Situational Judgement Question Bank 1 Instructions

Use this question bank to practice Situational Judgement questions.

You will be presented by a set of hypothetical scenarios based in a clinical or educational setting and may involve a student or clinician at their center. You will be asked to make judgments as to the appropriateness or the importance of a series of statements in response to the scenario.

It is in your best interest to answer all questions as there is no penalty for guessing. All unanswered questions will be scored as incorrect.

Click the Next (N) button to proceed.

 

Saima is a 5th year medical student on a GP placement and is asked to sort out the file records into an order which organises patient records by date of birth and age. The receptionist has asked Saima to do this for several hours and is becoming impatient with her, but Saima is finding it difficult to cope with the demands of the task, and would prefer to sort the patients by alphabetical order instead.

How appropriate are each of the following responses by Saima in this situation?

1. Ask the receptionist for help on how to sort the information by both date of birth and age.
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    Explanation

    The correct answer is A. It is clear that Saima is struggling at this task, but she needs to make it clear to the receptionist, who may not be aware that she is finding it hard. Asking for assistance acknowledges the fact that the receptionist is becoming frustrated, and will hopefully make her less agitated. It could also improve the team dynamic, and in terms of the task the receptionist could give advice to make the task more efficient and reach task completion faster.

    Post Comment

    Saima is a 5th year medical student on a GP placement and is asked to sort out the file records into an order which organises patient records by date of birth and age. The receptionist has asked Saima to do this for several hours and is becoming impatient with her, but Saima is finding it difficult to cope with the demands of the task, and would prefer to sort the patients by alphabetical order instead.

    How appropriate are each of the following responses by Saima in this situation?

    2. Apologise to the receptionist, and tell her that she will make more of an effort now that she has raised the concern.
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    Explanation

    The correct answer is A. First of all, Saima is acknowledging the fact that the receptionist is unhappy with her, and apologising to her is the correct thing to do. It is likely that the receptionist will now be more understanding, and it displays an important part of working in a team, as being able to admit your own faults shows humility and will help Saima when she becomes a doctor, as every doctor makes mistakes now and then.

    Post Comment

    Saima is a 5th year medical student on a GP placement and is asked to sort out the file records into an order which organises patient records by date of birth and age. The receptionist has asked Saima to do this for several hours and is becoming impatient with her, but Saima is finding it difficult to cope with the demands of the task, and would prefer to sort the patients by alphabetical order instead.

    How appropriate are each of the following responses by Saima in this situation?

    3. Tell the receptionist that it will take him some time, and she will carry out the task at her own pace.
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    Explanation

    The correct answer is C. The receptionist is frustrated with Saima for taking her time, and telling her that she will do it at her own pace does not resolve this issue, and could harm the team dynamic. It would be better for Saima to come to a compromise with the receptionist. It is not an awful course of action, as Saima has agreed to complete the task, but has just said that it will take slightly longer.

    Post Comment

    Saima is a 5th year medical student on a GP placement and is asked to sort out the file records into an order which organises patient records by date of birth and age. The receptionist has asked Saima to do this for several hours and is becoming impatient with her, but Saima is finding it difficult to cope with the demands of the task, and would prefer to sort the patients by alphabetical order instead.

    How appropriate are each of the following responses by Saima in this situation?

    4. Tell the receptionist that she will continue filing via alphabetical order rather than date of birth and age, and asks her to respect the fact that she prefers this.
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    Explanation

    The correct answer is D. The receptionist has already raised an issue with Saima about this, and the fact that she is going against what the receptionist has already said is significant, because Saima is not participating in a mutual discussion. If Saima had kindly asked if it would be possible to use this alternative method, it would have been appropriate. But here in the response Saima is dismissing the receptionist’s preference.

    Many responses in Situational Judgement involve a lack of discussion, and this immediately makes the response inappropriate because it is always important to attempt a mutual agreement when two parties disagree. Do not forget that the receptionist is very important to the GP practice, and her complaints should be regarded earnestly.

     

     

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    Diego is a medical student and is currently on an acute surgery ward placement. He is asked by the consultant to take blood from the patient, as the patient urgently requires a blood test. Diego is usually very successful at blood-taking, and has not made a mistake on the several times he has carried it out, so the consultant feels that the procedure can be carried out without their supervision. Unfortunately, Diego finds that only a small amount of blood is drawn into the vial, and a lot less than what is required, and this is because he has missed the vein. To compound the problems, the patient is in agony and panicking.

    How appropriate are each of the following responses by Diego in this situation?

    5. Apologise to the patient, and ask for their consent to take another sample of blood.
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    Explanation

    The correct answer is A. Ideally mistakes should not happen in medicine because they can potentially compromise patient safety. However they inevitably do occur, and therefore it is understandable that Diego was unable to take blood successfully here, as long as he learns from his mistake and tries to work to prevent it from occurring again. Apologising to the patient directly attends to the patient’s concerns, and asking for permission ensures that consent is given. The key point in the scenario is that Diego is ‘usually very successful’ at taking blood, and therefore it is acceptable for him to try again. If it was his first time, then it would be best to get another member of the medical team to perform the action. 

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    Diego is a medical student and is currently on an acute surgery ward placement. He is asked by the consultant to take blood from the patient, as the patient urgently requires a blood test. Diego is usually very successful at blood-taking, and has not made a mistake on the several times he has carried it out, so the consultant feels that the procedure can be carried out without their supervision. Unfortunately, Diego finds that only a small amount of blood is drawn into the vial, and a lot less than what is required, and this is because he has missed the vein. To compound the problems, the patient is in agony and panicking.

    How appropriate are each of the following responses by Diego in this situation?

    6. Promptly leave to fetch the consultant and ask them to take the blood instead.
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    Explanation

    The correct answer is C.Remember that patient safety is the main concern. Whilst it would be appropriate to get a consultant if Diego feels that he is unable to take blood in the stressful scenario, however he should not leave the patient when they are in pain and panicking. However, the consultant will be more likely able to take blood safely the second time round, so this is not an awful response, as it is appropriate in terms of getting the blood sample.

    Post Comment

    Diego is a medical student and is currently on an acute surgery ward placement. He is asked by the consultant to take blood from the patient, as the patient urgently requires a blood test. Diego is usually very successful at blood-taking, and has not made a mistake on the several times he has carried it out, so the consultant feels that the procedure can be carried out without their supervision. Unfortunately, Diego finds that only a small amount of blood is drawn into the vial, and a lot less than what is required, and this is because he has missed the vein. To compound the problems, the patient is in agony and panicking.

    How appropriate are each of the following responses by Diego in this situation?

    7. Immediately try to take blood again, and try to seize the opportunity when the patient is not looking to take a second sample.
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    Explanation

    The correct answer is D. This is an extremely inappropriate thing to do. The patient is clearly in agony, so trying to take blood again without the patient’s consent is an extreme violation of the guidelines of good medical practice. It would be necessary to ask first, and only take blood when the patient has agreed. Otherwise, this is a very poor approach, and an inappropriate thing to do.

    Post Comment

    Diego is a medical student and is currently on an acute surgery ward placement. He is asked by the consultant to take blood from the patient, as the patient urgently requires a blood test. Diego is usually very successful at blood-taking, and has not made a mistake on the several times he has carried it out, so the consultant feels that the procedure can be carried out without their supervision. Unfortunately, Diego finds that only a small amount of blood is drawn into the vial, and a lot less than what is required, and this is because he has missed the vein. To compound the problems, the patient is in agony and panicking.

    How appropriate are each of the following responses by Diego in this situation?

    8. Ask the patient if they would like someone else to take the blood instead.
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    Explanation

    The correct answer is B. It would be more appropriate for Diego to take another attempt at taking the blood, because a procedure like blood taking can be complicated and is not always successful due to a number of factors. After obtaining consent this would be a very appropriate thing to do. Equally, the patient might want a different person to try because they might not feel comfortable with Diego having another attempt since he was not successful the first time – so it is not an inappropriate response. This is seen as a second best solution to the problem, and so is appropriate but not ideal.

     

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    Safiya is a medical student who is currently on an orthopaedics ward. One of the patients has finished their treatment, and Safiya is escorting them out of the hospital. On the third floor, Safiya sees an elderly man who looks confused and lost. He doesn’t seem to have any guardian or relatives.

    How appropriate are each of the following responses by Safiya in this situation?

    9. After escorting the patient, speak to the elderly man and try to look for a relative or guardian, whilst reassuring and comforting him.
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    Explanation

    The correct answer is A. This is exemplary behaviour by Safiya. She is ensuring that the patient has been dealt with, and is then going to the elderly person. The elderly patient is not in an urgent situation, so Safiya should not leave her current patient, but it is important to attend when Safiya is free. Whether the elderly man is a patient or not, it is important for Safiya to reassure and comfort him.

    Post Comment

    Safiya is a medical student who is currently on an orthopaedics ward. One of the patients has finished their treatment, and Safiya is escorting them out of the hospital. On the third floor, Safiya sees an elderly man who looks confused and lost. He doesn’t seem to have any guardian or relatives.

