UKCAT Situational Judgement Help? Watch

chelsea1605
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Hello,

So I am currently preparing for my UKCAT exam which I have pushed back to mid September now.
I have been using Medify as one of my resources and have just completed a SJT 'mini mock' on there.

There is a scenario which I got wrong and am still unsure about despite having read the explanation.
Here is the scenario, it is from one of the 'Appropriateness' type questions:

"A junior doctor is working on the accident and emergency ward. A 37-year-old man arrives on the ward complaining of a testicular lump. After assessing him, the junior doctor can find nothing at all wrong with the patient. The junior doctor has several other patients waiting to be seen but the gentleman is still complaining. The gentleman is convinced he has testicular cancer as he feels pain in the groin region.

How appropriate are each of the following responses by the junior doctor in this situation?

Request an additional ultrasound to further confirm the diagnosis."

My answer was it is "appropriate but not ideal" because I thought the junior doctor was right to have remained confident in their diagnosis but also tried to do something to reassure the skeptical patient. An ultrasound would have done this which is why i thought the response was 'appropriate' however I said it was not ideal because the man wasn't immediately reassured, and it just seemed a bit dismissive to me since the text suggested the man was quite agitated about it.

The correct answer was 'Inappropriate but not ideal' and the explanation that Medify gave was 'as there no confirmed signs of a problem it is unwise to use up hospital resources' but isn't the whole point of the ultrasound to confirm it?? Can you call it confirmed just from an examination?
Medify says that these investigation are, and I quote, 'meant to confirm or point to possible diagnoses on the basis of clinical evidence.'
If so why is it inappropriate to give the ultrasound?

I looked at GMCs Good Medical Practice and it says 'Provide effective treatments based on the best available evidence'. Wouldn't the ultrasound have given 'the best available evidence'?
So basically what it's saying here is that since there is no 'clinical' evidence something is wrong, the ultrasound is inappropriate, EVEN THOUGH the patient is still complaining? I thought we are supposed to act in the best interest of the patient?
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Minerva
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(Original post by chelsea1605)
Hello,

So I am currently preparing for my UKCAT exam which I have pushed back to mid September now.
I have been using Medify as one of my resources and have just completed a SJT 'mini mock' on there.

There is a scenario which I got wrong and am still unsure about despite having read the explanation.
Here is the scenario, it is from one of the 'Appropriateness' type questions:

"A junior doctor is working on the accident and emergency ward. A 37-year-old man arrives on the ward complaining of a testicular lump. After assessing him, the junior doctor can find nothing at all wrong with the patient. The junior doctor has several other patients waiting to be seen but the gentleman is still complaining. The gentleman is convinced he has testicular cancer as he feels pain in the groin region.

How appropriate are each of the following responses by the junior doctor in this situation?

Request an additional ultrasound to further confirm the diagnosis."

My answer was it is "appropriate but not ideal" because I thought the junior doctor was right to have remained confident in their diagnosis but also tried to do something to reassure the skeptical patient. An ultrasound would have done this which is why i thought the response was 'appropriate' however I said it was not ideal because the man wasn't immediately reassured, and it just seemed a bit dismissive to me since the text suggested the man was quite agitated about it.

The correct answer was 'Inappropriate but not ideal' and the explanation that Medify gave was 'as there no confirmed signs of a problem it is unwise to use up hospital resources' but isn't the whole point of the ultrasound to confirm it?? Can you call it confirmed just from an examination?
Medify says that these investigation are, and I quote, 'meant to confirm or point to possible diagnoses on the basis of clinical evidence.'
If so why is it inappropriate to give the ultrasound?

I looked at GMCs Good Medical Practice and it says 'Provide effective treatments based on the best available evidence'. Wouldn't the ultrasound have given 'the best available evidence'?
So basically what it's saying here is that since there is no 'clinical' evidence something is wrong, the ultrasound is inappropriate, EVEN THOUGH the patient is still complaining? I thought we are supposed to act in the best interest of the patient?
Yes, if there's absolutely nothing to suggest a problem. The examination is the clinical evidence - assuming it's been done competently, of course.

I have to say, I don't quite follow 'inappropriate but not ideal' as a possible response...
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