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UMAT: Section II - sample questionsSection II of the UMAT: Interaction SkillsConsists of 36 questions, 45 minutesThis section of the UMAT includes scenario-type questions and dialogue stimulus which requires the student to identify the emotions being conveyed in the stimulus or to identify the most appropriate response to a situation. Sample Question 1You are a receptionist working in a small rural doctor's surgery. It has been a very busy day. There are already six patients who are waiting to see the doctor and they have made appointments. The next appointment is Mrs. Yarra, who comes in with a friend and asks for her friend to be seen by the doctor after her for a check-up. The friend does not have an appointment.What do you think is the best option? A) You tell her that the friend will see the doctor once he has attended to the six patients who have been waiting, even if it means that the friend has to wait a while. B) You tell her that as she does not have an appointment, the doctor can not see her. C) You tell her that the doctor is all booked out for now, and as all she requires is a check-up you will have to give her the earliest appointment the very next morning. D) Tell her to not worry and just go home and take an aspirin. The correct answer is (C). The receptionist is prioritising and describes the difficulty with the friend seeing the doctor at present, especially since all she requires is a check-up. Sample Question 2A patient has arrived at his doctor's clinic to receive his test results. Dr: We have found that the lung patch we had checked out isn't an infection after all. It appears to be a cancerous growth. Patient: I have cancer? Is this the end for me? Dr: Is this what cancer means to you? That it is the end for you? Patient: Well it's cancer Doctor: Not necessarily. Different people view cancer in different ways. How do you understand it? In his response, the doctor has A)not addressed the patient's emotional reactions.B)lied to the patient about what his results signify. C)expressed an understanding of how the diagnosis sounds and feels to the patient. D)provided the patient with sufficient explanation of his results, while failing to include the patient's own ideas The correct answer is (C).Failing to explore the patient's combination of ideas about the diagnosis, symptoms and therapy will only weaken any further discussion with the patient. It is your responsibility to listen to the patient and to show that you understand his response to the diagnosis. Consider the following approach for revealing a diagnosis: Dr: So, to get to the point, the test results show that you have cancer. Patient: What? Oh God, oh no, please, God no! Dr: But don't worry, we have some extremely effective chemotherapy for your cancer. Patient: Oh no, this can't be happening. Oh God, please no! In his method of approach, the doctor has: A)saved time on the consultation.B)been honest with the patient regarding the diagnosis. C)reassured the patient that he will receive the best possible care for his illness. D)ineffectively conveyed the patient's diagnosis and has failed to respond to his emotions. The correct answer is (D). The reassurance the doctor provided shows that he has ignored the patient's shock and fear. He has not taken time in giving the bad news and has not elicited the patient's deepest sense of loss and grief. Sample Question 320 year old Sharon accompanies her 40 year old mother to the local GP surgery. The mother is consulted privately regarding her stomach pains, and the doctor suspects a serious disorder. The mother seems very distressed upon exiting the room, and the daughter stops the doctor in the hallway demanding to know the likely diagnosis. She asks the doctor not to mention any more bad news to her mother as it is depressing her.What should the doctor do? A) Tell her it is nothing serious and to schedule another consultation where he will speak to them both about it. B) Say that he realises she must be worried about her mother's health, but he has yet to determine what is wrong with her, and that he will tell her in the next consult. C) Say that he realises she must be worried about her mother, but as a doctor, he has an obligation to inform her mother about all the findings. D) Mention that her mother is the patient, and by law, he has an obligation to inform her of all the findings. The correct answer is (C). A patient has a right to know all the findings and details available about their condition so that they are able to make a decision based on this. Option C is the correct answer as it is also empathetic to the patient's relative. Sample Question 4You are a GP consulting a man who has lost his wife of 43 years to breast cancer three months ago. He is finding it very hard to deal with the loss and he can not understand how this could happen in such a happy and healthy family.Which one of the following options is the best response in such a situation? A) I understand this must be a tough time for you. B) You look like you are having a tough time dealing with this. Let's talk about it. C) Losing a family member is a very sad experience, but one must find ways to move on with their life. D) It sounds like you were very close to your father. The correct answer is (B). Counselling families about death is a difficult task, where it is important for the doctor to get the patients talking about it. Option B is an empathetic response and invites the patient to openly discuss his feelings. Sample Question 5Jacobi Black is a 22 year old girl who was diagnosed with swimmers shoulder a few weeks ago. Prior to this she was intensively training for the Olympics, 5 hours a day on average. She is being treated by the physiotherapy clinic in the medical centre you work at and you have given he some exercises to help relax the shoulder muscles and alleviate the pain. However lately, she has been reluctant to keep appointments with you and is becoming slack with the exercises. One day when her boyfriend brings her in, you have a chance to talk to her about it.What is the best course of action to ensure her co-operation? A) Jacobi, it's very important that