    How appropriate are each of the following responses by Safiya in this situation?

    10. Ask the receptionist to sort out the situation with the elderly man, because she has patients to deal with.
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    Explanation

    The correct answer is C. This is an inappropriate thing to do because it assumes that the receptionist does not have her own work to attend to. It is not the receptionist’s responsibility to help the elderly man, and by taking time out of her own work she will fall behind on her own tasks. It does still solve the issue, so does not have any major negative consequences, so it is not an awful response. It would have been more appropriate to deal with the elderly man directly. 

    Post Comment

    Safiya is a medical student who is currently on an orthopaedics ward. One of the patients has finished their treatment, and Safiya is escorting them out of the hospital. On the third floor, Safiya sees an elderly man who looks confused and lost. He doesn’t seem to have any guardian or relatives.

    How appropriate are each of the following responses by Safiya in this situation?

    11. Ask the patient that is being escorted out to wait there for a few minutes, and she will return to them as soon as she can, after she has dealt with the elderly man.
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    Explanation

    The correct answer is A. In this scenario, the patient has finished his treatment therefore it is likely that they are not requiring immediate medical care. The elderly man could be in danger, so it would be better to ask the patient to wait politely, find out more about the elderly man and then go from there. This occurs a lot in the medical field, and is often called triaging. This is where doctors decide what patients need to be treated with the greatest priority. It is important to note that Safiya is not leaving the patient, but instead asking them to wait a few moments. In this time she can assess the risk of the elderly man, and then re-triage accordingly. 

    Post Comment

    Safiya is a medical student who is currently on an orthopaedics ward. One of the patients has finished their treatment, and Safiya is escorting them out of the hospital. On the third floor, Safiya sees an elderly man who looks confused and lost. He doesn’t seem to have any guardian or relatives.

    How appropriate are each of the following responses by Safiya in this situation?

    12. Comfort the elderly man and reassure him that he is in the hospital and in capable hands.
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    Explanation

    The correct answer is A.  Again this is a very appropriate thing to do. Safiya sees that the elderly man is either confused or lost. By reassuring him it will help comfort them and let them know that they are being cared for.

    Post Comment

    Safiya is a medical student who is currently on an orthopaedics ward. One of the patients has finished their treatment, and Safiya is escorting them out of the hospital. On the third floor, Safiya sees an elderly man who looks confused and lost. He doesn’t seem to have any guardian or relatives.

    How appropriate are each of the following responses by Safiya in this situation?

    13. Ask the patients and colleagues who are nearby if they know who the man is.
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    Explanation

    The correct answer is B. This is an appropriate thing to do, it will be useful to check if anyone knows who he is as it will potentially help resolve the situation. However for something to be a very appropriate thing to do, it has to be the optimal approach. If Safiya first talked to the man directly and then asked about those nearby it would be a very appropriate thing to do. However, it is an appropriate, but not ideal scenario as there could have been a potentially better solution.

     

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    Sunita is a 6th year medical student who is on the tube to her placement at Royal Free Hospital. The tube stops at Mornington Crescent station, and the driver makes an announcement that a passenger has fallen ill and asks for anyone of a medical background to come forward and help. Sunita is not yet a doctor, but has had a significant amount of medical training. The driver repeatedly makes the announcements, and Sunita assumes that there are no other passengers with a medical background on the train. Sunita is unsure whether she should respond to the announcement or not.

    How important are the following factors to consider for Sunita?

    14. The passengers are becoming extremely worried.
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    Explanation

    The correct answer is C.  She should consider this to an extent because it means that several people are being affected by her indecisiveness. However, she should still respond appropriately and calmly regardless of how others are reacting. Passengers becoming more anxious does not necessarily correlate with the severity of the situation, so it should not force Sunita into action.



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    Sunita is a 6th year medical student who is on the tube to her placement at Royal Free Hospital. The tube stops at Mornington Crescent station, and the driver makes an announcement that a passenger has fallen ill and asks for anyone of a medical background to come forward and help. Sunita is not yet a doctor, but has had a significant amount of medical training. The driver repeatedly makes the announcements, and Sunita assumes that there are no other passengers with a medical background on the train. Sunita is unsure whether she should respond to the announcement or not.

    How important are the following factors to consider for Sunita?

    15. There could be other medical professionals on board, who may be more qualified than Sunita but have not yet come forward.
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    Explanation

    The correct answer is D.  No one else has come forward yet, so if Sunita believes she can help she should not wait to see if someone else comes forward. It is best to assume that no one will come forward, and if when Sunita is escorted to the scene there is a qualified doctor she can let him help instead.

     



    Post Comment

    Sunita is a 6th year medical student who is on the tube to her placement at Royal Free Hospital. The tube stops at Mornington Crescent station, and the driver makes an announcement that a passenger has fallen ill and asks for anyone of a medical background to come forward and help. Sunita is not yet a doctor, but has had a significant amount of medical training. The driver repeatedly makes the announcements, and Sunita assumes that there are no other passengers with a medical background on the train. Sunita is unsure whether she should respond to the announcement or not.

    How important are the following factors to consider for Sunita?

    16. The tube driver now says that it is a medical emergency and paramount that someone comes forward.
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    Explanation

    The correct answer is A. It becomes increasingly clear that medical attention is required, and by not helping at all Sunita is hindering the situation and potentially endangering the passenger that has fallen ill. It is therefore very important to consider the fact that the situation is an emergency.

    Post Comment

    Sunita is a 6th year medical student who is on the tube to her placement at Royal Free Hospital. The tube stops at Mornington Crescent station, and the driver makes an announcement that a passenger has fallen ill and asks for anyone of a medical background to come forward and help. Sunita is not yet a doctor, but has had a significant amount of medical training. The driver repeatedly makes the announcements, and Sunita assumes that there are no other passengers with a medical background on the train. Sunita is unsure whether she should respond to the announcement or not.

    How important are the following factors to consider for Sunita?

    17. Even if Sunita does go to the medical emergency, she may not be able to help as much as others might be able to.
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    Explanation

    The correct answer is C.  She is a 6th year medical student, so it is likely that she is able to help in some shape or form. Her help will be better than a normal person with no medical background, so it can only be a bonus even if she cannot help as much as others would be able to do. It doesn’t change whether or not she responds to the scenario. However, she must still recognise the limits of her own competence. This is therefore relatively unimportant for her to think about.




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    Edward and Kar-Yeung are two medical students in a maxillo-facial ward. Edward sees Kar-Yeung taking selfies of herself while the consultant is speaking to the patient. Edward also sees Kar-Yeung talking about a friend’s birthday party she went to, and observes that the patient is visibly annoyed even though the patient does not say anything. At this moment in time, Kar-Yeung and the patient are not aware that Edward has seen and heard these things.

    How appropriate are each of the following responses by Edward in this situation?

    18. Monitor Kar-Yeung’s behaviour in order to see if she continues to display similar behaviour and misconduct.
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    Explanation

    The correct answer is C. Not reporting the issue or dealing with it directly is likely to mean that it will continue, and it does not help to resolve the situation quickly. The patient is already annoyed, so waiting is not a good course of action here. At the very least Edward should speak to Kar-Yeung if he does not want to report it.  The reason it is not awful is because monitoring Kar-Yeung’s behaviour over a longer period of time could help Edward understand if this was a one-off or if it is a continuing problem, and will therefore enable Edward to make a more accurate assessment of the problem. It is therefore an inappropriate, but not awful response.

    In some scenarios monitoring behaviour in the long term is the best option. For example, if you are a junior doctor and saw a fellow colleague use her phone on the ward, you do not have to report it immediately. Instead, it is better to speak to your colleague and see if it is repeated again. It may have just been an emergency or a particularly important call, and even if it wasn’t the colleague might stop after you have a word. Here, the action is not as appropriate because the patient is already annoyed and Edward is not speaking to Kar-Yeung.

     

    Post Comment

    Edward and Kar-Yeung are two medical students in a maxillo-facial ward. Edward sees Kar-Yeung taking selfies of herself while the consultant is speaking to the patient. Edward also sees Kar-Yeung talking about a friend’s birthday party she went to, and observes that the patient is visibly annoyed even though the patient does not say anything. At this moment in time, Kar-Yeung and the patient are not aware that Edward has seen and heard these things.

    How appropriate are each of the following responses by Edward in this situation?

    19. Speak to Kar-Yeung personally at the end of the consultation, and tell her that he has seen her actions, and remind her of the code of conduct for being a medical professional.
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    Explanation

    The correct answer is A. Instead of reporting to the consultant or other senior professionals directly, Edward is first treating the issue at a local level. Remember it is always best to resolve conflict directly wherever possible, unless it involves a compromise of patient safety, confidentiality or data handling. The manner in which Edward is approaching this scenario is not very confrontational, and by dealing with Kay-Yeung directly, it will help resolve the issue more quickly. If Kar-Yeung repeatedly performed similar behaviour after Edward has spoken to him, it would be completely acceptable for him to report it to a consultant. It is therefore a very appropriate thing to do.

