Single best answer MCQs in anaesthesia: volume I clinical anaesthesia

Abstract

This compact tome – sized just small enough to fit into the pocket of scrub pants – is yet another preparatory book aimed directly at the anxious hearts and vulnerable wallets of those about to take their anesthesia certification exams. Perhaps knowing that this book from the United Kingdom would join the ranks of other, better-known, and mostly American-produced exam-prep manuals, the editors aimed for a niche within this little market: specifically, Single Best Answer MCQs in Anaesthesia is intended to address the increasingly popular trend of constructing multiple choice questions (MCQs) as exercises in clinical reasoning. For the purposes of this review, this book is compared with two of the above-mentioned American manuals: Hall and Chantigian’s Anesthesia: A Comprehensive Review, 4 Edition, 2010, and Chu’s Clinical Anesthesiology Board Review: A Test Simulation and SelfAssessment Tool, 2005. The book includes 150 MCQs, each of which has a clinically-based stem and five distractors. The book is divided into five sections of 30 questions, and each section is followed by an answer code. Every answer includes a detailed explanation of the clinical reasoning and is accompanied by one or two recent references. The content of the questions is almost always current, correct, and relevant. This volume has a few important strengths. First, the questions are very likely newer than those in other MCQtype review books (for example, Clinical Anesthesia Board Review contains the American Board of Anesthesiology (ABA) exam questions from the early 1990s, while the 2010 edition of Anesthesia: A Comprehensive Review retains many of the same questions as its 2002 edition). All of the questions in Single Best Answer MCQs are based on clinical reasoning, whereas the other two manuals include only a small percentage of this type of question. The questions cover a fairly reasonable spectrum of North American anesthesia practice, although the authors tend to favour the content areas of resuscitation and management of medical comorbidities. The degree of difficulty of the questions is variable; most items target residents’ knowledge levels from postgraduate year 3 (PGY-3) to PGY-5. Several caveats should be considered before paying $60 to buy this book. First, owing to its British roots, the Canadian reader will encounter unfamiliar terminology, medication names, acronyms, guidelines, and measurement units throughout the text. Second, unlike its competitors, this book does not reference the major anesthesia textbooks (e.g., Miller’s Anesthesia, Barash’s Clinical Anesthesia, and Stoelting’s Anesthesia and Co-existing Disease), but instead it references scientific articles. This referencing approach to source documents allows the tome to be as current as possible, but it also means that some older, smaller, and lesser-known studies are used to support questions about some rather esoteric topics. And third, Canadian anesthesia practitioners might legitimately consider some of the content to be the territory of other specialties, for example, ultrasound findings in acute pancreatitis or classification of postpartum suicide. Perhaps there is also some overemphasis on relatively rare diseases, such as Guillain-Barre syndrome, which merited two questions from the first 60 questions in the book. This education enthusiast has some additional comments regarding the questions themselves. While most questions are well-written, some use a ‘‘clinical’’ example whose only function is to disguise a question that tests knowledge recall. In the majority of cases, questions would benefit A. Fraser (&) The Ottawa Hospital, Ottawa, ON, Canada