Q22 Management Viva Practice Question

You have 10 (ten) minutes to complete this station, after reading time.

You are a GP. Sharif is a 45-year-old man who comes to see you for help with his sleep. He arrived in Australia a number of years ago as an asylum seeker
from Afghanistan. He works as an interpreter and is a leader in his community. He spent several years in refugee camps in Pakistan before travelling to
Australia by boat. He then spent several years in a detention centre before being recognized as a refugee and given permission to stay in Australia. His
family remains in Afghanistan. He comes to see you for help with his sleep.

Over recent months, he reports that his sleep has deteriorated. He finds it hard to get to sleep and often wakes with nightmares and cannot get back to
sleep as he lies awake worrying about his family and countrymen. He feels guilty that he cannot protect them and for the good life he now has. He is more
worried than ever about his family’s safety, given the increasing power of the Taliban. He finds it hard to concentrate on his work and has been irritable and
jumpy recently.

Your tasks are to discuss with the examiner:

1. Your approach to obtaining any extra information that would help you understand the presenting problem and to establish a provisional diagnosis
differential diagnoses.

2. Your trauma informed management plan.

 End of Term Management Viva Marking Guide 2021 (Phase 3 Psychiatry)
Student Details: Examiner:
Return to: ug.psych@unsw.edu.au

Question Number: Please Mark / Circle one grade for each -see Pg2 for guidelines

1. Judgement and approach to management: appropriate provisional diagnosis or F B P P+

differential diagnosis, recognises crucial information, logical approach (e.g. refining
diagnosis, exploring options in treatment), approach is appropriate to the clinical Borderline Good
context, adapts approach to additional information Fail Grade Pass Exceptional
2. Application of medical knowledge: applies relevant knowledge correctly, depth of F B P P+
understanding demonstrated in decisive and confident approach, approach based on Borderline Good
evidence or guidelines, approach demonstrates learning from clinical experiences Fail Grade Pass Exceptional
3. Safe practice: recognises life-threatening or potentially serious aspects, considers F B P P+
potential adverse consequences of actions, demonstrates safe judgement, aware of Borderline Good
ethical and/or legal implications of actions Fail Grade Pass Exceptional
4. Interprofessional communication: clear and concise discussion, demonstrates F B P P+
ability to recognise and respond to critical information, requires minimal prompting to Borderline Good
elicit relevant information Fail Grade Pass Exceptional
Examiner’s Comments Overall Evaluation
(please note, while the marks provided above should inform the overall evaluation, a ‘fail’ mark in one
or more component is neither mandated nor required for an unsatisfactory overall evaluation)

☐ Unsatisfactory with serious concerns (outright fail)

☐ Borderline Pass with concerns

☐ Pass
Guidelines for Borderline Grade
This grade represents a borderline performance for this criterion. The student has failed to address an essential element OR the student has an understanding of the skill
but has not demonstrated an overall satisfactory level of competency for this element of the station. This student is not a

CLEAR FAIL, nor a CLEAR PASS on this criterion. 

• B is not pass conceded or low-level pass.

• B can be given if the examiner cannot make a decision between clear Fail (F) or clear Pass (P).
• B means that further information is required.
• A statistical algorithm will be applied to convert B grades into either F or a P after the exam. The outcome depends on a range of factors including the
performance of the student in other stations (student ability), and how other students performed in the same station (station difficulty).

Guidelines for Fail Grade

A fail grade in each of the following criteria would require that the student has failed in all or most of the elements.

Criterion 1: Judgement and approach to management

• Fails to interpret clinical information to determine a suitable provisional diagnosis or differential diagnosis.
• Fails to recognise significance of crucial information.
• Unable to outline a logical approach to management.
• Approach is based solely on a general understanding of a disease and fails to relate approach to the context of the case and any additional information.

Criterion 2: Application of medical knowledge

• Fails to demonstrate suitable level of knowledge.
• Knowledge is erratic and not directly relevant to the clinical case.
• Knowledge is superficial and student frequently changes answers reflecting lack of understanding.

Criterion 3: Safe practice

• Fails to recognise life-threatening or potentially serious aspects of case.
• Fails to understand potentially serious consequences of actions/decisions.
• Fails to consider safety issues and patient’s well-being in decision-making.
• Is not aware of ethical or legal implications of actions.

Criterion 4: Inter-professional communication

• Fails to communicate understanding and approach in a clear and concise manner.
• Fails to recognise and respond to critical information in original case or any additional information.
• Lacks focus in discussion. Requires considerable prompting to ascertain understanding and elicit relevant information.