How the matching items work
The first items in Reading Part A ask you to choose a text: 'Which text tells you…?' You answer with a letter, A, B, C or D. The four texts are all on one topic, so each item is a choice between four.
Two facts change how you should work. First, one text can be the answer many times. A long guideline might be the answer to three items and a short leaflet to none. Do not cross out a letter because you have already used it. Second, the topic is the same in all four texts. If the topic is warfarin, the word warfarin appears everywhere. Hunting for a word that is in every text wastes time.
So the real question is not 'where is this word?' but 'which kind of text would contain this kind of information?'
Know what each text is
In the first minute, label each text by its type and purpose. Most Part A texts fall into a few familiar types, and each type answers a different kind of question.
| Text type | What it is for | Items it usually answers |
|---|---|---|
| Table (doses, scores, schedules) | Quick reference values | How much, how often, which score, which product for which situation |
| Flowchart or numbered steps | A sequence of actions and decisions | What to do first, what to do next, what to do if a result is high or low |
| Patient or family leaflet | Plain-language advice for people who are not clinicians | What to tell the patient, warning signs to report at home, what to avoid |
| Guideline or policy paragraphs | Rules, reasons and responsibilities | Who is responsible, why something is done, which patients it applies to, exceptions |
Also notice the audience. A leaflet talks to you, the patient. A guideline talks about staff, the nurse or the medical officer. An item that asks what a patient should do at home almost always points to the leaflet.
Match by purpose, not by words
Here is a short example set. The topic is caring for a peripheral intravenous cannula. The four texts are:
- Text A: a table of phlebitis scores with an action for each score.
- Text B: two paragraphs on dressings, flushing and which staff may insert a cannula.
- Text C: a flowchart for deciding whether a cannula should stay in or come out.
- Text D: a leaflet for patients called 'Your drip: what to tell us'.
Which text tells you whether a graduate nurse may insert a cannula without supervision?
Scan for nurse in all four texts. It appears in A, B and D, so start reading each one.
Who may do something is a rule about roles. Rules about roles belong in a guideline, so the answer is likely B. Scan B for insert to confirm.
Why: The item asks about a rule, so the type of text tells you where to look before you read anything.
Which text explains what a patient should report if the arm becomes sore?
Text A mentions pain in the score table, so choose A.
The item is about what the patient should report. That is advice to a patient, which points to the leaflet, D.
Why: Pain appears in two texts, but only one is written for the patient to act on.
Which text helps you decide what to do when the cannula is no longer needed?
Choose B because it is the longest text and probably mentions everything.
A decision about keeping or removing the device is a step in a procedure. Look at the flowchart, C.
Why: Items that say what to do when or decide whether usually point to steps or a flowchart.
Which text gives the action for a score of 2?
B was the answer to item 1, so it is probably not B again. Pick between A and C.
A score linked to an action is a reference value, which is the table, A.
Why: Never choose by counting letters. Here the answer is A, but B could easily have been correct again.
Paraphrase between the item and the text
Matching items are often written in different words from the texts. The item checks whether you recognise the same idea in another form.
| Item says | Text may say |
|---|---|
| who must be told | notify, inform, escalate to |
| how long | duration, for up to, until |
| children | paediatric, under 12 years |
| stop the medicine | withhold, cease, discontinue |
| signs of infection | redness, swelling, discharge, fever |
| at home | after discharge, once you leave hospital |
| before surgery | pre-operative, prior to the procedure |
When an item does not seem to match anything, translate its key idea into clinical words and look again. When it seems to match everything, go back to the purpose and audience of each text.
Common mistakes
- Choosing the first text where you see the word. The key word may appear in two or three texts. Check which text actually gives the information the item asks for.
- Assuming each letter is used once. Part A matching is not one-to-one. The same letter can be right for several items.
- Confirming for too long. If your map points clearly to one text, a quick scan to confirm is enough. Save time for the short-answer items, which need exact copying.
- Ignoring the audience. Tell the patient and staff must point to different texts.
Matching is the fastest part of Part A when your map is good. A clear first minute can save you several minutes over the matching items, and that time pays for the harder short answers later.
Check yourself
4 quick questions. Tap an answer to see why.
1 An item asks: 'Which text gives advice a patient can follow at home?' Which text type is most likely?
2 You have already answered B for two items. The next item also seems to point to B. What should you do?
3 The topic is warfarin. An item asks which text explains why INR is checked more often after antibiotics are started. What is the best first move?
4 Which pair is a likely paraphrase between an item and a text?