Pharmacy regulator’s insight - sigma Mathematics and ... · Pharmacy regulator’s insight Lisa Smith ... Water BPC required is 15 mL ... questions in the calculations did

Pharmacy regulator’s insight

Lisa Smith Assessment writing manager November 2014

Baby died after 'decimal' error

A mistake over a decimal point caused the death of a Derby baby in March 2002 who was

given 10 times the recommended amount of heart medication (digoxin), a coroner has ruled.

The child received 222 micrograms instead of 22 micrograms.

Registration assessment

• Must be passed in order to register

• The purpose is to ensure that PRTPs demonstrate an understanding of how to apply knowledge appropriately and in a timely manner when making professional judgements in pharmacy practice contexts. In addition it ensures that candidates are appropriately numerate to practice as a pharmacist

• National assessment • The GMC has agreed to develop a single national

licensing examination

The registration assessment

• Closed book examination – 90 questions in 90 minutes

• Open book examination – Includes 20 pharmaceutical calculations – 80 questions in 150 minutes – No calculators – References: BNF, BNF for Children

Pass requirements

• The overall mark is calculated by adding the marks from both papers together to create a total. The pass mark is usually 70%*, which equals:

• 119/170 overall and • 14/20 in calculations

• *The Board of Assessors use an equating process to

ensure that each sitting of the assessment has the same level of difficulty and so the pass mark can be moved if necessary.

Peppermint water case

• 3-week old Matthew Young died after he had been prescribed peppermint water to treat colic when he was four days old

• Doubt about whether university and pre-registration

training led to an appreciation of the differences between chloroform water in its different forms

• In 2002, RPSGB introduced a separate calculations

section into the registration assessment

You have been asked to prepare 300 mL Gentian Mixture, Alkaline, BP using the following formula.

Gentian Mixture, Alkaline, BP

Concentrated Compound Gentian Infusion BP

Sodium Bicarbonate BP

Double-strength Chloroform Water BP

Water

1 mL

500 mg

5 mL

to 10 mL

As you have no double-strength chloroform water you decide to use concentrated chloroform water.

FIRST STATEMENT SECOND STATEMENT

The volume of Concentrated Chloroform Water BPC required is 15 mL

Concentrated Chloroform Water BPC is 20 times the strength of Double-strength Chloroform Water BP

Facility %A %B %C %D %E %None

0.69 6 3 5 69* 16 1

Number of candidates

Pass rates – June sittings Percentage of candidates that passed

94.5%

82.4%

91.1% 86.5%

92.7% 94.3% 89.9%

86.7% 85.5%

94.6%

77.8%

85.3%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

2002 2003 2004 2006 2007 2008 2009 2010 2011 2012 2013 2014

Pass rates – September sittings

Percentage of candidates that passed

74.6%

80.2%

71.4% 73.3%

83.9% 80.6% 81.9% 81.9%

77.8%

87.9%

58.2%

69.2%

60.9%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

Calculations – pass rate Percentage of candidates that passed Calculations section

92.3% 94.9%

88.4%

95.1% 98.0%

76.1%

89.7% 90.4% 94.0%

88.5%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

Jun-10 Sep-10 Jun-11 Sep-11 Jun-12 Sep-12 Jun-13 Sep-13 Jun-14 Sep-14

June 2014 – lowest marks

• 46% overall and 50% for calcs • 51% overall and 30% for calcs • 51% overall and 45% for calcs • 53% overall and 35% for calcs

September 2014 - feedback

In the open book paper a couple of calculations were very difficult and a lot of time was spent on them which hindered the time I had to complete the open book paper

There were some ambiguous question also with the calculation for Endokay no 1 question not properly worded

Some calculations question were not clearly understandable and were made hard compare to June exam

Unfortunately, a couple of questions in the calculations did not have the right answers in the options that were provided.

I wonder why there is no syllabus for the exam? We are basically meant to cram whole BNF to pass the closed book exam.

However, I would like to thank GPhC for taking time to set the Assessment.

Q74 (OB) - The candidate reported that there was no correct answer.

Facility Biserial St Err Biserial %A %B %C %D %E %None

0.49 0.34 0.05 11 33 49* 4 3 1

Water mineral analysis has revealed a fluoride ion content of 0.2 parts per million. Which one of the following is the volume of En-De-Kay paediatric drops that would provide an appropriate daily dose of fluoride ion for a child who is 7 years old for the prophylaxis of dental caries?

