Book Review

What is good about this book?

For trainees revising for the Applied Knowledge Test (AKT), this book fulfils an important role: an easily digestible, yet comprehensive overview of the information required to score highly on the (often intimidating) evidence-based practice and critical appraisal components of the exam. The text correlates closely with the RCGP curriculum and tests knowledge throughout, making the otherwise fairly uninviting prospect of sitting down to read a statistics textbook a little more palatable.

For those who are starting revision, with the time and inclination to fully understand the concepts covered, the chapters can be read sequentially. Each is manageable in length, with regularly interspersed questions to check and consolidate learning. The explanations are clear and concise, yet enough detail is provided to avoid resorting to memorising formulas without understanding the concepts. Alternatively, for those requiring a more focused approach, the final chapter of revision questions can be attempted to identify relevant areas of the book to concentrate on. There is also a very convenient glossary, and some key tables that would be very useful for last minute ‘cramming’.

The book is keen to stress the concept of evidence-based practice, where evidence is weighed up together with the needs and preferences of individual patients. Principles are related to patients throughout, and it is repeatedly highlighted how critical appraisal skills are crucial to providing good patient care and staying up to date. To this end, this book manages to balance the need of the reader to pass the AKT, while also equipping them with lifelong skills to practice as an evidence-based future GP.

What is bad about this book?

Any statistics textbook has a hard job keeping its readers entertained, and this book is perhaps no exception. Similarly, with the predominance of online question banks, often with very detailed answers and explanations, for many trainees a traditional textbook simply will not be part of their revision strategy. For these reasons, this book is not for everyone.

The first chapter is a generic introduction to the AKT. Most of this information could be found elsewhere, and it is unlikely that someone sufficiently far into their revision as to be consulting a specialist book will need this basic information. This space could have been better utilised, with more worked examples or further details on key areas, which are covered only superficially, e.g. how to choose the most appropriate statistical test.

One of the key issues is that, with the exception of the final chapter, lists of answers are not provided for questions. Answers and explanations are discussed within the chapter text, but there is no option to quickly check your answers before deciding whether to read the chapter in detail. This may motivate some to actually read the main body of the text, but many will simply find it frustrating, particularly if they are used to the instant feedback provided by online question banks, and are trying to target their revision where it is most needed.

There is also a repetitive predominance of single best answer questions, often testing ‘dry’ knowledge of statistical definitions rather than requiring the reader to apply their understanding to worked examples or real-life data. More questions involving the interpretation of graphical information would be a welcome addition, and would more accurately reflect the exam itself.

While several of the ‘text heavy’ chapters in this book were well-written and interesting, e.g. ‘Qualitative methods’, or relevant beyond the limited scope of the AKT, e.g. ‘Research in general practice’, the large blocks of text found throughout are off-putting. This fairly ‘wordy’ revision guide is likely to discourage trainees who are close to their exam, who may prefer additional practice questions and more succinct explanations.