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SJT-Honesty and Integrity
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| Your Score | Average of all Users | Percentile | |
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| Honesty and Integrity |
Honesty and Integrity
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Average score:
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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.
Max is a CT1 (core training year 1) working in an intensive care unit. One of Max’s jobs is to prescribe pain relief to an elderly woman who is in severe pain. Max decides to prescribe morphine to help relieve her pain. However, after Max gives her the drug, she has a reaction, and he realises he has given the wrong dose of the drug. Max is able to stabilise the patient and she will not suffer any long-term consequences are a result. Whilst she is unable to communicate, her son is waiting to speak to her doctor.
How appropriate are each of the following responses by Max in this situation?
Explanation
The correct answer is D.
The duty of candour is a key principle in medical ethics. The duty of candour requires doctors to inform patients if they have made a mistake. This is outlined in Good Medical Practice which states “You must be open and honest with patients if things go wrong. If a patient under your care has suffered harm or distress, you should: a) put matters right (if that is possible) b) offer an apology c) explain fully and promptly what has happened and the likely short-term and long-term effects” (Good Medical Practice, p18). Therefore, by failing to inform the patient’s next of kin about the mistake you are violating Good Medical Practice, so this action is very inappropriate.
Top Tip: Remember, actions are not taken in isolation. Multiple actions can be very appropriate as you are not ranking options.
Max is a CT1 (core training year 1) working in an intensive care unit. One of Max’s jobs is to prescribe pain relief to an elderly woman who is in severe pain. Max decides to prescribe morphine to help relieve her pain. However, after Max gives her the drug, she has a reaction, and he realises he has given the wrong dose of the drug. Max is able to stabilise the patient and she will not suffer any long-term consequences are a result. Whilst she is unable to communicate, her son is waiting to speak to her doctor.
How appropriate are each of the following responses by Max in this situation?
Explanation
The correct answer is A.
By informing the patient’s next of kin about the mistake and offering an apology, you are complying with the duty of candour. This is outlined in Good Medical Practice which states “You must be open and honest with patients if things go wrong. If a patient under your care has suffered harm or distress, you should: a) put matters right (if that is possible) b) offer an apology c) explain fully and promptly what has happened and the likely short-term and long-term effects” (Good Medical Practice, p18). Therefore, this action is very appropriate.
Top Tip: Remember, actions are not taken in isolation. Multiple actions can be very appropriate as you are not ranking options.
Max is a CT1 (core training year 1) working in an intensive care unit. One of Max’s jobs is to prescribe pain relief to an elderly woman who is in severe pain. Max decides to prescribe morphine to help relieve her pain. However, after Max gives her the drug, she has a reaction, and he realises he has given the wrong dose of the drug. Max is able to stabilise the patient and she will not suffer any long-term consequences are a result. Whilst she is unable to communicate, her son is waiting to speak to her doctor.
How appropriate are each of the following responses by Max in this situation?
Explanation
The correct answer is A.
If you make any mistakes or notice any clinical incidents you should report them through the appropriate procedures. This is outlined in Good Medical Practice which states “To help keep patients safe you must: contribute to adverse event recognition”. Therefore, by reporting the incident you are complying with Good Medical Practice, so this action is very appropriate. Remember, these options are not done in isolation, so it would still be possible to seek advice and inform the medical school at the same time.
Top Tip: Remember, actions are not taken in isolation. Multiple actions can be very appropriate as you are not ranking options.
Max is a CT1 (core training year 1) working in an intensive care unit. One of Max’s jobs is to prescribe pain relief to an elderly woman who is in severe pain. Max decides to prescribe morphine to help relieve her pain. However, after Max gives her the drug, she has a reaction, and he realises he has given the wrong dose of the drug. Max is able to stabilise the patient and she will not suffer any long-term consequences are a result. Whilst she is unable to communicate, her son is waiting to speak to her doctor.
How appropriate are each of the following responses by Max in this situation?
Explanation
The correct answer is A.
By informing the patient’s next of kin about the mistake and offering an apology, you are complying with the duty of candour. This is outlined in Good Medical Practice which states “You must be open and honest with patients if things go wrong. If a patient under your care has suffered harm or distress, you should: a) put matters right (if that is possible) b) offer an apology c) explain fully and promptly what has happened and the likely short-term and long-term effects” (Good Medical Practice, p18). Therefore, this action is very appropriate.
