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Critical Appraisal for medical interviews - Preparing for AFP (Academic Foundation Programme)

2018-10-08 · Podcast or interview · Ali, Ankur Khajuria · recording, 10:08 · watch on YouTube

Topic: Medicine and his doctor years · mode: Conversation and interview · tags: Aimed at students

In the third part of Ali's Medical Mondays series on the Academic Foundation Programme, surgeon Ankur Khajuria explains how to prepare for the critical appraisal interview station: read lots of abstracts, summarise the paper, use PICO, discuss biases and internal and external validity, and never say one paper would change your practice.

What is said

The parts of the video and what is said in each (★ — how much it matters to the video).

00:00:00 — Medical Mondays: the AFP critical appraisal station, who the video is for, the talk with Ankur Khajuria

  • ★★ Ali's Medical Mondays video covers how to prepare for the critical appraisal component of the Academic Foundation Programme. — 00:00:00 · Academic Foundation Programme
  • ★ Ali calls his Academic Foundation Programme mini-series niche: it is aimed only at fifth- and sixth-year UK medical students, and others will probably not find it helpful. (hedged) — 00:00:00 · Academic Foundation Programme
  • ★★ Six months before the video Ali filmed a talk on the Academic Foundation Programme critical appraisal station with his friend Ankur Khajuria, a surgeon who has written books about the AFP and runs a course for it. — 00:00:29 · Academic Foundation Programme

00:01:00 — Papers prepared in advance at Oxford, abstracts on the day in London, Ali's feedback

  • ★★ Ankur Khajuria says the Oxford Academic Foundation Programme interview commonly asks about a paper you have read recently, and not having read one there does not come across well. — 00:01:00 · Academic Foundation Programme
  • ★★ Ankur Khajuria says his friends spoke with people who had done the Oxford interview before and prepared two papers for it. — 00:01:00
  • ★★ Ankur Khajuria says talking about a paper you prepared is still a critical appraisal, but a nicer one, because you have almost prepared it beforehand. — 00:01:30
  • ★★ Ali says that in London and a few other places the Academic Foundation Programme interview gives you an abstract on the day to critically appraise. — 00:01:58 · London, Academic Foundation Programme
  • ★★ The feedback on Ali's Academic Foundation Programme interview showed he fell down on the critical appraisal station; he did all right in clinical emergencies because he had memorised the Oxford Handbook. — 00:01:58 · Academic Foundation Programme
  • ★★ Ali wishes he had discovered Ankur Khajuria's book AFP Secrets sooner and tells viewers to get it. — 00:01:58

00:02:27 — Critical appraisal is all about practice: read lots of abstracts, expect a randomised controlled trial

  • ★★ Ankur Khajuria says many Academic Foundation Programme applicants have done a little research but were never taught critical appraisal skills. — 00:02:27 · Academic Foundation Programme
  • ★★★ Ankur Khajuria says the key to getting comfortable with critical appraisal is reading lots of abstracts; he read New England Journal abstracts, which have many randomised trials. — 00:02:56
  • ★★ Ankur Khajuria says the Academic Foundation Programme critical appraisal is generally of a randomised controlled trial, certainly in London, though cohort studies and other designs can come up. — 00:03:25 · London, Academic Foundation Programme
  • ★★ Ankur Khajuria says the more you practise critical appraisal before the interview, the more comfortable you will be in it. — 00:03:25
  • ★★ Ankur Khajuria developed his own way of critically appraising a paper, documented in his book; viewers can follow it or develop their own, but must cover some key areas. — 00:03:55

00:04:18 — Summarise the paper, PICO, biases, internal and external validity

  • ★★★ Ankur Khajuria advises first summarising the paper or abstract quickly: its design, what it compares, the primary and secondary endpoints, the safety outcome and what it shows overall. — 00:04:18
  • ★★ Ankur Khajuria says that after presenting your summary of the paper you can, depending on your confidence, carry on talking or wait for the examiner to lead. — 00:04:47
  • ★★★ Ankur Khajuria recommends the PICO framework to find a paper's research question: patient population, intervention, comparator and outcome. — 00:04:47
  • ★★★ Ankur Khajuria advises discussing a paper's biases, such as selection bias, and how randomisation and allocation concealment address them. — 00:05:16
  • ★★★ Ankur Khajuria: After biases, Ankur Khajuria advises covering internal validity, related to the biases, and external validity: whether the results apply to your own patient population. — 00:05:44
  • ★★ Ankur Khajuria says that after you present the abstract, Academic Foundation Programme interviewers commonly ask whether the paper will change your practice. — 00:05:44 · Academic Foundation Programme

00:06:13 — Would this paper change your practice?

  • ★★ Asked whether a paper would change his practice, Ali would check whether its patient group matches his own (an RCT done in Vietnam might not apply in the UK) and what two treatments it compares. — 00:06:13
  • ★★★ Ankur Khajuria says the key to critical appraisal is saying one paper will not change your practice unless it is groundbreaking: look at the other literature, consider a systematic review and look for gaps in the data. — 00:06:52

00:07:34 — Resources: Cochrane checklists and How to Read a Paper

  • ★★ Ankur Khajuria: For other critical appraisal resources, Ankur Khajuria points to the material from Cochrane, which has developed checklists you can use. — 00:07:34
  • ★★ Ankur Khajuria warns that critical appraisal checklists can make you come across formulaic in the interview; the appraisal should come naturally and flow. — 00:08:01
  • ★★ Ali recommends the book How to Read a Paper, recommended on another Academic Foundation Programme course he attended; he read it cover to cover and found it enjoyable. — 00:08:31 · Academic Foundation Programme

00:09:00 — Links, the final video of the series on the personal interview, sign-off

  • ★★ Ali calls Ankur Khajuria's book pretty good; he did not take Ankur's course himself but has heard it is good. — 00:09:00
  • ★★ Ali says the next video, the final one of his Academic Foundation Programme mini-series, will be on how to prepare for the personal interview. — 00:09:00 · Academic Foundation Programme
  • ★★ Ali's Academic Foundation Programme interview at EBH had nothing academically fancy about it, and many other places also hold a personal interview. — 00:09:41 · Academic Foundation Programme

Threads in this video

Where the stories that moved here went next

Mentioned

Central: Academic Foundation Programme · Ankur Khajuria · critical appraisal

Also: Projects: Medical Mondays

Works: AFP Secrets · How to Read a Paper · New England Journal of Medicine · Oxford Handbook of Clinical Medicine

Organizations: Cochrane

Concepts: PICO framework · randomised controlled trial · systematic review

Places: London · Vietnam

Only in the description or credits: High Yield

Also centred on Ankur Khajuria: Academic Foundation Programme (AFP) - Why should you apply? · Clinical Emergency Scenarios - AFP Interview preparation · Academic Foundation Programme · AFP Interview Preparation - The personal interview · Academic Foundation Programme

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