QBase Anaesthesia 1, 2 And 3. By Hammond and McIndoe Review published in: British Medical Journal, Volume 319: 21 August 1999 Reviewed by Ian Barker Consultant Anaesthetist Sheffield Children's Hospital Candidates have different techniques for answering multiple choice exams. Many simply tick the answers they believe to be correct and then leave the room, but there are other, more complex patterns of behaviour: the gambler, 'I'm not sure about this answer, but the chances are that it's correct so I'll tick it'; the bookmaker, 'If I answer 75 percent of the questions correctly then I'll pass the exam no matter what the results of the rest': the compulsive ticker, 'I can't bear to see both boxes left blank without my pencil mark somewhere'; and the worrier, 'But surely somebody somewhere has presented with hypomarmitaemia in Blogg's disease'. These three books contain a collection of multiple choice questions that are arranged to simulate the examinations set by The Royal College of Anaesthetists. Volume 1 is aimed at the primary exam and covers physiology, pharmacology, statistics, clinical measurement and some anaesthesia. Volume 2 is aimed at the final exam and covers anaesthesia, intensive care, medicine, and associated sciences. Volume 3 covers exclusively medicine at the level of the final exam and would be useful to a wider audience that just anaesthetists, particularly final year medical students. The questions in all three volumes are clear and relevant, and the answers are given with comprehensive explanations and references for further reading. The books alone would be a valuable resource for both anaesthetic trainees and trainers. But this is not the full story: each book is accompanied by a CD-ROM that, contains the questions, answers, and explanations from the volume accompanied by a 'QBase' program, which allows the user to interact with the exams. The programs are designed for Windows 3.1 or later, although they do not run as true Windows: there is no title bar, which means it is not possible to change the size of the window, minimise it to the task bar, or close the program quickly. 'Help' is not readily at hand - an online help feature might be too much to expect, but even an email address would be helpful. The instructions, however, are easy to follow, and I found that all three discs installed easily in Windows 98. They create a 0.5Mb 'QBase' directory on the hard drive from which the programs are launched. The programs present the multiple choice exams electronically. The main menu allows a random or a user defined set of questions to be selected, and there is an option for monitoring 'level of confidence' during the exam. Responses are selected with the mouse and if the 'level of confidence' option has been chosen the program asks whether the response is 'positive' or is an 'educated' or 'complete' guess. Questions can be marked during the exam, and correct answers and explanatory notes are available if required. Alternatively, the exams can be declared as complete at any time. This brings up an analysis screen, which presents a summary of results and allows questions to be reviewed according to whether they were answered correctly. It can also make comparisons with previous attempts, provide a breakdown of exam performance according to subject, and produce a print out of results. Finally, the programs can provide advice on examination technique. Results can be displayed according to the 'level of confidence' of the response, and the program offers tips such as 'educated guessing improved your score', 'wild guessing is not recommended for you' and even 'more revision is essential'. Anaesthetic candidates for the Royal College exams should remember that, while a few lucky guesses might make the difference between success and failure in the multiple choice section, those who pass are invited to appear for a viva voce, where their knowledge will be assessed again and their shortcomings will be recognised.