     

     

    Post Comment

    Edward and Kar-Yeung are two medical students in a maxillo-facial ward. Edward sees Kar-Yeung taking selfies of herself while the consultant is speaking to the patient. Edward also sees Kar-Yeung talking about a friend’s birthday party she went to, and observes that the patient is visibly annoyed even though the patient does not say anything. At this moment in time, Kar-Yeung and the patient are not aware that Edward has seen and heard these things.

    How appropriate are each of the following responses by Edward in this situation?

    20. Speak to Kar-Yeung during the consultation in front of the patient, and tell her that he has seen her actions, and remind her of the code of conduct for being a medical professional.
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    Explanation

    The correct answer is D. Edward should speak to Kar-Yeung privately at the end. The patient is likely to lose confidence in the two medical students and the medical team in general, so this is an inappropriate action. Kar-Yeung’s actions are not endangering the patient, and to address the issue immediately Edward can change the topic of conversation instead of confronting Kar-Yeung about the code of conduct she must follow. Even if he does want to speak to her now, instead of reminding her of her code of conduct he can focus the conversation on the patient’s care.

     

     

    Post Comment

    Edward and Kar-Yeung are two medical students in a maxillo-facial ward. Edward sees Kar-Yeung taking selfies of herself while the consultant is speaking to the patient. Edward also sees Kar-Yeung talking about a friend’s birthday party she went to, and observes that the patient is visibly annoyed even though the patient does not say anything. At this moment in time, Kar-Yeung and the patient are not aware that Edward has seen and heard these things.

    How appropriate are each of the following responses by Edward in this situation?

    21. Speak to the consultant who is supervising Kar-Yeung.
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    Explanation

    The correct answer is C. Whenever there is an opportunity, you should always try and resolve conflict directly. Here Edward is involving other people who are not necessarily connected to the scenario. If you see this sort of question in the exam, recognise the role of the players and try and appreciate the circumstances at which higher authority or other personnel can be avoided. This is a great example of such a case. Only report to higher authorities or other medical professionals if it involves compromising patient safety, patient confidentiality or data handling. Edward could have approached Kar-Yeung directly and this could have helped resolve the issue much more efficiently as well. It is therefore an inappropriate thing to do. The reason it is inappropriate but not awful is because of the fact that it could help resolve the conflict regardless and it is not the most terrible thing to do.

     

     

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    A junior doctor called Bhavik is on a night shift which is meant to end at 8am. At 7am, a consultant asks Bhavik to chase up on some CT scans from the radiology department that have been e-mailed to him. However, the IT is currently under security attack, so Bhavik is unable to access his e-mail. Bhavik has been working since 9pm, and acknowledges that he will be unable to analyse the CT scans before he leaves. So he asks Lisa, another junior doctor who is starting her shift at 8am, to follow up on the CT scans. Lisa refuses to agree to Bhavik’s request and tells him that he needs to stay beyond his shift and find the CT scans himself because she is preoccupied. Bhavik realises that this means that he will have to stay another 2-3 hours beyond his shift, and will mean he will not get a lot of rest before his next shift in the hospital.
    How appropriate are each of the following responses by Bhavik in this situation?

    22. Remain in the hospital until the IT becomes fixed and he can access his e-mail.
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    Explanation

    The correct answer is C.Let us consider the consequences of Bhavik staying further than his shift. If he returns home later, there is less time until his next shift and he may not have time to rest much before his next one. Remember patient safety is paramount, and the most important factor to consider in decisions. A common Medic Mind phrase is ‘tired doctors make mistakes’. This means that it is inappropriate to stay too late and compromise on having rest. Another reason this response is inappropriate is that it is unreasonable for Bhavik to be allocated a task out of hours, especially when it means that he will have to stay 2-3 hours beyond his shift. If it was a shorter period than this, then it may be acceptable. Now the question remains whether it is C or D. Arguably Bhavik could just sleep earlier than he normally does to make up for the lack of sleep the night before. Staying beyond his shift will also mean that the task will be completed, which it may not otherwise be. This means the answer is C.

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    A junior doctor called Bhavik is on a night shift which is meant to end at 8am. At 7am, a consultant asks Bhavik to chase up on some CT scans from the radiology department that have been e-mailed to him. However, the IT is currently under security attack, so Bhavik is unable to access his e-mail. Bhavik has been working since 9pm, and acknowledges that he will be unable to analyse the CT scans before he leaves. So he asks Lisa, another junior doctor who is starting her shift at 8am, to follow up on the CT scans. Lisa refuses to agree to Bhavik’s request and tells him that he needs to stay beyond his shift and find the CT scans himself because she is preoccupied. Bhavik realises that this means that he will have to stay another 2-3 hours beyond his shift, and will mean he will not get a lot of rest before his next shift in the hospital.
    How appropriate are each of the following responses by Bhavik in this situation?

    23. Speak to the consultant managing Lisa to inform them of the situation, and tell them to make sure that Lisa checks the CT scans.
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    Explanation

    The correct answer is B.Remember patient safety is the main concern. If Bhavik goes to the consultant, it will ensure that the problem is adequately resolved, as the consultant will take action. This will mean patient safety is not compromised, which makes the action appropriate.  It is suggested that whenever junior doctor colleagues have disputes, they should attempt to try and solve the problems directly with each other, and only address higher authority if necessary. However, Bhavik did try and ask Lisa who refused, and in this scenario the main priority is to get the CT scan checked. Patient safety is the main concern but the reason the answer is B and not A is because Bhavik has not tried his hardest to convince Lisa to take on the task, and he may in fact be able to persuade her. The answer is therefore B.

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    A junior doctor called Bhavik is on a night shift which is meant to end at 8am. At 7am, a consultant asks Bhavik to chase up on some CT scans from the radiology department that have been e-mailed to him. However, the IT is currently under security attack, so Bhavik is unable to access his e-mail. Bhavik has been working since 9pm, and acknowledges that he will be unable to analyse the CT scans before he leaves. So he asks Lisa, another junior doctor who is starting her shift at 8am, to follow up on the CT scans. Lisa refuses to agree to Bhavik’s request and tells him that he needs to stay beyond his shift and find the CT scans himself because she is preoccupied. Bhavik realises that this means that he will have to stay another 2-3 hours beyond his shift, and will mean he will not get a lot of rest before his next shift in the hospital.
    How appropriate are each of the following responses by Bhavik in this situation?

    24. Check the CT results the next morning on the next shift if Lisa has not already done so.
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    Explanation

    The correct answer is D. If CT scans are not checked, the patient’s safety could be compromised.This can lead to potential consequences that could otherwise have been prevented. By assuming that Lisa will carry out the command despite the fact that she has refused, or assuming that he can just do the checks tomorrow is naive, and a direct compromise of patient safety. The answer is therefore D.

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    A junior doctor called Bhavik is on a night shift which is meant to end at 8am. At 7am, a consultant asks Bhavik to chase up on some CT scans from the radiology department that have been e-mailed to him. However, the IT is currently under security attack, so Bhavik is unable to access his e-mail. Bhavik has been working since 9pm, and acknowledges that he will be unable to analyse the CT scans before he leaves. So he asks Lisa, another junior doctor who is starting her shift at 8am, to follow up on the CT scans. Lisa refuses to agree to Bhavik’s request and tells him that he needs to stay beyond his shift and find the CT scans himself because she is preoccupied. Bhavik realises that this means that he will have to stay another 2-3 hours beyond his shift, and will mean he will not get a lot of rest before his next shift in the hospital.
    How appropriate are each of the following responses by Bhavik in this situation?

    25. Appreciate Lisa’s point of view and explain that this situation is a one-off and circumstantial, and ask her to reconsider her decision to help.
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    Explanation

    The correct answer is A. Here Bhavik is approaching the situation very delicately. He is first accepting of the fact that Lisa did not accept the first time, and by looking at her point of view he is maintaining peace with his fellow colleague. By asking her to reconsider, it gives a sense of discussion rather than order. Bhavik is also approaching her directly and dealing with the issue locally, instead of asking one of the consultants or someone with authority. It is therefore a very appropriate thing to do.

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    Kiana is an Emergency Department doctor dealing with a patient on a busy Friday night. She is about to take a history from a new patient, who has been admitted with a head wound after falling over while intoxicated. The patient has been here multiple times this week, with alcohol related issues, and been seen by Kiana most nights. Just as Kiana is about to go and see the patient, he emerges from his bay, fully naked, and starts making rude comments towards her.

    How important to take into account are the following considerations for Kiana when deciding how to respond to the situation?

    26. Kiana does not like the patient as a person.
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    Explanation

    The correct answer is D.  Doctors are often put in situations where they do not personally get on with their patients. As a professional, we must put personal differences aside and treat all patients equally. It would be unfair for Kiana to let her personal views and opinions affect this patient’s care. Despite his rude comments, and her personal dislike, is something that Kiana should actively not consider, and therefore this response is inappropriate.