Top Tip: Remember, actions are not taken in isolation. Multiple actions can be very appropriate as you are not ranking options.
Faith
Medicmind Tutor
Sat, 03 Jul 2021 09:55:36
Hi, Just wondering how this is very appropriate because there was no effort to apologise for the accident? Thank you
Maddy
Medicmind Tutor
Sun, 08 Aug 2021 19:31:16
There was no apology given or effects explained so would the answer not be appropriate but not ideal? thank you
s
Medicmind Tutor
Wed, 18 Aug 2021 14:26:55
Would the answer not be B since no reason or apology was given for the incident? the incident was not even explained to the son properly
A
Medicmind Tutor
Tue, 24 Aug 2021 07:39:50
I agree with the comments below. previously, and effort was made to apologise to the next of kin which was "very appropriate". however, the statement stated is just about informing the next of kin, not apologising, so it would make sense for the answer to be answer option B.
anon
Medicmind Tutor
Sun, 29 Aug 2021 20:45:57
can you please update some of these answers a lot of them seem to be wrong? surely b would be is the answer?
Fatima
Medicmind Tutor
Wed, 08 Sep 2021 15:05:19
Are you sure the answer would be very appropriate? because no apology has been made therefore i think it should be considered as appropriate but not ideal
Chi
Medicmind Tutor
Mon, 13 Sep 2021 14:21:41
I agree with everyone else on this one. The statement before said he told her son and apologised but this one says that he just told her son, no apology so wouldn't this be less appropriate than the other?
Yopi
Medicmind Tutor
Fri, 17 Sep 2021 20:05:12
The apology although it is kind to add it is not necessary because him informing them there was a mistake is more important than him apologising for it
Vinuki
Medicmind Tutor
Fri, 24 Dec 2021 08:26:07
The statement doesn't indicate an apology being made and only informing the son is included. So shouldn't this be "Appropriate but not ideal" since the apology is not included Thanks
Gamerzone
Medicmind Tutor
Wed, 23 Feb 2022 11:15:34
Assuming the question doesn't specifically say that you WONT apologize its reasonable to assume that you probably will broski's.
Max is a CT1 (core training year 1) working in an intensive care unit. One of Max’s jobs is to prescribe pain relief to an elderly woman who is in severe pain. Max decides to prescribe morphine to help relieve her pain. However, after Max gives her the drug, she has a reaction, and he realises he has given the wrong dose of the drug. Max is able to stabilise the patient and she will not suffer any long-term consequences are a result. Whilst she is unable to communicate, her son is waiting to speak to her doctor.
How appropriate are each of the following responses by Max in this situation?
Explanation
The correct answer is D.
The duty of candour is outlined in Good Medical Practice which states “You must be open and honest with patients if things go wrong. If a patient under your care has suffered harm or distress, you should: a) put matters right (if that is possible) b) offer an apology c) explain fully and promptly what has happened and the likely short-term and long-term effects” (Good Medical Practice, p18). The key term is “you”, as Max has made the mistake, he should make every effort to be the doctor explaining this mistake. Furthermore, it is usually inappropriate to delegate these difficult conversations to more junior colleagues without direct supervision. Therefore, this action is very inappropriate.
Top Tip: Remember, actions are not taken in isolation. Multiple actions can be very appropriate as you are not ranking options.
Jonathan is a 27-year-old cancer patient who has been diagnosed with an osteosarcoma. His doctor Dr Mike has recommended chemotherapy and radiotherapy which he believes is Jonathan’s best chance to survive the cancer. However, Jonathan has been involved in online discussion boards and tells Dr Mike that he wants to use alternative medicine. Jonathan believes that a combination of a vegan diet, essential oils and alkaline water. Dr Mike is deeply concerned as he knows Jonathan is very likely to die if he does not undergo his recommended treatment.
How important is it to take into account are the following considerations for Dr Mike when deciding how to respond to the situation?
Explanation
The correct answer is A.
