Mastering The Time Pressures Of The PSA

We know from previous Prescribing Safety Assessment candidates that the time pressures are seen as the biggest challenge of the PSA exam. 

But there’s a good reason why you’re expected to be able to answer 120 questions in 2 hours! The PSA is designed to simulate the real-life pressures of prescribing in a clinical setting. You won’t have time, as a prescriber, to look up every decision in MedicinesComplete or the BNF. You will need to be able to complete dosage calculations quickly and accurately, spot risks, and communicate effectively with patients in order to do your job. 

So the most important thing to bear in mind if you’re worried about the time pressures of the PSA is that they’re in place for a reason! With that in mind, there are some steps you can take to manage your time effectively in the exam.

 

Ahead of time 

1. Understand the exam format inside out

Different sections of the PSA are weighted differently, and each section is asking you to demonstrate a different area of prescribing competency. So you need to understand exactly what’s being asked of you in each section, as well as how many marks are at stake. You can do this by:

  • Logging into your PSA platform account and reading through the official information
  • Reading our blog post for a detailed breakdown of what’s in the PSA 
  • Completing our free PSA Prep eLearning sessions

The PSA Prep eLearning sessions have been created by a team of experts to address common challenges encountered in the exam – including time pressures – and will help you understand the exam format and what’s expected of you in each section.

2. Get familiar with the BNF

Both MedicinesComplete and the NICE BNF are available in the exam, so it’s vital that you familiarise yourself with these resources ahead of time. In particular, spend time on the ‘treatment summaries’ section of the BNF, which you’ll need to consult if you don’t know the medication required for a particular treatment, as it’s not always immediately obvious where to find particular topics (for example, opioid conversion comes under ‘palliative care’ – if you didn’t know that in advance, you could spend valuable time searching).

3. Practise… with a timer! 

If you’ve not practised answering 60 question items within 120 minutes, you’ll find it more difficult to manage your time effectively on exam day. 

So, once you’ve completed the official PSA practice papers, take a look at the extra practice papers available from BPS Assessment. We’ve created the only available 2 hour practice paper, marked out of 200 (just like the real exam) so that you can understand exactly where you struggle time-wise when it comes to answering 60 questions in 120 minutes. 

You get unlimited attempts on our practice paper too, so you can practise as many times as you need in order to feel confident about that 2 hour countdown on the day.

 

On exam day

1. Consider a timing plan

Having a rough idea of how long you should be spending on each section of the exam will help you manage your time effectively. 

There are 200 marks available in total over the 120 minutes of the exam. If we look at that time broken down across the 8 sections of the exam, we get: 

  • Section 1: Prescribing (PWS) is worth 80 marks = 48 minutes
  • Section 2: Prescription Review (REV) is worth 32 marks = 19 minutes 12 seconds
  • Section 3: Planning Management (MAN) is worth 16 marks = 9 minutes 36 seconds
  • Section 4: Providing Information (COM) is worth 12 marks = 7 minutes 12 seconds
  • Section 5: Calculation Skills (CAL) is worth 16 marks = 9 minutes 36 seconds
  • Section 6: Adverse Drug Reactions (ADR) is worth 16 marks = 9 minutes 36 seconds
  • Section 7: Drug Monitoring (TDM) is worth 16 marks = 9 minutes 36 seconds
  • Section 8: Data Interpretation (DAT) is worth 12 marks = 7 minutes 12 seconds

You may not want to allocate every single second of the exam, however! You’ll need time to take a breath and reset every now and again, as well as a cushion of time for any unexpected challenges. This is just a starting point. 

2. Breathe… you’ve got this! 

Lots of Prescribing Safety Assessment candidates find the time pressure to be the biggest challenge when it comes to exam day. So you’re not alone! Just remember that the time pressures are there to simulate the real-life challenges of prescribing and to help you become a safe and accurate prescriber. 

Good luck!

How To Find The Best PSA Practice Papers

Once you’ve been registered for the Prescribing Safety Assessment by your organisation, you will be able to login to your PSA platform account and take advantage of the four 30-item practice papers that are included. But once you’ve done those, where do you look next? 

The good news is that you don’t have to look far! 

As the learning and assessment branch of the British Pharmacological Society (who deliver the PSA in partnership with MSC Assessment), we have worked with a team of experts to create three additional practice papers to help PSA candidates (as well as candidates for the Prescribing Skills Assessment overseas) prepare for their final prescribing exam. 

Paper 1 and Paper 2 are 30-item practice papers, just like the papers you’ll already have encountered in your PSA platform account. They’re aligned to the BNF and are designed to provide the most authentic practice environment possible. 