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    Kiana is an Emergency Department doctor dealing with a patient on a busy Friday night. She is about to take a history from a new patient, who has been admitted with a head wound after falling over while intoxicated. The patient has been here multiple times this week, with alcohol related issues, and been seen by Kiana most nights. Just as Kiana is about to go and see the patient, he emerges from his bay, fully naked, and starts making rude comments towards her.

    How important to take into account are the following considerations for Kiana when deciding how to respond to the situation?

    27. The patient’s sex.
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    Explanation

    The correct answer is D.  Whilst our instinct may be that his sex would matter in this situation, as we may be more inclined to preserve a female’s patient modesty, this would be our own internal bias coming into play. Whether the patient is male or female, we must act to preserve their modesty when in this compromising situation. The patient’s sex does not matter in this situation, and once again, we must actively not consider it.



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    Kiana is an Emergency Department doctor dealing with a patient on a busy Friday night. She is about to take a history from a new patient, who has been admitted with a head wound after falling over while intoxicated. The patient has been here multiple times this week, with alcohol related issues, and been seen by Kiana most nights. Just as Kiana is about to go and see the patient, he emerges from his bay, fully naked, and starts making rude comments towards her.

    How important to take into account are the following considerations for Kiana when deciding how to respond to the situation?

    28. The fact the patient has been here multiple times this week.
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    Explanation

    The correct answer is B. This is not a consideration for the immediate situation, as we must mainly act to preserve the patient’s modesty and treat the current head injury. However, it is something we should still consider, as it may imply an underlying issue which needs to be resolved. Therefore, this response is important, but not crucial to the situation.


    Post Comment

    Kiana is an Emergency Department doctor dealing with a patient on a busy Friday night. She is about to take a history from a new patient, who has been admitted with a head wound after falling over while intoxicated. The patient has been here multiple times this week, with alcohol related issues, and been seen by Kiana most nights. Just as Kiana is about to go and see the patient, he emerges from his bay, fully naked, and starts making rude comments towards her.

    How important to take into account are the following considerations for Kiana when deciding how to respond to the situation?

    29. The patient is known to be homosexual.
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    Explanation

    The correct answer is D. This should not play any part in whether we treat the patient, or how we act towards the patient. It would be wrong for us to change any aspect of our behaviour based on the patient’s sexuality. This would be discriminatory, and immoral for a doctor to consider.

    Post Comment

    Kiana is an Emergency Department doctor dealing with a patient on a busy Friday night. She is about to take a history from a new patient, who has been admitted with a head wound after falling over while intoxicated. The patient has been here multiple times this week, with alcohol related issues, and been seen by Kiana most nights. Just as Kiana is about to go and see the patient, he emerges from his bay, fully naked, and starts making rude comments towards her.

    How important to take into account are the following considerations for Kiana when deciding how to respond to the situation?

    30. The patient can be seen by other patients.
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    Explanation

    The correct answer is A. The crux of this scenario is the fact the patient’s modesty is compromised. We must act to preserve this, and every patient has the right to privacy and respect. The fact the patient is naked is the most important thing to consider when responding to this immediate situation. Kiana should act to quickly cover the patient up. Equally, but not as importantly, other patients may be uncomfortable seeing a man like this, and many patients are in very distressing situations within the Emergency Department, which need not be exacerbated. 

     

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    A junior doctor, Alex, is taking part on a ward round on the weekend, and it is especially busy today as a number of staff have called in sick. As soon as he enters the ward, a nurse from the surgeon’s team calls him to let him know that many of the surgeons are not available today. They inform Alex that he will have to explain to Jeffrey, one of the patients in Alex’s ward, that his operation will have to be delayed until the next day, and that he will be the first patient on the list. Alex knows that Jeffrey is having a colonoscopy and is extremely worried and anxious already that it is a risk to his life. However, delaying the operation by one day is not going to make a difference to Jeffrey’s safety. Alex plan to tell Jeffrey that his colonoscopy will not take place today.

    How appropriate are each of the following responses by Alex in this situation?

    31. Alex explains to Jeffrey the reasons why his surgery won’t happen today.
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    Explanation

    The correct answer is A. Jeffrey is extremely anxious, and so informing him the reasons why the surgery can’t take place is an extremely appropriate thing to do because it will put him at ease and reduce any anger towards the medical team.

    Post Comment

    A junior doctor, Alex, is taking part on a ward round on the weekend, and it is especially busy today as a number of staff have called in sick. As soon as he enters the ward, a nurse from the surgeon’s team calls him to let him know that many of the surgeons are not available today. They inform Alex that he will have to explain to Jeffrey, one of the patients in Alex’s ward, that his operation will have to be delayed until the next day, and that he will be the first patient on the list. Alex knows that Jeffrey is having a colonoscopy and is extremely worried and anxious already that it is a risk to his life. However, delaying the operation by one day is not going to make a difference to Jeffrey’s safety. Alex plan to tell Jeffrey that his colonoscopy will not take place today.

    How appropriate are each of the following responses by Alex in this situation?

    32. Alex tells a medical student who is doing the ward round with them to explain to Jeffrey the reasons why his surgery has been delayed to tomorrow.
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    Explanation

    The correct answer is D. Alex already knows Jeffrey and it is likely that Jeffrey has a significant amount of trust in Alex as a doctor, and so will rely on him for information. Delegating the task onto a medical student is a very inappropriate thing to do because it will not reassure Jeffrey, as he is already anxious. Delegation can sometimes be useful, however when a patient is anxious and has a great deal of trust in a certain doctor, it can have implications in the future as the patient can lose trust in the medical team. Additionally, it is unfair to let a medical student break unwanted news to an already anxious patient.

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    A junior doctor, Alex, is taking part on a ward round on the weekend, and it is especially busy today as a number of staff have called in sick. As soon as he enters the ward, a nurse from the surgeon’s team calls him to let him know that many of the surgeons are not available today. They inform Alex that he will have to explain to Jeffrey, one of the patients in Alex’s ward, that his operation will have to be delayed until the next day, and that he will be the first patient on the list. Alex knows that Jeffrey is having a colonoscopy and is extremely worried and anxious already that it is a risk to his life. However, delaying the operation by one day is not going to make a difference to Jeffrey’s safety. Alex plan to tell Jeffrey that his colonoscopy will not take place today.

    How appropriate are each of the following responses by Alex in this situation?

    33. Promise to Jeffrey that Alex will manage to somehow turn it around and make the colonoscopy occur today.
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    Explanation

    The correct answer is D. This is an extremely inappropriate thing to do. The surgeons have already informed Alex that the operation cannot take place today, so giving false hope will not bring any benefits in the long term. The operation most probably won’t happen today, and Jeffrey will lose trust in the team.

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    A junior doctor, Alex, is taking part on a ward round on the weekend, and it is especially busy today as a number of staff have called in sick. As soon as he enters the ward, a nurse from the surgeon’s team calls him to let him know that many of the surgeons are not available today. They inform Alex that he will have to explain to Jeffrey, one of the patients in Alex’s ward, that his operation will have to be delayed until the next day, and that he will be the first patient on the list. Alex knows that Jeffrey is having a colonoscopy and is extremely worried and anxious already that it is a risk to his life. However, delaying the operation by one day is not going to make a difference to Jeffrey’s safety. Alex plan to tell Jeffrey that his colonoscopy will not take place today.

    How appropriate are each of the following responses by Alex in this situation?

    34. Tell Jeffrey that he can come back to him tomorrow with any questions he may have, instead of asking them right now, as he is extremely busy due to the shortage of staff.
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    Explanation

    The correct answer is D. This is an extremely inappropriate thing to do. Making Jeffrey wait until tomorrow will make him even more anxious and will mean that he has to wait even longer to find out the latest update. Alex should take the earliest opportunity to try and clarify everything.

    As a doctor, you will be very time pressured, but you cannot let patients see that their time with you is short-cut or rushed. Fr example, GPs often have to run appointments in 10 minute slots, seeing patient after patient. There is a balance between time efficiency, and cutting the patient off to give a rushed service. Here Jeffrey is exposing structural and management issues in the hospital’s staffing as an excuse for poor care, which should not happen.

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    A junior doctor, Alex, is taking part on a ward round on the weekend, and it is especially busy today as a number of staff have called in sick. As soon as he enters the ward, a nurse from the surgeon’s team calls him to let him know that many of the surgeons are not available today. They inform Alex that he will have to explain to Jeffrey, one of the patients in Alex’s ward, that his operation will have to be delayed until the next day, and that he will be the first patient on the list. Alex knows that Jeffrey is having a colonoscopy and is extremely worried and anxious already that it is a risk to his life. However, delaying the operation by one day is not going to make a difference to Jeffrey’s safety. Alex plan to tell Jeffrey that his colonoscopy will not take place today.

    How appropriate are each of the following responses by Alex in this situation?