Autonomy (the right to have control over your own treatment) is one of the four pillars of medical ethics. This principle is also found in Good Medical Practice which states “You must work in partnership with patients, sharing with them the information they will need to make decisions about their care” (Good Medical Practice, p16). Therefore, you must consider Jonathan’s right to autonomy, so this consideration is very important.
Top Tip: Even if a patient’s views do not appear rational to you, you still have a responsibility to respect their views and work with them to ensure they get the best care.
Jonathan is a 27-year-old cancer patient who has been diagnosed with an osteosarcoma. His doctor Dr Mike has recommended chemotherapy and radiotherapy which he believes is Jonathan’s best chance to survive the cancer. However, Jonathan has been involved in online discussion boards and tells Dr Mike that he wants to use alternative medicine. Jonathan believes that a combination of a vegan diet, essential oils and alkaline water. Dr Mike is deeply concerned as he knows Jonathan is very likely to die if he does not undergo his recommended treatment.
How important is it to take into account are the following considerations for Dr Mike when deciding how to respond to the situation?
Explanation
The correct answer is B.
Dr Mike has a responsibility to use the best evidence to provide patient’s with the best quality of treatment, this principle is contained in Good Medical Practice which states “In providing clinical care you must: provide effective treatments based on the best available evidence” (Good Medical Practice, p8). The reason this factor is not very important is because Dr Mike knows this is clearly not the most appropriate treatment option. Therefore, this consideration is important.
Top Tip: Even if a patient’s views do not appear rational to you, you still have a responsibility to respect their views and work with them to ensure they get the best care.
Arshiya
Medicmind Tutor
Sun, 19 Sep 2021 14:16:39
Considering the lack of medical trials, and licensing, surely there would be contraindications? Hence, very important? I'm just confused because this answer contradicts the MHRA
Isabel
Medicmind Tutor
Wed, 29 Jun 2022 12:56:46
This should surely be very important?? Considering this and respecting his autonomy are not mutually exclusive. The impact of refusing treatment on the patient is massive, so he should absolutely consider that when deciding how to respond.
MakeItMakeSense
Medicmind Tutor
Tue, 26 Jul 2022 14:53:22
This is wrong it's definitely very important because if a patient has little to no evidence/ does not fully know about the extent of treatment he/she is needed to receive or what must be done to help them it is of high importance that he/she is informed fully about it
Jonathan is a 27-year-old cancer patient who has been diagnosed with an osteosarcoma. His doctor Dr Mike has recommended chemotherapy and radiotherapy which he believes is Jonathan’s best chance to survive the cancer. However, Jonathan has been involved in online discussion boards and tells Dr Mike that he wants to use alternative medicine. Jonathan believes that a combination of a vegan diet, essential oils and alkaline water. Dr Mike is deeply concerned as he knows Jonathan is very likely to die if he does not undergo his recommended treatment.
How important is it to take into account are the following considerations for Dr Mike when deciding how to respond to the situation?
Explanation
The correct answer is A.
Dr Mike’s key concern must be the best interest of the patient. This is the principle of beneficence which is one of the four pillars of medical ethics. Doctors must also use the best evidence to provide patient’s with the best quality of treatment, this principle is contained in Good Medical Practice which states “In providing clinical care you must: provide effective treatments based on the best available evidence” (Good Medical Practice, p8). Therefore, as Dr Mike knows Jonathan is not receiving the care which is in his best interests, he must consider this factor. Therefore, this consideration is very important.
Top Tip: Even if a patient’s views do not appear rational to you, you still have a responsibility to respect their views and work with them to ensure they get the best care.
Jonathan is a 27-year-old cancer patient who has been diagnosed with an osteosarcoma. His doctor Dr Mike has recommended chemotherapy and radiotherapy which he believes is Jonathan’s best chance to survive the cancer. However, Jonathan has been involved in online discussion boards and tells Dr Mike that he wants to use alternative medicine. Jonathan believes that a combination of a vegan diet, essential oils and alkaline water. Dr Mike is deeply concerned as he knows Jonathan is very likely to die if he does not undergo his recommended treatment.
How important is it to take into account are the following considerations for Dr Mike when deciding how to respond to the situation?
