Open and closed questions

1.I’m finding it hard to know whether I’m using either too many open or closed questions. It is such a delicate balance.

You are absolutely correct in that demonstrating the use of open and closed questions in the MRCPsych CASC exam requires a delicate balance to elicit the required information.

An examiner only gets an impression about your interview skills from a brief 7/10 minute ‘snapshot’. The aim therefore is not to give them any reason to raise an eyebrow and criticise your interview skills by asking too many closed or open questions in a row. 

The most important time to demonstrate the use of open questions is at the beginning of a station. An examiner will be primed to ensure that you do this and once the examiner sees you have asked an open question may switch their focus to other aspects of your history taking e.g empathy, responding to verbal cues etc.  

As the interview progresses it is reasonable to go onto asking closed questions to elicit the required information. As you practice, you’ll naturally be able to tell for yourself if you are asking too many closed questions in a row and if you find you are just make sure you add in an open question.

I ask an open question at the beginning and give it about a minute before going into a few closed questions. It is excellent that you are practicing with a digital watch as well as you will have much better sense of timekeeping during the station. 

I have attempted to incorporate all of the potential items that you should attempt to ask in the videos. You are correct in that you don’t need to ask everything to pass. Overall, examiners just want to make sure that you are practice safely and understand that you cannot elicit all of the information in 7/10 minutes but can elicit the critical information.

Also, are you practicing in a study group? If so, it is always useful to get them to film e.g via mobile phone you doing a MRCPsych CASC station just so you can critique your own interview style. Additionally, getting a Consultant (preferably a college examiner) in your Trust to watch you interview is ideal.