you continue your exercises, otherwise your shoulder may begin to feel worse. B) Adhering to exercise regimens is very hard at times, but I think you should persist to make your shoulder heal completely. C) Recovering from an injury can be difficult. Can you tell me what is concerning you about the exercise regimen? D) Jacobi, if you want to continue professional swimming later on in life, then it is important that we heal your shoulder completely. Is there anything concerning you? The correct answer is (C). Patients esp. young ones may struggle with recovery from an injury. For whatever reason, they may not comply with exercises and treatment. It is your job to find out why and get them back on track. C is an empathetic response which lets the patient feel comfortable with opening up and talking about it. Sample Question 6As a doctor in a suburban clinic, your patients have been complaining to you a lot about the nurse in your surgery lately. The chief complaint seems to be with her impertinent attitude and remarks, especially to children and the elderly.What should your actions be? A) Give this nurse less shifts and eventually replace her with someone more suitable. B) Sit down and discuss the issue with her privately at a time outside of work hours. C) Take her aside one day while at work, and have a quick word with her. D) Show her a good example by always being very polite around her and other patients in front of her. The correct answer is (B). It offers the possibility of a discussion where the issue can be best dealt with, without compromising the nurse's privacy. This is more preferred than a quick word' that option C suggests. Sample Question 7Patient : Three years ago I suffered a heart attack and was in hospital out in Eden . My family GP didn't come to see me for a week and when he did come, the first thing he said to me was John, it's about time you free the hospital bed and go home to recover. If I could have jumped out of the bed right then I would have torn his head off with my bare hands, I was fuming. Upon making this comment, the patient is likely to feel: A)embarrassedB)irate C)saddened D)offended The correct answer is (B). At the time of the incident, the patient was very angry at the doctor. Reliving the situation afterwards would bring up similar feelings. Following the above comment from the patient, the doctor replies saying: Dr: Was the pain you experienced three years ago similar to the pain you are experiencing today? Following the Doctor's reply, Bob is likely to feel: A)ashamedB)confused C)despaired D)not understood The correct answer is (D). Not responding to the patient's emotions is inconsiderate. The best treatment for anger is understanding. If, on the other hand, the doctor had replied as follows: Dr: Sounds like you were pretty upset with your GP back then. The patient might have felt: A)supportedB)aware C)satisfied D)bewildered The correct answer is A. If the doctor shows the patient that he understands his thoughts and feelings, the patient is most likely to feel looked after and cared for by the doctor. Sample Question 8A 55 year old man dies of complications with a lung transplant. He had decided to have to operation done to better his chances of staying alive. Prior to the operation you have warned him of the possible complications that may occur. His daughter now comes in to talk to you about the situation and is upset that the doctors could have performed the operation more effectively and that there was no need for her father to die.What is best response that you can give? A) "I'm sorry about your father's death, but I had explained to him the likelihood of the possible complications that could occur." B) "I was very sorry to hear to of your father's death, and it must be very upsetting for you too. However, I had discussed with him the side effects of the surgical procedure in great depth, and the decision was his entirely." C) "Sorry to hear about his death, I can see you are very upset. To undergo the operation, however, was his decision" D) "Sorry to hear of his death, but he had no option but to undergo that procedure." The correct answer is (B). The daughter has come to find out whether choosing the operation was the father's decision and not yours. It is important to convey your condolences to her and acknowledge her grief as well, re-stating that the decision was her father's. Sample Question 9A 44 year old woman has come to you regarding a pain in her stomach. Her daughter's blood test results had come in earlier that day and she has been found positive for HIV.You think that you should say something, but what would be the most appropriate thing to say? (Keeping in mind that the mother is unaware of any of this). A) I just want you to pass on the results of your daughter's blood results to her. B) Can you remind your daughter to call me? I want to have a word with her. C) Your daughter's results have come back, and the news is not good. D) Can you ask your daughter to call me? The results of her blood test are back. The correct answer is (B). Doctor-patient confidentiality has become very important to preserve, even from family members. It is obvious that the mother can not be told of the daughter's blood test results, but it is preferred not to say the reason why the daughter should contact the GP as well. Sample Question 10A 56 year old woman comes to see her GP for a viral throat infection. She has been your patient for a number of years and has always had a bad back due to a prolapsed disk 10 years ago. As your consultation is about to end, she brings it up and mentions being distressed by it.What should be the GP's response? A) You've had this for many years; I thought you would get used to it. B) Has anyone commented on it? C) This bad back doesn't have to be distressing. We can do something about it. D) This is something you've had for many years, why is it distressing you now? The correct answer is (D). The patient is distressed by an abnormality, but only brings it up now after so many years. This points to an underlying cause, which the GP needs to probe thoroughly before presenting any solutions.
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