Explanation
The correct answer is C.
You should never treat patients differently based on their age or any other protected characteristics. This principle is contained in Good Medical Practice which states “You must not unfairly discriminate against patients or colleagues by allowing your personal views [This includes your views about a patient’s or colleague’s lifestyle, culture or their social or economic status, as well as the characteristics protected by legislation: age, disability, gender reassignment, race, marriage and civil partnership, pregnancy and maternity, religion or belief, sex and sexual orientation] to affect your professional relationships or the treatment you provide or arrange” (Good Medical Practice, p20). However, this factor might be considered as his age may affect what treatment is appropriate. Therefore, this factor could be considered but it does not have to be. So, this factor is of minor importance.
Top Tip: Even if a patient’s views do not appear rational to you, you still have a responsibility to respect their views and work with them to ensure they get the best care.
??
Medicmind Tutor
Fri, 24 Jun 2022 07:26:45
but i thought that over the age of 16, they are assumed to be fully competent despite their age
asab
Medicmind Tutor
Sat, 24 Sep 2022 19:25:15
I think this should be not important at all
Mr Miah
Medicmind Tutor
Sat, 01 Jul 2023 16:36:35
This sounds like BS - the usual woke shit
Jonathan is a 27-year-old cancer patient who has been diagnosed with an osteosarcoma. His doctor Dr Mike has recommended chemotherapy and radiotherapy which he believes is Jonathan’s best chance to survive the cancer. However, Jonathan has been involved in online discussion boards and tells Dr Mike that he wants to use alternative medicine. Jonathan believes that a combination of a vegan diet, essential oils and alkaline water. Dr Mike is deeply concerned as he knows Jonathan is very likely to die if he does not undergo his recommended treatment.
How important is it to take into account are the following considerations for Dr Mike when deciding how to respond to the situation?
Explanation
The correct answer is B.
Taking into accounts the benefits and risks (including side effects) is a key principle of medicine. This principle is outlined in Good Medical Principle which states “You must work in partnership with patients, sharing with them the information they will need to make decisions about their care, including: their condition, its likely progression and the options for treatment, including associated risks and uncertainties” (Good Medical Practice, p16). However, the reason this factor is not very important is because Dr Mike’s professional judgement is that this is the most appropriate treatment option. Therefore, this consideration is important.
Top Tip: Even if a patient’s views do not appear rational to you, you still have a responsibility to respect their views and work with them to ensure they get the best care.
Dr Murphy is a GP partner working in a London GP Practice. One of her long-term patients is an elderly man called James. James has multiple health conditions including COPD, heart failure and BPH. He is on multiple different medications and requires multiple GP consultations a month. As a sign of appreciation for what Dr Murphy has done, James buys Dr Murphy a bottle of champagne. Dr Murphy is unsure whether she should accept this gift.
How important is it to take into account are the following considerations for Dr Murphy when deciding how to respond to the situation?
Explanation
The correct answer is A.
The decision to accept a gift depends on several factors. The value of a gift must influence a decision regarding whether to accept it for example, it would usually be appropriate to accept a box of chocolates but inappropriate to accept a car because you must not accept any gift which would affect your decision making. A more valuable gift is more likely to influence your clinical decisions or give the appearance of influencing your clinical decisions. This principle is outlined in Good Medical Practice which states “You must not ask for or accept – from patients, colleagues or others – any inducement, gift or hospitality that may affect or be seen to affect the way you prescribe for, treat or refer patients or commission services for patients. You must not offer these inducements” (Good Medical Practice, p24). Therefore, you must consider the value of the champagne, so this consideration is very important.