Paper 3, however, is something special. It’s the only available 60-item practice paper, with 200 marks up for grabs (just like the real exam). That means you can take things to the next level and time yourself over 2 hours. Not only will you get a really good understanding of the time pressures involved in the Prescribing Safety Assessment, but you will also get a taste of what it’s like to prescribe under pressure in real life. 

You get lots of detailed feedback on your answers, so you can understand where you went wrong and learn how to correct yourself. You also get unlimited attempts on all three papers, so you can assess your weakest areas (with the help of our feedback) and improve as you practise. 

Covid preview on laptop

So what are you waiting for? You can grab all three papers today for just £40 (and you’ll get 9 PSA Prep eLearning sessions to go with them) or you can buy them individually. Papers 1 and 2 are £15 each, whereas Paper 3 is £25. 

Find Out More About Our Practice Papers

What’s In The PSA Exam?

A Quick Guide To Prescribing Safety Assessment Questions

he Prescribing Safety Assessment is designed to test the prescribing competencies expected of a Foundation Year 1 doctor (as outlined in Outcomes for graduates). 

You have 2 hours to complete the exam, answering 120 question items that are worth 200 marks overall. These question items are broken down into 8 sections, each worth a specific number of marks. 

So what’s included in each section and what will you need to do? 

 

Section 1: Prescribing (PWS)

80 marks (8 question items worth 10 marks each)

The purpose of this section is to demonstrate your ability to write a safe and effective prescription, to manage acute medical emergencies, and to plan appropriate drug therapy for common indications.

For each question item, you’ll be given a clinical scenario followed by a request to prescribe a single appropriate medicine or intravenous fluid, using one of a variety of prescription forms. 

Typical scenarios involve the treatment of acute conditions (e.g. acute asthma attack, acute heart failure), chronic conditions (e.g. depression, reflux oesophagitis), and important symptoms such as pain. 

You’ll need to decide between different drugs, formulations, routes, doses and dose intervals. You’ll be expected to write an unambiguous and complete prescription (approved name of drug, appropriate form, correct dose and route).

Your answer can be selected from the responsive fields available on the prescription form. You’ll need to begin by typing your answer into the field – this will trigger a drop-down menu from which you can select your answer. 

 

Section 2: Prescription Review (REV)

32 marks (8 question items worth 4 marks each)

The purpose of this section is to demonstrate your ability to review the prescribing of others, to spot potentially important errors and to make changes that will improve patient outcomes.

In this section, you’ll be given scenarios that require you to review a current list of prescribed medicines (such as an inpatient prescription chart or a referral letter from a GP). You’ll have 6-10 medicines to review for each question item.

Usually, this means interpreting the list of medicines in light of a clinical problem, spotting important drug interactions, identifying obvious or serious dosing errors or noting suboptimal prescriptions. 

You’ll need some knowledge of common effects, adverse reactions and interactions of common medicines. You should have time to consult the BNF for relevant information that goes beyond the core knowledge base of a minimally competent Foundation doctor. 

 

Section 3: Planning Management (MAN)

16 marks (8 question items worth 2 marks each) 

The purpose of this section is to demonstrate your ability to plan appropriate treatment for common clinical indications.

For each question item, you’ll be given a clinical scenario followed by a request to identify the most important treatment (from a list of 5) to manage that particular patient. You’ll need to select between a range of options, some of which would help, some of which would harm, and some of which would do nothing.

You’ll need to decide which treatment is most appropriate based on symptoms, signs, and investigations – this could be a preventive, curative, symptomatic, or palliative treatment. Some of the scenarios may relate to clinical toxicological emergencies that a foundation doctor might be expected to manage. 

 

Section 4: Providing Information (COM)

12 marks (6 question items worth 2 marks each) 

The purpose of this section is to demonstrate your ability to provide patients with important information about their medicines.

In this section, you’ll be given scenarios in which a patient is about to start taking a new treatment or where further advice about an existing treatment is required. 

You’ll need to choose the most important piece of information from a list of 5 (where 4 are distractors). Examples of the medicines that might be the focus of discussion include insulin, warfarin, salbutamol inhaler, methotrexate, or an oral hypoglycaemic.  

 

Section 5: Calculation Skills (CAL)

16 marks (8 question items worth 2 marks each) 

The purpose of this section is to demonstrate your ability to calculate appropriate drug doses and record the outcome accurately.

For each scenario in this section, you’ll need to make an accurate calculation of the dose or rate of administration of a medicine. This means interpreting the problem correctly and using basic arithmetic to work out the correct answer. For example, you may be asked to identify the correct number of tablets to achieve a required dose, calculate the required dose based on weight or body surface area, or dilute a drug for administration in an infusion pump. 