    35. Speak to Jeffrey directly, and explain to him that having the operation one day later will not affect his safety or health.
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    Explanation

    The correct answer is A. We know that Jeffrey is extremely worried and anxious already, and so telling him that the delay will not affect his safety will help to settle and reassure him. It is therefore a very appropriate thing to do.

     

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    A group of junior doctors are celebrating finishing their first official week of being a doctor at a party, hosted by Konstantinos who has a few alcoholic beers. The next morning, Konstantinos is browsing social media and finds that his friend Tim, who is also a junior doctor, has posted a “snapchat story” which contains several pictures from the party. This includes ones of Konstantinos drinking alcoholic beers. This “story” is set to public, meaning anyone including patients and other colleagues are able to see them, and it is clear from the picture that it is Konstantinos. At the end of the party, Konstantinos and his friends, including Tim, went to drink inside their hospital office, and from the pictures it is clear that they were at the hospital.

    How appropriate are each of the following responses by Konstantinos to the scenario?

    36. Text Tim and tell him that his Snapchat story is public, and that anyone can clearly identify the hospital from the pictures that have been taken.
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    Explanation

    The correct answer is A. Konstantinos should not have been drinking in his hospital office regardless if it was not on duty. The main issue to address is that patient confidence in the medical profession should not be compromised. Texting Tim addresses the problem of the photos being publicly available and will help resolve the situation.

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    A group of junior doctors are celebrating finishing their first official week of being a doctor at a party, hosted by Konstantinos who has a few alcoholic beers. The next morning, Konstantinos is browsing social media and finds that his friend Tim, who is also a junior doctor, has posted a “snapchat story” which contains several pictures from the party. This includes ones of Konstantinos drinking alcoholic beers. This “story” is set to public, meaning anyone including patients and other colleagues are able to see them, and it is clear from the picture that it is Konstantinos. At the end of the party, Konstantinos and his friends, including Tim, went to drink inside their hospital office, and from the pictures it is clear that they were at the hospital.

    How appropriate are each of the following responses by Konstantinos to the scenario?

    37. Block Tim from Snapchat.
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    Explanation

    The correct answer is C. Tim should not have put that on his Snapchat story, and so it is completely understandable why Konstantinos would want to block him. However, it is not ideal as it does not address the emerging problem which remains that the photos are public and could damage the hospital’s reputation. Moreover, Tim may put more incriminating evidence on social media, which Konstantinos will not be able to see or respond to if he blocks Tim.

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    A group of junior doctors are celebrating finishing their first official week of being a doctor at a party, hosted by Konstantinos who has a few alcoholic beers. The next morning, Konstantinos is browsing social media and finds that his friend Tim, who is also a junior doctor, has posted a “snapchat story” which contains several pictures from the party. This includes ones of Konstantinos drinking alcoholic beers. This “story” is set to public, meaning anyone including patients and other colleagues are able to see them, and it is clear from the picture that it is Konstantinos. At the end of the party, Konstantinos and his friends, including Tim, went to drink inside their hospital office, and from the pictures it is clear that they were at the hospital.

    How appropriate are each of the following responses by Konstantinos to the scenario?

    38. E-mail the hospital management team and inform them that the hospital’s reputation has been potentially been compromised.
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    Explanation

    The correct answer is B. The hospital’s reputation has been potentially compromised because of Konstantinos’ and Tim’s behaviour. Therefore informing them is a good thing to do. However, it is highly unlikely that emailing the hospital will directly and immediately help solve the problem. Konstantinos is bypassing those that are involved, and therefore it will delay the response. The group of junior doctors themselves need to recognise the obvious bad behaviour they have committed and therefore come to response solution. Instead of e-mailing the hospital management, it would be better to e-mail Tim and inform him to take it down. It is therefore not an ideal thing to do.

     

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    A group of junior doctors are celebrating finishing their first official week of being a doctor at a party, hosted by Konstantinos who has a few alcoholic beers. The next morning, Konstantinos is browsing social media and finds that his friend Tim, who is also a junior doctor, has posted a “snapchat story” which contains several pictures from the party. This includes ones of Konstantinos drinking alcoholic beers. This “story” is set to public, meaning anyone including patients and other colleagues are able to see them, and it is clear from the picture that it is Konstantinos. At the end of the party, Konstantinos and his friends, including Tim, went to drink inside their hospital office, and from the pictures it is clear that they were at the hospital.

    How appropriate are each of the following responses by Konstantinos to the scenario?

    39. Start a debate at lunchtime with other junior doctors, consultants and medical students about the advantages and disadvantages of Snapchat.
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    Explanation

    The correct answer is C. This is not addressing the issue directly because Tim is not in this scenario. Konstantinos is bringing it up with fellow staff members that may or may not have been at the party. Nonetheless, informing them of what happened will not change the probability that Tim will take the snapchat story down. A better method would have been to respond directly to Tim instead of doing it this way. The reason it is inappropriate but not awful is because this discussion will not have a negative impact, however it is not useful.

     

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    Sujinth is a junior doctor who has been asked to take a lumbar puncture by the consultant on a ward on a patient called Urvneek. The puncture is required for an extremely important examination. Sujinth is uncomfortable with this request because he has a fear of needles that he developed a couple of months ago on his elective where he accidentally pricked his own finger when he was taking blood from a patient in Peru. As a result of this, he is fearful of needles, and becomes anxious every time he sees them. The lumbar puncture procedure requires needles.  Sujinth tells the consultant of this experience, and also tells them that his future area of medicine that he will specialise in after this placement does not involve needles. Despite this, the consultant tells him to carry out the lumbar puncture.

    How appropriate are each of the following responses by Sujinth in this situation?

    40. Tell the consultant that it is unfair to ask him to do the procedure despite the fact that he told him that he feels uncomfortable to do so.
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    Explanation

    The correct answer is C. Sujinth is being extremely confrontational here. Saying this to the consultant will create friction in the team, and could lead to further problems in the future. This means it is inappropriate. It could be seen as an attack on the consultant’s ability to assess his team’s abilities. The reason this response is not awful is because it means that Sujinth is less likely to carry out the lumbar puncture and potentially endanger the patient.

     

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    Sujinth is a junior doctor who has been asked to take a lumbar puncture by the consultant on a ward on a patient called Urvneek. The puncture is required for an extremely important examination. Sujinth is uncomfortable with this request because he has a fear of needles that he developed a couple of months ago on his elective where he accidentally pricked his own finger when he was taking blood from a patient in Peru. As a result of this, he is fearful of needles, and becomes anxious every time he sees them. The lumbar puncture procedure requires needles.  Sujinth tells the consultant of this experience, and also tells them that his future area of medicine that he will specialise in after this placement does not involve needles. Despite this, the consultant tells him to carry out the lumbar puncture.

    How appropriate are each of the following responses by Sujinth in this situation?

    41. Say sorry to the consultant because he does not want to do the procedure, and explain to the consultant that it might be better to find another doctor to carry out the procedure, in case something goes wrong if Sujinth panics.
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    Explanation

    The correct answer is A. This is a very appropriate thing to do. As we considered earlier, the most important person in this scenario is the patient. It is vital that their safety is not compromised and if Sujinth does carry out the procedure, he could panic and potentially permanently damage the patient. A lumbar puncture needs to be done very precisely, as it can lead to nerve damage to the spine and paralysis if performed wrong.

    It can also be argued that it is reasonable for him to say no to the procedure, and ask someone else to do it. It becomes even more appropriate when you consider the fact that Sujinth’s future speciality will not involve needles. If it was a speciality such as surgery, Sujinth would have to somehow find a way to overcome his fears and learn.

    He also apologises to the consultant, compared to the previous response where it came across as more hostile. Sujinth is being sensitive to the situation and this will ensure patient safety is not compromised, so the answer is therefore A, a very appropriate thing to do.

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    Sujinth is a junior doctor who has been asked to take a lumbar puncture by the consultant on a ward on a patient called Urvneek. The puncture is required for an extremely important examination. Sujinth is uncomfortable with this request because he has a fear of needles that he developed a couple of months ago on his elective where he accidentally pricked his own finger when he was taking blood from a patient in Peru. As a result of this, he is fearful of needles, and becomes anxious every time he sees them. The lumbar puncture procedure requires needles.  Sujinth tells the consultant of this experience, and also tells them that his future area of medicine that he will specialise in after this placement does not involve needles. Despite this, the consultant tells him to carry out the lumbar puncture.

    How appropriate are each of the following responses by Sujinth in this situation?

    42. Explain to the consultant that he will try to do his best on the lumbar puncture, but once the consultant has left Sujinth will ask someone else to carry out the lumbar puncture.
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    Explanation

    The correct answer is D. Remember patient safety is the most important thing. The fact that Sujinth is not carrying out the procedure is a good thing. However, Sujinth is lying to his consultant by telling them that he will indeed carry out the procedure. It would have been better for Sujinth to tell the consultant the truth. Indeed, if another doctor performs the puncture well, the consultant will ask Sujinth again next time if he believes Sujinth did it. This response involves lying to the consultant, and this is not appropriate.

