to understand the information, weigh up the pros and cons of the treatment, and relay this information back to you. Once this had been established, I would proceed with implementing the pain management process as well as reviewing the underlying cause for the pain, and how this can be best managed to prevent future distress.
Physician Associate Interview Scenario 4
If a patient requires 250ml in 8 hours of an intravenous medication, what is the desired flow rate?
(Provide your answer to 1 decimal place)
‘X’ ml over 1 hour
250/8 = 31.25
‘X’ = 31.25 ml/hour
= 31.3 ml/hour (1 decimal place)
Physician Associate Interview Scenario 5
You are a second year PA student and you have just seen one of the doctors come out of the store room and put three syringes and needles in his pocket.
Explain what actions you would take in this scenario.
Average Candidate Response:
It is strange to see a doctor put syringes and needles in their pocket. It is unusual but he might be using it for a patient. If he is not using it for a patient, it is considered stealing. Stealing, particularly from a doctor who is meant to set good examples, is not acceptable and I would report it to the GMC.
Excellent Candidate Approach
There are many reasons for why a doctor may put syringes and needles in his pocket. He may need to pick up other equipment or resources to tend to a patient. Another reason may be because he may need it for a patient he is seeing later on, where he will not have access to these resources. Since this situation does sound quite unusual, and as a physician associate student who has less experience and knowledge than the doctor, it would be appropriate to politely ask the doctor for which patient this equipment is for and for what condition it will be used to treat or manage. Asking with an interest may make it seem less so an accusation, as one may not be certain that the doctor is performing unlawful actions.
If the doctor fails to provide a satisfactory answer, it would be important to escalate this matter to another junior doctor or consultant to ensure that preventable patient or employee harm does not occur. In future, it may be appropriate to review access to store rooms, to further prevent misuse of limited NHS resources.
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