A 0.15 mL

B 0.3 mL

C 0.6 mL

D 1 mL

E 1.32 mL

BNF for Children

Water content less than F- 300 micrograms/litre (0.3 parts per million) By mouth Child 6 months–3 years F- 250 micrograms daily Child 3–6 years F- 500 micrograms daily Child 6 years and over F- 1 mg daily Water content between F- 300 and 700 micrograms/litre (0.3–0.7 parts per million) Child 3–6 years F- 250 micrograms daily Child 6 years and over F- 500 micrograms daily Water content above F- 700 micrograms/litre (0.7 parts per million), supplements not advised


0.96 0.28 0.09 0 1 *96 0 2 0

A child is prescribed 150 micrograms of adrenaline (epinephrine) to be given by intramuscular injection for anaphylactic shock. Which one of the following is the volume of adrenaline 1 in 1000 that the child should be given?

A 0.05 mL

B 0.1 mL C 0.15 mL D 0.2 mL E 1.5 mL


0.93 0.45 0.07 0 1 3 *93 2 0

Mrs B has brought a prescription into your pharmacy for her 4-year-old daughter, child B, for ranitidine 75 mg/5 mL oral solution. The dose on the prescription is 4 mg/kg twice daily. Given that child B weighs 15 kg which one of the following is appropriate dosage guidance for inclusion on the label you produce for this medicine?

A give 0.2 mL using the oral syringe provided twice a day

B give 0.8 mL using the oral syringe provided twice a day

C give 2 mL using the oral syringe provided twice a day

D give 4 mL using the oral syringe provided twice a day

E give 8 mL using the oral syringe provided twice a day


0.65 0.31 0.05 13 3 *65 11 7 2

Mrs D has been diagnosed with colorectal cancer. The oncologist decides to treat Mrs D with capecitabine at a dose of 1.25 g / m2 twice daily for 14 days; subsequent courses repeated after a 7-day interval. Given that Mrs D has a body surface area of 1.65 m2 and capecitabine is available as a 500 mg tablet. How many tablets will she need for her first cycle of chemotherapy?

A 56 tablets

B 100 tablets

C 112 tablets

D 168 tablets

E 224 tablets


0.96 0.37 0.08 2 *96 1 1 1 1

If 400 mg of potassium permanganate is dissolved in 2.5 litres of water what is the percentage strength of the resulting solution?

A 0.008% w/v

B 0.016% w/v

C 0.032% w/v

D 0.064% w/v

E 0.128% w/v


0.93 0.38 0.07 *93 2 3 1 1 0

Mrs D is prescribed morphine sulfate 240 mg to be given over 24 hours using a syringe driver. Given that the morphine sulfate solution that is used contains 20 mg/mL, the infusion rate should be set at:

A 0.5 mL/hour

B 1 mL/hour C 2 mL/hour D 5 mL/hour E 10 mL/hour


0.90 0.37 0.06 2 2 3 *90 3 1

What weight of Aqueous Cream, BP is required to make 240 g of the following formula?

Salicylic Acid BP 8%A

Zinc Oxide BP 10%

Starch BP 12%

Aqueous Cream BP to 100%

A 144 g

B 152 g

C 160 g

D 168 g

E 176 g


0.58 0.21 0.05 11 18 *58 6 7 1

A 10-year-old boy of average build has been diagnosed with epilepsy and is commencing on Epilim liquid (sodium valproate). His dose is 10 mg/kg daily for the first week, increasing to 20 mg/kg daily for two weeks then stabilising at 25 mg/kg daily as a maintenance dose. How many 300 mL bottles of Epilim liquid will be needed for the first eight weeks of therapy?

A 2

B 3

C 4

D 5

E 6

Future considerations • Board of Assessors reviewing the assessment • Multistage review

• Under consideration (confidential please!): – Use of calculators – Style of questions – Number of questions – Range of questions, syllabus – Standard setting methodology – Separate paper

Future considerations • The national registration assessment seems here to

stay • Some changes are likely for the sittings in 2016

Any questions?

Contact details

• email [email protected] • web pharmacyregulation.org • twitter @TheGPhC • facebook.com/The GPhC • linkedin.com/company/general-pharmaceutical-

council

Pharmacy regulator’s insight - sigma Mathematics and ... · Pharmacy regulator’s insight Lisa Smith ... Water BPC required is 15 mL ... questions in the calculations did

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