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    Sujinth is a junior doctor who has been asked to take a lumbar puncture by the consultant on a ward on a patient called Urvneek. The puncture is required for an extremely important examination. Sujinth is uncomfortable with this request because he has a fear of needles that he developed a couple of months ago on his elective where he accidentally pricked his own finger when he was taking blood from a patient in Peru. As a result of this, he is fearful of needles, and becomes anxious every time he sees them. The lumbar puncture procedure requires needles.  Sujinth tells the consultant of this experience, and also tells them that his future area of medicine that he will specialise in after this placement does not involve needles. Despite this, the consultant tells him to carry out the lumbar puncture.

    How appropriate are each of the following responses by Sujinth in this situation?

    43. Tell the consultant that he will only do the procedure if someone is there with them to support him during the lumbar puncture, and to help him in case he panics.
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    Explanation

    The correct answer is C. The patient may see Sujinth panicking if he carries out the lumbar puncture, and even if someone takes over this won’t change. It might be a better solution if the person supporting and accompanying them carries out the procedure from the beginning.
    However, the reason it is C and not D is because Sujinth is accepting the fact that he may be a risk to the patient and by having someone accompany him the environment becomes much safer and secure. If the other person did the procedure, it would’ve been faster, safer and would not compromise the patient’s safety. The answer is therefore C.

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    Hector is an orthopaedics consultant. The time is 6pm and Hector is due to finish his shift at 6:30pm, and meet his wife for dinner. At 6pm, Hector was due to have a handover meeting with Abdul, a fellow orthopaedics consultant, where they would discuss the patient issues that are still outstanding and need to be dealt with by the incoming doctor. Abdul calls Hector to inform him that his son’s babysitter has only just arrived, and will be there around 7:00pm – more than 30 minutes after Hector’s shift finishes.

    How appropriate are each of the following responses by Hector in this situation?

    44. Still leave 6:30pm but go around and make detailed notes about patients that still have outstanding issues in their patient records so that when Abdul finally arrives he will still be partially informed.
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    Explanation

    The correct answer is C. Hector is meeting his wife for dinner. This is not an urgent or unavoidable reason for missing work, whereas Abdul’s is because he cannot leave his son unattended. This means that there is no reason not to wait for 30 minutes, especially because it is a small duration and avoids the workload being burdened on others, including junior doctors who are likely to already be quite occupied. This makes it an inappropriate cause of action.

    Now we need to decide whether it is C or D. Although his reasons are not very reasonable, Hector is still leaving a record of notes and this may be sufficient even if it is not ideal. This makes it an inappropriate but not awful course of action. The answer is therefore C.

     

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    Hector is an orthopaedics consultant. The time is 6pm and Hector is due to finish his shift at 6:30pm, and meet his wife for dinner. At 6pm, Hector was due to have a handover meeting with Abdul, a fellow orthopaedics consultant, where they would discuss the patient issues that are still outstanding and need to be dealt with by the incoming doctor. Abdul calls Hector to inform him that his son’s babysitter has only just arrived, and will be there around 7:00pm – more than 30 minutes after Hector’s shift finishes.

    How appropriate are each of the following responses by Hector in this situation?

    45. Text his wife and tell her that he is going to be late.
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    Explanation

    The correct answer is A. This is a very appropriate thing to do. In terms of time, texting his wife is the most efficient method of letting her know that he is going to be late as it will not take a long period of time. He is informing her and keeping her in the loop about what is happening. This also means that Hector is prioritising patient safety over personal dealings, as it is likely that this dinner is not an event that is completely unavoidable.

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    Hector is an orthopaedics consultant. The time is 6pm and Hector is due to finish his shift at 6:30pm, and meet his wife for dinner. At 6pm, Hector was due to have a handover meeting with Abdul, a fellow orthopaedics consultant, where they would discuss the patient issues that are still outstanding and need to be dealt with by the incoming doctor. Abdul calls Hector to inform him that his son’s babysitter has only just arrived, and will be there around 7:00pm – more than 30 minutes after Hector’s shift finishes.

    How appropriate are each of the following responses by Hector in this situation?

    46. Speak to a junior doctor on the ward and tell them all the necessary information, to then tell Abdul when he arrives.
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    Explanation

    The correct answer is C. Hector would potentially leave early simply based on the reason that he can make his dinner. This is not an emergency, and is something that can be missed or delayed. It is therefore inappropriate of him to burden a junior doctor, who is likely to be busy with other things. However, telling a junior doctor will mean that the patient information is still passed on, rather than Hector leaving and not doing anything. The answer is therefore C, inappropriate but not awful.

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    Hector is an orthopaedics consultant. The time is 6pm and Hector is due to finish his shift at 6:30pm, and meet his wife for dinner. At 6pm, Hector was due to have a handover meeting with Abdul, a fellow orthopaedics consultant, where they would discuss the patient issues that are still outstanding and need to be dealt with by the incoming doctor. Abdul calls Hector to inform him that his son’s babysitter has only just arrived, and will be there around 7:00pm – more than 30 minutes after Hector’s shift finishes.

    How appropriate are each of the following responses by Hector in this situation?

    47. Write down all the necessary patient test results and investigations which can be handed to Abdul when he arrives and so wait for his arrival.
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    Explanation

    The correct answer is A. Giving a verbal handover with accompanying notes means that Abdul is very informed, and it is the best way to deal with the scenario.

     

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    Hector is an orthopaedics consultant. The time is 6pm and Hector is due to finish his shift at 6:30pm, and meet his wife for dinner. At 6pm, Hector was due to have a handover meeting with Abdul, a fellow orthopaedics consultant, where they would discuss the patient issues that are still outstanding and need to be dealt with by the incoming doctor. Abdul calls Hector to inform him that his son’s babysitter has only just arrived, and will be there around 7:00pm – more than 30 minutes after Hector’s shift finishes.

    How appropriate are each of the following responses by Hector in this situation?

    48. Before leaving at 6:30pm, spend 2 minutes jotting down the notes for Abdul.
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    Explanation

    The correct answer is D. This is worse than the response in Question 44, because the notes lack detail and are written quickly. Consider Abdul in this scenario. He will arrive at the hospital, and will be given a set of notes which have been written in a certain manner, perhaps ineligible and could consist of a lot of shorthand which each doctor uses differently. Written communication is not always effective. It would have been better if there was verbal communication between the two, like in the previous scenario where notes were accompanied by verbal handover as well. It could occur that the information is misinterpreted, and so this is a very inappropriate thing to do, especially as Hector is assuming that everything will be sorted out, when actually this may not be the case. The answer is therefore D, a very inappropriate thing to do.

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    Roshni is a pupil in a Biology lesson when she hears her friend, Harveen, snoring and finds that she has fallen asleep midway during a tutorial. The teacher tells Harveen to wake up, and she becomes embarrassed and swears at the teacher. Roshni sees the teacher and Harveen then arguing, and hears the teacher make a racial slur towards Harveen. Roshni knows the teacher well, and so was extremely surprised to hear the racial comment. Roshni now sees Harveen crying because of the comment that has been made.

    How appropriate are each of the following responses by Roshni in this situation?

    49. Report the teacher’s behaviour to the headmaster.
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    Explanation

    The correct answer is A. Usually, we advise you to always try to resolve conflict directly and at a local level. However this is a scenario is an exception. The teacher has made very serious comments to the pupil, which require immediate action that can only be authorised by senior employees including a headteacher. It is therefore a very appropriate thing to do.

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    Roshni is a pupil in a Biology lesson when she hears her friend, Harveen, snoring and finds that she has fallen asleep midway during a tutorial. The teacher tells Harveen to wake up, and she becomes embarrassed and swears at the teacher. Roshni sees the teacher and Harveen then arguing, and hears the teacher make a racial slur towards Harveen. Roshni knows the teacher well, and so was extremely surprised to hear the racial comment. Roshni now sees Harveen crying because of the comment that has been made.

    How appropriate are each of the following responses by Roshni in this situation?

    50. Comfort Harveen and try and make her feel better.
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    Explanation

    The correct answer is A. The two issues at hand are that Harveen is very upset, and that the teacher is acting unprofessionally to students. This deals with the first issue. It is very appropriate for Roshni to comfort her friend. She is obviously hurt by the comments that have been made, and so it is vital that she responds as immediately as possible, and comforting Harveen will help her feel reassured that there are people at hand to help her if she feels hurt by the comments made.

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    Roshni is a pupil in a Biology lesson when she hears her friend, Harveen, snoring and finds that she has fallen asleep midway during a tutorial. The teacher tells Harveen to wake up, and she becomes embarrassed and swears at the teacher. Roshni sees the teacher and Harveen then arguing, and hears the teacher make a racial slur towards Harveen. Roshni knows the teacher well, and so was extremely surprised to hear the racial comment. Roshni now sees Harveen crying because of the comment that has been made.