Top Tip: Remember, you are not ranking the options by importance, multiple actions can be very important as in some decisions you must consider multiple factors.
dr murphy
Medicmind Tutor
Fri, 30 Jul 2021 18:58:14
dis is gay
Anonymous
Medicmind Tutor
Tue, 03 Aug 2021 11:19:17
dis is very gay
ya
Medicmind Tutor
Tue, 10 Aug 2021 10:16:53
very very. agreed
chungus
Medicmind Tutor
Tue, 10 Aug 2021 11:55:29
considering one of the questions just before this was about discrimination im not sure how you thought describing this as gay was a good idea lol
A
Medicmind Tutor
Tue, 24 Aug 2021 07:45:40
I don't think writing something discriminative is appropriate considering this is SJT. kinda ironic lol
P
Medicmind Tutor
Sat, 28 Aug 2021 17:44:47
Writing discriminative comments is really inappropriate and harmful. I don't see the reason why you really needed to.
s
Medicmind Tutor
Sun, 19 Sep 2021 21:03:48
dis hella gay
Josh
Medicmind Tutor
Wed, 22 Sep 2021 14:18:53
This is fucking gay
DEEZNUTZ
Medicmind Tutor
Fri, 07 Jan 2022 23:19:26
I have to agree that using the word gay in a SJT question is quite ironic and discriminative but the truth is, this question itself is GAY.
Mr M
Medicmind Tutor
Fri, 20 May 2022 08:57:24
rage
UCAT GOAT
Medicmind Tutor
Sun, 31 Jul 2022 09:12:38
Ignoring the discrimination in the comments, this question is a perfect example as to why you need to read the GMP document, as there is a section on patient gifts.
dr murphy
Medicmind Tutor
Sun, 26 Mar 2023 20:07:29
very lgbbq if i do say so myself
dr murphy
Medicmind Tutor
Sun, 26 Mar 2023 20:09:38
gp = gay pornstar
..
Medicmind Tutor
Sun, 06 Aug 2023 21:19:30
future medics in this comment section fr
Dr Murphy is a GP partner working in a London GP Practice. One of her long-term patients is an elderly man called James. James has multiple health conditions including COPD, heart failure and BPH. He is on multiple different medications and requires multiple GP consultations a month. As a sign of appreciation for what Dr Murphy has done, James buys Dr Murphy a bottle of champagne. Dr Murphy is unsure whether she should accept this gift.
How important is it to take into account are the following considerations for Dr Murphy when deciding how to respond to the situation?
Explanation
The correct answer is A.
The decision to accept a gift depends on several factors. Doctors have a responsibility to maintain a good doctor-patient relationship with all their patients. This principle is outlined in Good Medical Practice which states “Patients need good doctors. Good doctors make the care of their patients their first concern… [they] establish and maintain good relationships with patients” (Good Medical Practice, p4). Therefore, you must consider the effect of your decision on the doctor-patient relationship, so this consideration is very important.
Top Tip: Remember, you are not ranking the options by importance, multiple actions can be very important as in some decisions you must consider multiple factors.
ano
Medicmind Tutor
Wed, 28 Jul 2021 22:37:41
isnt it C??
dr mike
Medicmind Tutor
Fri, 30 Jul 2021 18:59:21
i agree dr ano this is meant to be D
A
Medicmind Tutor
Tue, 24 Aug 2021 07:49:41
I think the answer is A considering the fact the patient is a long-term patient of Dr Murphy and wants to show appreciation, so is more of a kind gesture.
j
Medicmind Tutor
Mon, 07 Feb 2022 11:08:45
hello
B
Medicmind Tutor
Fri, 24 Jun 2022 07:25:16
is it not B, as it is an important factor but not the only thing he should be considering
Dr Murphy is a GP partner working in a London GP Practice. One of her long-term patients is an elderly man called James. James has multiple health conditions including COPD, heart failure and BPH. He is on multiple different medications and requires multiple GP consultations a month. As a sign of appreciation for what Dr Murphy has done, James buys Dr Murphy a bottle of champagne. Dr Murphy is unsure whether she should accept this gift.
How important is it to take into account are the following considerations for Dr Murphy when deciding how to respond to the situation?
Explanation
The correct answer is D.
Regardless of whether Dr Murphy likes champagne or not, this should not influence his decision. His decision must only be based on how it affects his care for his patients. Therefore, you must not consider this factor, so this consideration is not important at all.
Top Tip: Remember, you are not ranking the options by importance, multiple actions can be very important as in some decisions you must consider multiple factors.
Dr Murphy is a GP partner working in a London GP Practice. One of her long-term patients is an elderly man called James. James has multiple health conditions including COPD, heart failure and BPH. He is on multiple different medications and requires multiple GP consultations a month. As a sign of appreciation for what Dr Murphy has done, James buys Dr Murphy a bottle of champagne. Dr Murphy is unsure whether she should accept this gift.
