Situation Judgement Test for Application to Foundation Training, Exercises of Medicine

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Situation Judgement

Test for Application to

Foundation Training

Elaine Denniss

Careers Consultant

What Are Situational Judgement Tests?

SJTs are as measurement method designed to assess judgement in work-relevant situations:

Assess your judgement in challenging situations that a

Foundation doctor might encounter at work during the first year of an

integrated Foundation Programme

Scored against a pre-determined key

Focus on non-academic/professional attributes (eg teamworking, empathy, integrity)

Why Change to SJTs?

Research evidence to support use in this context

• SJTs are increasingly used in high stakes selection (in medical selection in the UK and elsewhere – police, FBI, fire service)
• Within medical selection, SJTs have been shown to be a reliable and valid method of selection
• Evidence shows ability to predict performance in the role

Sufficient questions can be developed for long-term use

Exam conditions – fair and consistent

Marks for near misses - able to differentiate between applicants

Clinicians involved in development of items – not the development and marking – SJTs are machine-markable

What does the FY1 SJT Measure?

SJTs measure understanding and awareness about what

constitutes effective behaviour in job relevance situations.

Patient Focus

• Ensures patient is the focus of care.
• Demonstrates understanding and appreciation of the needs of all patients, showing respect at all times.
• Takes time to build relationships with patients, demonstrating courtesy, empathy and compassion.
• Works in partnership with patients about their care.

Answering the SJT Questions

70 questions – 60 live questions and 10 embedded pilot questions

Worth 50 points in your application

2 different types of questions: Rank five actions (two thirds of the questions) Select three from eight (one third of the questions)

NB. You should answer what you ‘should’ do in the scenario

described, not what you ‘would’ do

Your best friend is on holiday abroad. During that period, her father is admitted in the hospital where you work, but in a different service. Your friend calls you, asking for information about her father as the hospital is refusing to give her any indication as to the nature of the illness or whether she needs to return from her holiday early.

Rank in order the following actions in response to this situation (1= most appropriate;

5= least appropriate).

A Decline politely, telling your friend that her request would be in breach of regulations B Ask your friend to give you written confirmation that you are permitted to request the information on her behalf C Ask your consultant for advice on what you should do D Tell your friend that you will ask her father to get in touch with you E Tell your friend that you will raise the matter with her father’s consultant

Example

Ideal rank 1 2 3 4 5 C 4 3 2 1 0 E 3 4 3 2 1 B 2 3 4 3 2 D 1 2 3 4 3 A 0 1 2 3 4

For this example a perfect 20 is: C E B D A

If you thought the answer was CDABE , you would score 12 marks, as follows: 4 points for option C as it is in the correct position 2 points for option D as the correct position is 4, but the applicant ranked it 2nd 2 points for option A as the correct position is 6, but the applicant ranked it 3rd 3 points for option B as the correct position is 3, but the applicant ranked it 4th 1 point for option E as the correct position is 2, but the applicant ranked it 5th

Marking

A nurse asks you to assess a patient who wants to self-discharge from the ward. The patient is still on the ward and has undertaken only part of the investigations he was meant to undertake for lung cancer. He is very agitated and anxious, and borders on aggressive, which is making the nursing staff feel threatened.

Choose the THREE most appropriate actions to take in this situation

A Spend some time listening to the patient’s concerns

B Tell the patient that you are sorry that he is upset C Tell the patient that you understand how he feels

D Explain to the patient that it is perfectly normal to be anxious about a possible

diagnosis of lung cancer

E Explain to the patient that it is important that he completes all the tests

F Explain to the patient that if he leaves he could be putting himself at risk

G Offer the patient help for his anxiety

Multiple Choice

Marking

For the full 12 marks you would need to indicate:

A Spend some time listening to the patient’s concerns

B Tell the patient that you are sorry that he is upset

E Explain to the patient that it is important that he completes all tests

You get 4 marks per correct answer so if you answered:

A, B and C you would get 8 marks

Answer to Question 1

C Explain to Mr Johnson the risks of leaving without treatment E Allow Mr Johnson to leave but ask him to return to the hospital as soon as possible D Telephone Mr Johnson’s next of kin to ask them to try and persuade him not to leave A Allow Mr Johnson to leave but advise him to see his General Practitioner if there are further problems B Prevent Mr Johnson from leaving by phoning security

Communicating to Mr Johnson the risks of leaving is important as he may not be aware of these risks (C). However, it is the patient’s choice as to whether he remains in hospital. Informing him that he should return to the hospital is important (E). Mr Johnsons’ next of kin are aware of the situation and may be able to persuade him to stay (D). By asking Mr Johnson to see his GP, instead of returning to the hospital, you would be passing responsibility for his care (A), however this is more appropriate than forcing a patient to stay against his wishes (B).

Example Question 2 – choose best 3

You review a patient on the surgical ward who has had an appendectomy done earlier on in the day. You write a prescription for strong painkillers. The staff nurse challenges your decision and refuses to give the medication to the patient.

Choose the THREE most appropriate actions to take in this situation

A Instruct the nurse to give the medication to the patient B Discuss with the nurse why she disagrees with the prescription C Ask a senior colleague for advice D Complete a clinical incident form E Cancel the prescription on the nurse’s advice F Arrange to speak to the nurse later to discuss your working relationship G Write in the medical notes that the nurse has declined to give the medication H Review the case again

Timing

The SJT will consist of around 70 questions in

2 hours 20 minutes SO ….

2 minutes per question!

SJT either:

Friday 4 December 2015 Friday 9 January 2016

Resources

BMJ - Tackling Situational Judgement Tests

http://careers.bmj.com/careers/advice/view-article.html?id=

Emedica

http://www.emedica.co.uk/bmjsjt.htm

Foundation Programme (UKFPO)

http://www.foundationprogramme.nhs.uk/pages/home/how-to-apply/SJT- FAQs (including information on scoring)

http://sjt.foundationprogramme.nhs.uk/sample