    How appropriate are each of the following responses by Roshni in this situation?

    51. Understand that the teacher only reacted in the way he did because of the manner in which Harveen spoke to the teacher.
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    Explanation

    The correct answer is D. Provocation is not an excuse for the behaviour of a teacher. Whilst the rude language by Harveen did contribute to the teacher’s actions, so it is not an important factor to consider. It is not a sufficient excuse for the behaviour that was exhibited and therefore Roshni should not let the situation pass based on the fact that the teacher was provoked.

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    Roshni is a pupil in a Biology lesson when she hears her friend, Harveen, snoring and finds that she has fallen asleep midway during a tutorial. The teacher tells Harveen to wake up, and she becomes embarrassed and swears at the teacher. Roshni sees the teacher and Harveen then arguing, and hears the teacher make a racial slur towards Harveen. Roshni knows the teacher well, and so was extremely surprised to hear the racial comment. Roshni now sees Harveen crying because of the comment that has been made.

    How appropriate are each of the following responses by Roshni in this situation?

    52. Try to persuade Harveen to leave the room and immediately talk to the headteacher herself directly.
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    Explanation

    The correct answer is C. It is likely that Harveen is traumatised by the event that has occurred, so it may be rash to persuade her to speak to the headteacher right away. It is important for Harveen to account her story, because the story may become twisted or change if it is not given from the perspective of the person it was directly involving. However the response is not appropriate because of the term ‘immediately’ – it is not an immediate concern for her and she may not be in a position where she can tell others about her story. It would be better to wait instead of doing this directly.

    Post Comment

    A group of medical students are taking part in their first problem based learning (PBL), and are solving a case of a patient with acromegaly, where they are trying to find the best possible treatment for it. They are currently all having a group discussion and almost everyone is contributing to it, apart from Mark who is on his phone and is not really participating in the discussion at all. One of Mark’s friends, Raheem, knows that Mark is a big extrovert and that he can offer good ideas and is usually loud, but isn’t saying much today.

    How appropriate are each of the following responses by Raheem in this situation?

    53. Telling the whole group that it is a group discussion and that everyone should take in turns to contribute ideas.
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    Explanation

    The correct answer is B. The main issue is that Mark is not pulling his weight. Ideally, we should resolve this with Mark directly. Talking to the entire group is a non-confrontational solution, as Raheem is not directly referring to Mark, and does not mention his name. By telling everyone to take turns, it will hopefully remind Mark that he is a medical student and that at University he should be contributing to the problem based learning session. This may however make Mark feel uncomfortable, and like he is being targeted in a group setting. It will not have any major negative consequences, but could be resolved better.

    Post Comment

    A group of medical students are taking part in their first problem based learning (PBL), and are solving a case of a patient with acromegaly, where they are trying to find the best possible treatment for it. They are currently all having a group discussion and almost everyone is contributing to it, apart from Mark who is on his phone and is not really participating in the discussion at all. One of Mark’s friends, Raheem, knows that Mark is a big extrovert and that he can offer good ideas and is usually loud, but isn’t saying much today.

    How appropriate are each of the following responses by Raheem in this situation?

    54. Speak to Mark directly, and ask him if he could attempt to contribute more to the group discussion.
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    Explanation

    The correct answer is A. Raheem is addressing the issue by speaking to Mark and hopefully it will mean that Mark contributes more to the conversation. He goes about is in a calm and collected manner, which seems as if he would be open to further discussion. It is the best local and direct solution.

     

    Post Comment

    A group of medical students are taking part in their first problem based learning (PBL), and are solving a case of a patient with acromegaly, where they are trying to find the best possible treatment for it. They are currently all having a group discussion and almost everyone is contributing to it, apart from Mark who is on his phone and is not really participating in the discussion at all. One of Mark’s friends, Raheem, knows that Mark is a big extrovert and that he can offer good ideas and is usually loud, but isn’t saying much today.

    How appropriate are each of the following responses by Raheem in this situation?

    55. Inform their professor that Mark is not contributing as much as he should.
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    Explanation

    The correct answer is D. Read the scenario carefully. It is their first group discussion. It is an extreme overreaction for Raheem to involve a professor, because it may just be a one-off. It is also means that Raheem is involving people that may not necessarily be involved. It would be better for Raheem to deal with it in the group or bring it up to Mark delicately. It is therefore a very inappropriate action.

     

    Post Comment

    A group of medical students are taking part in their first problem based learning (PBL), and are solving a case of a patient with acromegaly, where they are trying to find the best possible treatment for it. They are currently all having a group discussion and almost everyone is contributing to it, apart from Mark who is on his phone and is not really participating in the discussion at all. One of Mark’s friends, Raheem, knows that Mark is a big extrovert and that he can offer good ideas and is usually loud, but isn’t saying much today.

    How appropriate are each of the following responses by Raheem in this situation?

    56. Not say anything because he is worried it will ruin the group dynamic.
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    Explanation

    The correct answer is C. It is likely that soon the group will be unhappy with Mark not contributing, and it is an issue because as a medical student he will have to constantly contribute in these sorts of problem based learning scenarios. Avoiding the issue completely would be inappropriate. However, there are many potential explanations for Mark’s silence, including the fact that it

    is the first meeting, plus the potential that he is just getting to grips with the topic. It is therefore an inappropriate, but not awful approach.

    Post Comment

    Nimby is a 4th year medical student working in a cardiovascular ward, where he is shadowing consultants, junior doctors and nurses. Nimby does not get along with one of the doctors, Dr Nawan. He finds her difficult to approach and believes she lacks work ethic. One day Nimby walks past the ward, and finds that one of the nurses is speaking to a patient who has just finished surgery, and overhears the conversation. The patient is angry that no doctor has come to see her, and hears the nurse telling the patient that she has asked Dr Nawan to see her, but feels that Dr Nawan is not attending to all her tasks.

    How important to take into account are the following considerations for Nimby when deciding how to respond to the situation?

    57. That Nimby is a medical student, and he has less authority than the rest of the team.
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    Explanation

    The correct answer is D. This is not important at all. It does not matter whether Nimby is a nurse, medical student or a consultant. Reporting information about behaviour that is unacceptable does not depend on how much authority they have. Remember patient safety and professionalism are two of the most important considerations to make. If Nimby does not report this to the authorities, patient safety and professionalism are potentially compromised.

     

    Post Comment

    Nimby is a 4th year medical student working in a cardiovascular ward, where he is shadowing consultants, junior doctors and nurses. Nimby does not get along with one of the doctors, Dr Nawan. He finds her difficult to approach and believes she lacks work ethic. One day Nimby walks past the ward, and finds that one of the nurses is speaking to a patient who has just finished surgery, and overhears the conversation. The patient is angry that no doctor has come to see her, and hears the nurse telling the patient that she has asked Dr Nawan to see her, but feels that Dr Nawan is not attending to all her tasks.

    How important to take into account are the following considerations for Nimby when deciding how to respond to the situation?

    58. The patient knows Dr Nawan well, and Nimby feels that if he reports anything he will be shut down.
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    Explanation

    The correct answer is D. Again this is not important. The patient may defend Dr Nawan, and the matter could be easily brushed under the carpet. However, this should not occur. Nimby should not be afraid of the relationship that the two have already, because Nimby did hear the patient complain about the doctor, and so is not reporting any misinformation. The answer is therefore D, not important at all.

     

     

     

    Post Comment

    Nimby is a 4th year medical student working in a cardiovascular ward, where he is shadowing consultants, junior doctors and nurses. Nimby does not get along with one of the doctors, Dr Nawan. He finds her difficult to approach and believes she lacks work ethic. One day Nimby walks past the ward, and finds that one of the nurses is speaking to a patient who has just finished surgery, and overhears the conversation. The patient is angry that no doctor has come to see her, and hears the nurse telling the patient that she has asked Dr Nawan to see her, but feels that Dr Nawan is not attending to all her tasks.

    How important to take into account are the following considerations for Nimby when deciding how to respond to the situation?

    59. That Nimby is coming to the end of the placement, and will be in the neurology ward after.
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    Explanation

    The correct answer is C. Even if Nimby is leaving the ward soon, he has to address the problems he has spotted and act appropriately. Therefore this factor is not important, but it may affect how quickly he decided to act because he needs to address the issue before he moves wards. So the answer is C.

     

    Post Comment

    Nimby is a 4th year medical student working in a cardiovascular ward, where he is shadowing consultants, junior doctors and nurses. Nimby does not get along with one of the doctors, Dr Nawan. He finds her difficult to approach and believes she lacks work ethic. One day Nimby walks past the ward, and finds that one of the nurses is speaking to a patient who has just finished surgery, and overhears the conversation. The patient is angry that no doctor has come to see her, and hears the nurse telling the patient that she has asked Dr Nawan to see her, but feels that Dr Nawan is not attending to all her tasks.

    How important to take into account are the following considerations for Nimby when deciding how to respond to the situation?