How important is it to take into account are the following considerations for Dr Murphy when deciding how to respond to the situation?
Explanation
The correct answer is B.
The decision to accept a gift depends on several factors. The contents of the consultation may affect Dr Murphy’s decision on whether to accept the gift for example, if James had just requested opiates (strong pain killers) the gift might be or might be seen as an inducement which would violate Good Medical Practice. This principle is outlined in Good Medical Practice which states “You must not ask for or accept – from patients, colleagues or others – any inducement, gift or hospitality that may affect or be seen to affect the way you prescribe for, treat or refer patients or commission services for patients. You must not offer these inducements” (Good Medical Practice, p24). The reason, this consideration is not very important is because the contents of the consultation will not always be important, it will only be important in some specific circumstances. Therefore, Dr Murphy should consider this factor, so this consideration is important.
Top Tip: Remember, you are not ranking the options by importance, multiple actions can be very important as in some decisions you must consider multiple factors.
Dr House is a consultant nephrologist currently leading a ward round of the nephrology ward. One of his patients is a 67-year-old woman who has end-stage renal disease and requires haemodialysis. Unfortunately, as her condition has declined, she is no longer eligible for a transplant. On the ward round, she asks Dr House whether she is going to die. Dr House knows her condition is now likely terminal.
How appropriate are each of the following responses by Dr House in this situation?
Explanation
The correct answer is D.
By informing the patient that she is fine whilst knowing her condition is terminal, Dr House would be knowingly providing false information to his patient. This violates Good Medical Practice which states “You must listen to patients, take account of their views, and respond honestly to their questions” (Good Medical Practice, p17). Therefore, this action would be very inappropriate.
Top Tip: Remember, a “very inappropriate” action is an action which could cause harm and an “inappropriate but not awful” action is an action that does not cause harm but provides not benefit.
M
Medicmind Tutor
Sun, 26 Sep 2021 18:07:26
Wouldn't it be C as the action isn't causing any real harm.
@M
Medicmind Tutor
Sat, 25 Mar 2023 21:03:11
‘real harm’? Wait until she finds out that her illness is terminal and that she is actually going to die but her doctor told her ‘she will be fine’.
Dr House is a consultant nephrologist currently leading a ward round of the nephrology ward. One of his patients is a 67-year-old woman who has end-stage renal disease and requires haemodialysis. Unfortunately, as her condition has declined, she is no longer eligible for a transplant. On the ward round, she asks Dr House whether she is going to die. Dr House knows her condition is now likely terminal.
How appropriate are each of the following responses by Dr House in this situation?
Explanation
The correct answer is C.
By not informing the patient of the truth about her condition, Dr House is not providing truthful information to his patient. This violates Good Medical Practice which states “You must listen to patients, take account of their views, and respond honestly to their questions” (Good Medical Practice, p17). However, the reason this action is not very inappropriate is because Dr House does not directly lie to the patient. Therefore, this action would be inappropriate but not awful.
Top Tip: Remember, a “very inappropriate” action is an action which could cause harm and an “inappropriate but not awful” action is an action that does not cause harm but provides not benefit.
Mahad yusuf
Medicmind Tutor
Tue, 06 Jul 2021 05:11:06
After informing the patient the patient there condition is terminal is not a very appropriate thing to say that they will take good care of her after all they are doctors & nurses, she is in the best place possible to be sent off into the afterlife painlessly
the
Medicmind Tutor
Sat, 18 Sep 2021 09:52:41
I think I'd rather hear "Yeah, you have end-stage renal disease and will probably die, but we're going to take good care of you while you're still here" than "you're going to die lol". The latter is an exaggeration, but saying the former does somewhat provide the benefit of comfort to an extent, no?
Slightly psychotic
Medicmind Tutor
Mon, 15 Aug 2022 12:33:57
"Dr House is not providing truthful information to his patient." If 'we are going to take good care of you' is a lie, they probably shouldn't be taking care of this woman, no?