These scenarios will also require you to recognise and convert different expressions of drug doses and concentrations.  

These questions allow the use of a simple calculator to work out your answer – there is one built into the interface itself but you can also use your own.

 

Section 6: Adverse Drug Reactions (ADR)

16 marks (8 question items worth 2 marks each) 

The purpose of this section is to demonstrate your ability to detect, respond to and prevent potential adverse drug reactions.

There are 4 question item types in this section, covering:

  • Type A – identifying the most likely adverse effect of a specific drug
  • Type B – considering a presentation that could potentially be caused by an adverse drug reaction, and identifying the medicine most likely to have caused the presentation
  • Type C – considering a presentation where there are potential interactions between medicines currently being prescribed to a patient, and identifying the drug most likely to be clinically important
  • Type D – considering a presentation where a patient is suffering an adverse drug event, and deciding on the most appropriate course of action

For each question item, you’ll need to choose the most appropriate answer from a list of 5. 

 

Section 7: Drug Monitoring (TDM)

16 marks (8 question items worth 2 marks each) 

The purpose of this section is to demonstrate your knowledge of how drugs work and their clinical effects, and your ability to monitor them appropriately to maximise safety and efficacy.

In this section, you’ll be given scenarios that require you to make a judgement about how best to assess the impact of treatments that are ongoing or are being planned. 

You’ll need to show that you understand how to plan appropriate monitoring for beneficial and harmful effects based on factors such as clinical history, examination and investigation. This may involve taking blood samples at the right time, deciding which is the most appropriate assessment of outcome, and the timing of those measurements. 

For each question item, you’ll need to choose the most appropriate answer from a list of 5. 

 

Section 8: Data Interpretation (DAT)

12 marks (6 question items worth 2 marks each) 

The purpose of this section is to demonstrate your ability to interpret data on the impact of drug therapy and make appropriate changes, as well as critically appraising the results of relevant diagnostic, prognostic and treatment trials.

For each question item in this section, you’ll need to interpret data in light of a clinical scenario and decide on the most appropriate course of action with regard to prescribing. This may involve withdrawing a medicine, reducing its dose, no change, increasing its dose or prescribing a new medicine. The key focus of these question items is interpreting the data and deciding on its implications for prescribing. 

For each question item, you’ll need to choose the most appropriate answer from a list of 5. 

 

How Can You Prepare?

Now you know what’s in the PSA, it’s time to get exam ready! 

Firstly, take a look at our PSA Prep eLearning sessions and get even more details on the exam format, understanding what’s expected of you. There’s a session dedicated to each of the 8 question styles, and it’s completely FREE. 

Secondly, you’ll want to give yourself plenty of practice materials. Once you’ve taken advantage of the official practice papers, buy our 3 peer-reviewed practice papers for just £40 and take your revision to the next level. You have unlimited practice attempts on each of our papers, and you get helpful feedback on every question. They’re presented in the same format as the exam itself and they include the only full-length, 200-mark practice paper available (so you can time yourself over 2 hours and see how you do).

Good luck! 

PSA Sections Explained

There are 8 sections of the Prescribing Safety Assessment, each testing a different area of prescribing competency. Some sections are weighted more heavily than others, and some have a different number of question items than others. 

In order to prepare for your PSA exam, it’s important that you familiarise yourself with each of the 8 sections of the exam, so you know what’s expected of you and where you might find the most marks. 

 

Weighting Of PSA Exam Questions

There are 200 marks available in total, broken down across the 8 sections of the PSA as follows: 

  • Section 1: Prescribing (PWS) is worth 80 marks (8 question items worth 10 marks each)
  • Section 2: Prescription Review (REV) is worth 32 marks (8 question items worth 4 marks each)
  • Section 3: Planning Management (MAN) is worth 16 marks (8 question items worth 2 marks each) 
  • Section 4: Providing Information (COM) is worth 12 marks (6 question items worth 2 marks each) 
  • Section 5: Calculation Skills (CAL) is worth 16 marks (8 question items worth 2 marks each) 
  • Section 6: Adverse Drug Reactions (ADR) is worth 16 marks (8 question items worth 2 marks each) 
  • Section 7: Drug Monitoring (TDM) is worth 16 marks (8 question items worth 2 marks each) 
  • Section 8: Data Interpretation (DAT) is worth 12 marks (6 question items worth 2 marks each) 

 

PSA Sections Explained

Each section of the PSA is designed to test a different area of prescribing. In a nutshell, that means:

Section 1: Prescribing (PWS) tests your ability to write a safe and effective prescription, to manage acute medical emergencies, and to plan appropriate drug therapy for common indications. 