    60. The team will look down on Nimby and will think he is trying to break the team dynamic.
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    Explanation

    The correct answer is D. This should not be an important factor. While it may affect the team dynamic, patient safety is important. The team should not look down on Nimby for reporting unprofessional behaviour, and should be able to understand that the issue Nimby is reporting could be significant.

     

    Post Comment

    Aké and Songo are about to sit their first year examination for medicine. Aké is extremely anxious about entering the exam hall, as he needs to pass this exam to progress to second year. Aké tells Songo that he does not want to sit the exam due to the pressure, and is about to walk away from the examination venue.

    How appropriate are each of the following responses by Songo in this situation?

    61. Try to calm Aké down.
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    Explanation

    The correct answer is A. It is clear that Aké is extremely nervous, so calming him down will hopefully reassure him and relieve some of the pressure he is facing. It is therefore a very appropriate thing to do.

     

    Post Comment

    Aké and Songo are about to sit their first year examination for medicine. Aké is extremely anxious about entering the exam hall, as he needs to pass this exam to progress to second year. Aké tells Songo that he does not want to sit the exam due to the pressure, and is about to walk away from the examination venue.

    How appropriate are each of the following responses by Songo in this situation?

    62. Give Aké privacy and let him calm down on his own
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    Explanation

    The correct answer is C. Remember, always look at situational judgement scenarios from a medical point of view Imagine Aké was a patient. If Aké is abandoned then he would likely become even more anxious, because he will be alone without any support. Instead, it would be better to reassure him and make sure he is relaxed. Additionally, bear in mind that they need to enter the exam hall now, so Songo needs to act fast. The reason the answer is not D is because Songo needs to enter the hall herself, and sometime time alone can be helpful.

    Post Comment

    Aké and Songo are about to sit their first year examination for medicine. Aké is extremely anxious about entering the exam hall, as he needs to pass this exam to progress to second year. Aké tells Songo that he does not want to sit the exam due to the pressure, and is about to walk away from the examination venue.

    How appropriate are each of the following responses by Songo in this situation?

    63. Tell Aké to enter the venue and speak to the invigilators about his anxiety
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    Explanation

    The correct answer is A. If Aké speaks to one of the invigilators it will hopefully help reassure him and calm him down, and will help to deal with the situation at hand. It is likely that the invigilator will help him overcome his anxiety. It is therefore a very appropriate thing to do.

    Post Comment

    Aké and Songo are about to sit their first year examination for medicine. Aké is extremely anxious about entering the exam hall, as he needs to pass this exam to progress to second year. Aké tells Songo that he does not want to sit the exam due to the pressure, and is about to walk away from the examination venue.

    How appropriate are each of the following responses by Songo in this situation?

    64. Remind Aké that if he doesn’t pass this exam, he will not be able to enter second year.
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    Explanation

    The correct answer is C. This is an inappropriate thing to do because it could potentially raise his anxiety and put him under even more pressure than he already is under. It could however, stress to him the importance of sitting the exam rather than skipping it.

    Post Comment

    Vish is a new dentist at the dental practice and meets Firdous in the corridor during the lunch break.  Firdous asks Vish to play a game where they have to tell each other gossip about their patients. Other colleagues join in on this game, but Vish is uncomfortable with the game and tells Firdous that he doesn’t like it as he feels it is a breach of confidentiality. Firdous disagrees with him and along with the other colleagues continue playing the game.

    How important are the following considerations for Vish to consider when deciding how to respond to the situation?

    65. Vish is a new dentist, so the other colleagues may not listen to him.
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    Explanation

    The correct answer is D.This is not important at all. The game the dentists are playing is a huge breach of confidentiality. It is irrelevant whether Vish is a nurse, an experienced dentist or a new dentist – he has to do something.

    Post Comment

    Vish is a new dentist at the dental practice and meets Firdous in the corridor during the lunch break.  Firdous asks Vish to play a game where they have to tell each other gossip about their patients. Other colleagues join in on this game, but Vish is uncomfortable with the game and tells Firdous that he doesn’t like it as he feels it is a breach of confidentiality. Firdous disagrees with him and along with the other colleagues continue playing the game.

    How important are the following considerations for Vish to consider when deciding how to respond to the situation?

    66. That Vish is uncomfortable with the game
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    Explanation

    The correct answer is A. If Vish finds the game a breach of confidentiality, it is more than likely that patients would as well.  This is a violation of the trust they are putting in the dentist.

    Post Comment

    Vish is a new dentist at the dental practice and meets Firdous in the corridor during the lunch break.  Firdous asks Vish to play a game where they have to tell each other gossip about their patients. Other colleagues join in on this game, but Vish is uncomfortable with the game and tells Firdous that he doesn’t like it as he feels it is a breach of confidentiality. Firdous disagrees with him and along with the other colleagues continue playing the game.

    How important are the following considerations for Vish to consider when deciding how to respond to the situation?

    67. That the other colleagues including Firdous do not find the game offensive
  • 1
    0

    Explanation

    The correct answer is D. This is a breach of confidentiality. It is irrelevant whether the colleagues think it is right. They are in the wrong and are breaking the code of the dental profession. It is therefore not important at all if they believe it is normal because it is not.

    Post Comment

    Katie is a junior doctor, who is on a rotation with her friend from Medical School called Margaret. Katie has noticed that Margaret has been making many mistakes on the ward lately, such as forgetting simple tasks or making small prescribing errors. Margaret reveals to Katie that she is going through a break-up with her girlfriend, and has been feeling suicidal lately.

    68. Choose the one most appropriate action and one least appropriate action that Katie should take in response to this situation.
    Most Appropriate
    Least Appropriate
    Give Margaret the details of a suicide hotline, and encourage her to call if needed.
    Persuade Margaret to speak to her own GP, and tell them about how it has been affecting her work.
    Promise to keep whatever Margaret tells her private, in order to improve her trust in her.
    5
    10

    Explanation

    Most appropriate = B, Least appropriate = C

    Katie has 2 concerns to consider in the scenario; Margaret’s safety and Margaret’s patients safety.

    Option A will ensure Margaret is able to speak to someone, and receive some support. A suicide hotline will be able to support Margaret if she were to be in a crisis, however it will not be able to help her through the current issue, of heartbreak and how this is affecting her work.

    Option B is making sure that Margaret can receive long term care, and support going through her issues. She would be allowed to talk to her own GP about her issues at work, without breaking patient confidentiality here. This is the most appropriate option for making sure that her health, and the safety of her patient’s is looked after long term.

    Option C is very inappropriate. Whilst it is done with good intentions, Katie must remember her role as a professional, as well as a friend. Katie cannot make a promise to keep things private, as she may discover information which would put patients at danger – and therefore Katie has a duty to report this. It would be inappropriate for Katie to lie to Margaret in this way, and this is therefore the least appropriate option.

    Post Comment
    Imogen Medicmind Tutor

    Wed, 16 Sep 2020 17:38:10

    I put the correct answers

    Matt and Fin are two medical students in a local GP surgery. They are both asked to take a history from a patient. The patient gives a full history to them both, and then Matt leaves the room to allow Fin to perform an examination of her abdomen. The patient tells Fin that when they were walking into the surgery, she heard him and Matt say something that she thinks implies they had sex last night. Matt and Fin did have sex the night before. The patient asks Matt if this was true.

    69. Choose the one most appropriate action and one least appropriate action that Matt should take in response to this situation.
    Most Appropriate
    Least Appropriate
    Tell the patient that this consultation is not about him, and more about her, and so he doesn’t feel comfortable talking about himself.
    Tell the patient that they did not sleep together, and that she may have misheard something.
    Ignore the patient’s question, and carry on with the examination.
    1
    0

    Explanation

    Most appropriate = A, Least appropriate = B

    Medical professionals are often placed in uncomfortable situations when patient’s ask them about their personal life. The patient normally doesn’t mean any harm by this, and is just making small talk, however the doctor or medical student must remain professional.

    Option A allows Matt to politely decline to answer the patient’s question, with appropriate reasoning and also is completely transparent. He highlights how this situation makes him feel uncomfortable, which is being honest with the patient. Matt deals with a personal question very professionally, without insulting the patient. This is therefore the most appropriate response.

    Option B is directly lying to the patient, and even telling the patient they did not sleep together is revealing more personal information than he ought to. The patient may realise that Matt is lying, which would compromise the patient’s trust in the medical profession. He would be better to approach this scenario with honesty, rather than outrightly lie to the patient.

    Option C is slightly rude and may damage the relationship. Whilst it may seem like it’s appropriate to ignore the question, it is not a polite or respectful response. This may lead to the patient asking the question again, which will further the uncomfortable situation. It does not directly cause any harm, so is not the worst option.

    Post Comment
    a Medicmind Tutor

    Sun, 21 Mar 2021 14:32:32

    i believe these kind of question depend on the nature environment. i personally would ignore and continue. if she asked again ill professionally ask her to stop. other people's private life isn't her business

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