Tackling situational judgment tests
Doctors face many different types of assessment throughout their careers—from traditional multiple choice questions and extended matching questions to essay papers. Over recent years there has been a shift away from testing knowledge of facts, to tests that look at application of that knowledge. One of the ways that a person's judgment in various work based situations can be assessed is the situational judgment test (SJT), also known as a professional dilemma test.
Background Situational judgment tests have been used as far back as the 1940s. They have become increasingly popular as tools for recruitment because they can assess job related skills not tapped by other measures—ranging from problem solving and decision making, to interpersonal skills. SJTs are useful for assessing soft skills and non-academic, practical intelligence. They are often used in combination with a knowledge based test to give a better overall picture of a candidate's aptitude for a certain job. SJTs have been used as a recruitment tool by the Federal Bureau of Investigation, the Canadian Civil Service, the Department of Work and Pensions, and the NHS Graduate Management Training Scheme.
The SJT paper in selection for general practice specialty training The SJT was trialled in 2006 as an alternative to the competency based essay paper as part of the assessment for entry into general practice specialty training (GP ST). In 2007, all candidates applying to enter GP ST programmes at any level (ST1, ST2, or ST3) will be required to sit a 90 minute SJT paper and a 90 minute clinical problem solving paper as part of the shortlisting process.
The SJT paper has been set to assess the candidate against some of the competences in the national person specification for GP ST (box 1).
The paper has two sections, with different styles of questions. Both sections consist of work based scenarios that could be faced by a junior doctor, with multiple possible options to choose from. Scenarios range from ethical dilemmas to difficulties with colleagues or patients. Each scenario has been written to assess one or more of the competences in the national person specification.
The two sections differ in what the candidate is asked to do.
Section 1 Each scenario in this section is followed by five possible options or actions. Candidates are asked to rank the options from one (the most effective, or best, option) to five (the least effective, or worst, option). It is important to note that the ranking is relative: all the options may be effective, or ineffective. The candidate has to decide on the relative rank, rather than decide if each option is right or wrong. The first option may seem very sensible, but it is important to avoid assigning any rankings until you have considered each option carefully.
Situational judgment tests have been used as far back as the 1940s. They have become increasingly popular as tools for recruitment because they can assess job related skills not tapped by other measures
Sample question You have just started a job as a medical F2 in a new hospital. Your wife has a chest infection, and is not yet registered with a GP and has asked you to prescribe antibiotics. Rank the following options 1-5, 1 being the most effective/best option, five being the least effective/worst option:
Prescribe the medication as a private prescription, and arrange for her to register with a GP the following week
Tell her to register with a GP locally
Prescribe the medication on a hospital take home prescription with her details on it
Prescribe the medication on a hospital take home prescription with one of your patient's details on it. Collect the medication from the hospital pharmacy
Ask one of your work colleagues to write a prescription on a hospital take home script without seeing your wife.
Box 1 | Core competences in selection for entry to general practice specialty training (ST1-ST3)
Empathy and sensitivity: Capacity and motivation to take in other people's perspectives and treat others with understanding
Communication skills: Capacity to adjust behaviour and language as appropriate to needs of differing situations
Conceptual thinking and problem solving: Capacity to think beyond the obvious, with analytical and flexible mind
Coping with pressure: Capacity to recognise own limitations and develop appropriate coping mechanisms
Organisation and planning: Capacity to organise information and time effectively in a planned manner
Managing others and team involvement: Capacity to work effectively in partnership with others
Professional integrity: Capacity and motivation to take responsibility for own actions and demonstrate respect for all
Learning and personal development: Capacity and motivation to learn from experience and constantly update skills and knowledge
Questions taken from the Emedica online revision for GP ST stage 2 assessment. Answers and explanations at www.emedica.co.uk/bmjsjt.htm.
Section 2 This section offers similar scenarios, but the number of options offered is greater—seven or eight. The candidate must choose the three options that combined make the most appropriate response. Some of the options may be very similar, and some are paired or contradictory; for example, “Option A—refuse to see the patient,” “Option B—agree to see the patient with a chaperone.” If you can identify a pair, you can eliminate one choice; in this example, it is impossible for both option A and option B to be included in the best response. Check that all three options you choose make sense when looked at as a whole.
Sample question You are an FY2 doctor working in general medicine. The son of a patient who was recently admitted asks to see you privately on the ward. He expresses his gratitude for the care given to his mother. He gives you an envelope with £30 cash in it. Choose the three most appropriate actions to take in this situation.
Thank him for his gesture, saying it is very kind of him
Tell him that he should keep his money
Ask him not to tell anyone about this
Suggest that he donate the money to the ward, as everyone helped care for his mother
Suggest that he buys chocolates for the ward staff with the money
Take the money, and buy chocolates for the ward staff with it
Inform the ward staff about his gratitude for the care received.
Questions taken from the Emedica online revision for GP ST stage 2 assessment. Answers and explanations at www.emedica.co.uk/bmjsjt.htm.
Box 2 | Ten tips for the SJT paper
Make sure you are familiar with the competences in the national person specification
Read through the Good Medical Practice booklet
Read each scenario twice, highlighting any keywords as you go
Look at all the options before assigning any rankings (section 1)
Remember you are not being asked to judge if an option is right or wrong
Use only the information provided in the question—do not make assumptions
Look out for paired or contradictory statements (section 2)
Make sure your choices make sense when taken together (section 2)
Keep an eye on the clock—don't spend too long on any one question
Double check you have marked/circled the correct options—transcription errors are a silly way to lose marks
How to prepare for the SJT paper The SJT paper is not a test of clinical knowledge, so preparing for it (box 2) requires a different approach to that of revising for finals or membership exams. Familiarise yourself with the competences in the national person specification by downloading and reading the full document for your entry level. Read through the new edition of Good Medical Practice. Finally, practise sample questions under timed conditions to get used to the question format.
FURTHER INFORMATION
National person specifications for GP ST1-ST3 www.gprecruitment.org.uk/vacancies/specification.htm
Example questions for the SJT paper www.gprecruitment.org.uk/vacancies/examplequestions.htm; www.gpvts.info/sjt.htm
Online revision for GP ST entry assessment (including SJT paper) www.emedica.co.uk/s2.htm
Competing interests: MR is a director of Emedica, which provides courses and online revision for anyone interested in GP training (www.emedica.co.uk).
References Creighton P, Scott N. An introduction to situational judgement inventories. Sel Dev Rev 2006;22: 3-6. General Medical Council. Good medical practice . London: GMC, 2006. www.gmc-uk.org/guidance/good_medical_practice/index.asp. Mahibur Rahman director Swansea Emedica info@emedica.co.uk