Section 2: Prescription Review (REV) tests your ability to review the prescribing of others, to spot potentially important errors and to make changes that will improve patient outcomes.

Section 3: Planning Management (MAN) tests your ability to plan appropriate treatment for common clinical indications.

Section 4: Providing Information (COM) tests your ability to provide patients with important information about their medicines.

Section 5: Calculation Skills (CAL) tests your ability to calculate appropriate drug doses and record the outcome accurately.

Section 6: Adverse Drug Reactions (ADR) tests your ability to detect, respond to and prevent potential adverse drug reactions.

Section 7: Drug Monitoring (TDM) tests your knowledge of how drugs work and their clinical effects, and your ability to monitor them appropriately to maximise safety and efficacy.

Section 8: Data Interpretation (DAT) tests your ability to interpret data on the impact of drug therapy and make appropriate changes, as well as critically appraising the results of relevant diagnostic, prognostic and treatment trials.

 

PSA Sections Explained By The Experts

For a more detailed outline of what’s in the PSA, check out our What’s In The PSA Exam blog post. However, the best way to prepare is to watch PSA Prep, a set of 9 (totally free) eLearning sessions we’ve created for exam candidates, working with a team of experts. 

There’s a dedicated PSA Prep session for each of the 8 sections, providing you with a detailed outline of the section and addressing some of the biggest challenges faced by PSA candidates, such as coping with the time pressures, managing the calculations and identifying the key points in each clinical scenario. 

For instant access, simply create (or log in to) your BPS Assessment portal account and scroll down to ‘PSA Prep’.

 

How To Pass the PSA

Whether it’s the time pressure, the calculations, or identifying the key points in a clinical scenario, the Prescribing Safety Assessment (PSA) exam presents a lot of challenges for candidates. So let’s get prepared! Below we share 5 top tips to help you get 100% exam ready. 

 

1. Understand the exam format and what’s expected of you

First thing’s first: get familiar with the structure of the exam. We’ve included a breakdown of the 8 sections of the PSA exam in another blog post, but to get really familiar with what’s expected of you and what you’ll encounter in the exam, complete our free PSA Prep sessions, covering:

  • The exam format and layout of each question
  • Understanding how to answer the questions
  • Common challenges, like the time pressure and exam calculations

There’s one session dedicated to each of the 8 sections of the PSA exam, as well as an introductory session. To get instant access to these 9 free PSA Prep sessions, create a free BPS Assessment platform account here

 

2. Get familiar with MedicinesComplete and the NICE BNF

We know that time pressure is reported to be the biggest challenge for candidates sitting the PSA, so you don’t want to lose valuable minutes trying to navigate your way around the BNF! Both MedicinesComplete and the NICE BNF are available in the exam (depending on your location), so it’s important that you familiarise yourself with both of these resources ahead of time. That way, you’ll be as efficient as possible in the exam itself. 

 

3. Make good use of your PSA exam account 

As soon as you’ve been registered for the exam, you’ll be able to login to your PSA platform account. Read up on the exam, use the information you’ll find there, and complete the practice papers included. 

 

4. Practise, practise, practise

Once you’ve completed the practice papers included with your PSA account, consider broadening your revision materials and investing in more practice papers. You’ll find 3 bonus practice papers exclusively on the BPS Assessment Learner Portal.

These 3 papers offer 120 questions with unlimited practice attempts, so you really can ‘practise til perfect’. They include clear, in-depth feedback on each question style, so you can understand how to tackle the 8 different exam areas. Read through the feedback, assess your weakest areas, and keep on trying until you feel confident!

 

5. Time yourself!  

As we’ve said before, the time pressure is reported to be the biggest challenge for PSA candidates. That’s because the exam simulates prescribing under pressure in the real world. So it’s really important that you understand what it feels like to try answering those 60 question items in 2 hours! 

For that, you’ll need Practice Paper 3, which includes 60 question items and has 200 marks up for grabs, just like the real exam. Set your timer and see how you get on. You’ll soon work out where you’re losing time and which areas you need to focus on in order to make the best use of those 120 minutes (remember that the different sections of the exam are worth a different number of marks, so you should be spending more time on the sections with more marks). 

If you’re worried about prioritising your time in the exam, complete our free PSA Prep sessions to understand more about how points are allocated for each section of the exam before you time yourself with Practice Paper 3. 

 

Finally… good luck!

As the learning and assessment branch of the British Pharmacological Society, we’re committed to helping you become a confident, capable prescriber – not just so that you can pass the PSA, but so that you can excel in whatever prescribing career path that follows. We hope that resources like PSA Prep and our Prescribing Practice Papers help you take control of your revision, so that you can approach exam day with confidence. We believe in you!