Matt
Medicmind Tutor
Thu, 15 Sep 2022 09:52:07
Good care can also relate to palliative care not only treatment, this question should be appropriate but not ideal
Dr House is a consultant nephrologist currently leading a ward round of the nephrology ward. One of his patients is a 67-year-old woman who has end-stage renal disease and requires haemodialysis. Unfortunately, as her condition has declined, she is no longer eligible for a transplant. On the ward round, she asks Dr House whether she is going to die. Dr House knows her condition is now likely terminal.
How appropriate are each of the following responses by Dr House in this situation?
Explanation
The correct answer is A.
This action would be the ideal course of action. By sensitively explaining her prognosis, Dr House is being both honest and respectful. These principles are outlined in Good Medical Practice which states “You must listen to patients, take account of their views, and respond honestly to their questions” (Good Medical Practice, p17) and “You must treat patients as individuals and respect their dignity and privacy” (Good Medical Practice, p16). Therefore, this action would be very appropriate.
Top Tip: Remember, a “very inappropriate” action is an action which could cause harm and an “inappropriate but not awful” action is an action that does not cause harm but provides not benefit.
Dr House is a consultant nephrologist currently leading a ward round of the nephrology ward. One of his patients is a 67-year-old woman who has end-stage renal disease and requires haemodialysis. Unfortunately, as her condition has declined, she is no longer eligible for a transplant. On the ward round, she asks Dr House whether she is going to die. Dr House knows her condition is now likely terminal.
How appropriate are each of the following responses by Dr House in this situation?
Explanation
The correct answer is B.
This action may be appropriate because by coming back later, Dr House will have sufficient time to explain her prognosis whilst not in the time-pressured environment of a ward round. However, the reason this action is not very appropriate is because it does not immediately address the issue. Therefore, this action would be appropriate but not ideal.
Top Tip: Remember, a “very inappropriate” action is an action which could cause harm and an “inappropriate but not awful” action is an action that does not cause harm but provides not benefit.
a
Medicmind Tutor
Tue, 10 Aug 2021 10:19:17
why on earth would u leave ur patient under suspense like that omg
sissi
Medicmind Tutor
Sat, 14 Aug 2021 11:32:25
THATS WHAT I WAS THINKING its so mean but i guess seeing as its a ward round it I kinda get it
steve
Medicmind Tutor
Wed, 18 Aug 2021 14:34:26
are you going to die? find out after the break
the
Medicmind Tutor
Sat, 18 Sep 2021 09:53:35
LMAO
b
Medicmind Tutor
Sat, 13 Nov 2021 16:04:28
why leave the patient hanging?
Nikos
Medicmind Tutor
Wed, 09 Feb 2022 12:15:59
The comments are on point haha
:]
Medicmind Tutor
Mon, 18 Jul 2022 09:23:50
I mean, at least he's going to tell her
UCAT GOAT
Medicmind Tutor
Sun, 31 Jul 2022 09:14:32
This one should definitely be C. The hospital isn't a reality TV show.
nxndita
Medicmind Tutor
Wed, 03 Aug 2022 15:29:07
I thought this would be inappropriate but not awful...
MR UCAT
Medicmind Tutor
Tue, 06 Sep 2022 14:56:07
rely on official questions banks and mocks for definitive source of information, medic mind is unreliable in some scenarios
Dr Mumie
Medicmind Tutor
Fri, 13 Jan 2023 15:50:35
commercial break, brb
Mr Miah
Medicmind Tutor
Sat, 01 Jul 2023 16:37:27
sounds like BS yet again!!!!
Dr House is a consultant nephrologist currently leading a ward round of the nephrology ward. One of his patients is a 67-year-old woman who has end-stage renal disease and requires haemodialysis. Unfortunately, as her condition has declined, she is no longer eligible for a transplant. On the ward round, she asks Dr House whether she is going to die. Dr House knows her condition is now likely terminal.
How appropriate are each of the following responses by Dr House in this situation?
Explanation
The correct answer is D.
As a doctor, you have the responsibility to supervise more junior colleagues and medical students. This principle is outlined in Good Medical Practice which states “You should be prepared to contribute to teaching and training doctors and students [and] you must make sure that all staff you manage have appropriate supervision” (Good Medical Practice, p14). Furthermore, it is usually inappropriate to delegate these difficult conversations to more junior colleagues without direct supervision. Therefore, this action would be inappropriate because Dr House is delegating a very difficult conversation to a first-year doctor without supervision. Therefore, this action is very inappropriate.
Top Tip: Remember, a “very inappropriate” action is an action which could cause harm and an “inappropriate but not awful” action is an action that does not cause harm but provides not benefit.
sulaiman asghar
Medicmind Tutor
Fri, 13 Aug 2021 15:45:30
omg i got this one wrong lmao yolo :)
Dr Ahmed is a general surgery specialist trainee (ST4) working in the general surgery department of a major tertiary centre. One of the patients on the ward is Robert Jenkins who is the Secretary of State for Health. He is one of three patients who is on the surgical list and will require an HDU bed. However, there is only one HDU bed available. The consultant informs Dr Ahmed that Mr Jenkins will be the patient who gets the HDU bed and the other operations will be cancelled. However, Dr Ahmed knows that Mr Jenkins’ condition is the least serious of the three patients awaiting surgery and is unsure what to do.
You will not receive any marks for this question unless you select both the most and least appropriate actions
Explanation
Most Appropriate – Tell the consultant about his concerns
Least Appropriate – Do nothing
Option 1 is the least appropriate option. Dr Ahmed has a responsibility to raise concerns if he believes Good Medical Practice is being breached. This is outlined in Good Medical Practice which states “If patients are at risk because of inadequate premises, equipment or other resources, policies or systems, you should put the matter right if that is possible. You must raise your concern in line with our guidance and your workplace policy. You should also make a record of the steps you have taken.” (Good Medical Practice, p11). Furthermore, by doing nothing, Dr Ahmed is allowing discrimination to take place which violates Good Medical Practice which states “You must not unfairly discriminate against patients or colleagues by allowing your personal views [This includes your views about a patient’s or colleague’s lifestyle, culture or their social or economic status, as well as the characteristics protected by legislation: age, disability, gender reassignment, race, marriage and civil partnership, pregnancy and maternity, religion or belief, sex and sexual orientation] to affect your professional relationships or the treatment you provide or arrange” (Good Medical Practice, p20). Therefore, this is the least appropriate option.
Option 2 is the most appropriate option as Dr Ahmed is raising his concerns which is consistent with Good Medical Practice which states “If patients are at risk because of inadequate premises, equipment or other resources, policies or systems, you should put the matter right if that is possible. You must raise your concern in line with our guidance and your workplace policy. You should also make a record of the steps you have taken.” (Good Medical Practice, p11). Therefore, this is the most appropriate option.
Option 3 is neither the most appropriate nor the least appropriate option. Whilst Dr Ahmed is raising his concerns which is consistent with Good Medical Practice, he is unnecessarily escalating the situation before talking to the consultant responsible. Therefore, this is neither the most appropriate nor the least appropriate option.
Top Tip: You must always raise your concerns through the appropriate channels if you believe Good Medical Practice is not being adhered to.
Alireza G.
Medicmind Tutor
Sat, 04 Dec 2021 01:31:09
I think this is the smartest question from this whole course.
Vinuki
Medicmind Tutor
Fri, 24 Dec 2021 08:30:10
@Alireza G. I know right. It definitely is!!
anime
Medicmind Tutor
Sun, 17 Jul 2022 13:52:12
this situation reminds me of the first episode of the anime 'monster'
A
Medicmind Tutor
Sun, 31 Jul 2022 13:30:51
what's the difference between tell and inform?
Nicole
Medicmind Tutor
Thu, 04 Aug 2022 14:55:56
@A the distinction between the two approaches are that he could either tell the consultant who made the decision or go to the "lead" i.e. more senior consultant. This could be seen as unnecessarily escalating the situation :)
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Sat, 27 Aug 2022 17:01:54
Does confidentiality play a role in this? What about if the patient didn't want her son to know?
Fri, 02 Sep 2022 13:07:05
to answer your question Gemma. the reason he is permitted to inform the son without asking the mother is because in the text it clearly ays she is unable to communicate, and these situations should be explained as soon as possible.