Preparing for your SJT Susie Edwards

Preparing for your SJT Susie Edwards

Plan Quick overview of the SJT Focusing on scoring and the numbers bit What is actually being tested? Patterns and themes Extra information 11/24/2016 2

What is SJT? In a Situational Judgement Test (SJT) applicants are presented with a set of hypothetical work relevant scenarios and asked to make judgements about possible responses SJTs require applicants to use their judgement about what is effective behaviour in a work relevant situation rather than focusing on clinical knowledge or skills http://www.isfp.org.uk/isfpdocuments/pages/sjtmonograph.aspx SJT Monograph, F Patterson, V Ashworh, D Good

Foundation Programme Friday 2 nd December & Monday 9 th January UKFPO take the mean and standard deviation of the educational performance measure for that year and match the SJT marks to it

Mean Standard Deviation Minimum Maximum Equated Raw SJT Score 889.48 31.70 110.33 967.93 Scaled SJT Score 39.59 4.05 0.00 50.00 EPM Score 40.82 3.81 34.00 50.00 11/24/2016 5

Scaling and matching Despite the SJT being on a longer scale to the EPM (0 50 versus 34-50), the scaling process for the SJT takes into account the distribution of the EPM to ensure the distributions of each set of scores are similar. Therefore each measure exerts a similar weight on the total score and the rank awarded. 2016 equation: Scaled SJT Score = Equated raw SJT score x 0.133-78.571.331 E.g: 887 x 0.133 78.571= 39.4

Percentage of applicants SJT Score Range 0-30 31-35 36-40 41-45 46-50 Total 30-35 1.1% 3.1% 5.0% 1.5% 0.0% 10.7% Total EPM Score Range 36-40 1.8% 7.5% 19.4% 8.8% 0.1% 37.7% 41-45 0.7% 4.2% 19.0% 14.3% 0.5% 38.7% 46-50 0.1% 0.6% 5.2% 6.6% 0.5% 12.9% Total 3.7% 15.4% 48.6% 31.2% 1.2% 100% 11/24/2016 7

2016 Marks Average score: 38.48 points (891 marks)

Technical Report 2016 98.8% of applicants answered all questions Statistical difference were observed: Female applicants outperformed male applicants Younger applicants outperformed older applicants White applicants outperformed BME applicants UK trained applicants outperformed Non-UK trained applicants Exploring feasibility of computer based test and different scoring methods Applicants ability to answer questions correctly is increasing! Analysis of the Situational Judgement Test for Selection to the Foundation Programme 2015

SJT 70 questions 60 live questions and 10 embedded pilot questions 2 different types of questions: Rank five actions (two thirds of the questions) Select three from eight (one third of the questions)

SJT 70 questions Rank 1. Rank in order the appropriateness of the following actions in response to this situation (1= Most appropriate; 5= Least appropriate) 2. Rank the order in which the following tasks should be undertaken (1= Do first; 5= Do last) 3. Rank in order the importance of the following considerations in the management of this situation (1= Most important; 5= Least important) 4. Rank in order the extent to which you agree with the following statements in this situation (1= Most agree with; 5= Least agree with) Select three from eight In part two there are two formats of lead-ins you may be asked: 1. Choose the 3 most appropriate actions to take in this situation. 2. Choose the 3 most important considerations to take into account in the management of this situation 11/24/2016 11

Timing The SJT will consist of around 70 questions in 2 hours 20 minutes 2 minutes per question

Ranking Questions A total of 20 marks is available for each question and the least you can score if you answer is 8 For each of the five response options up to four marks are available If you tie two response options, you will receive 0 marks for each of the response options you tied There is no negative marking (i.e. marks will not be deducted from your overall score for any incorrect answers

Your best friend is on holiday abroad. During that period, her father is admitted in the hospital where you work, but in a different service. Your friend calls you, asking for information about her father as the hospital is refusing to give her any indication as to the nature of the illness or whether she needs to return from her holiday early. Rank in order the following actions in response to this situation (1= most appropriate; 5= least appropriate). A B C D E Decline politely, telling your friend that her request would be in breach of regulations Ask your friend to give you written confirmation that you are permitted to request the information on her behalf Ask your consultant for advice on what you should do Tell your friend that you will ask her father to get in touch with her Tell your friend that you will raise the matter with her father s consultant

Ideal rank 1 2 3 4 5 Highest score 20 : C E B D A C 4 3 2 1 0 E 3 4 3 2 1 12 : C D A B E B D 2 1 3 2 4 3 3 4 2 3 A 0 1 2 3 4 C E B D A Ask your consultant for advice on what you should do Tell your friend that you will raise the matter with her father s consultant Ask your friend to give you written confirmation that you are permitted to request the information on her behalf Tell your friend that you will ask her father to get in touch with her Decline politely, telling your friend that her request would be in breach of regulations

Multiple choice questions A total of 12 points is available for each question Four points are available for each of the three most appropriate response options If you choose more than three response options, you will score 0 for that question There is no negative marking (i.e. marks will not be deducted from your overall score for any incorrect answers)

During a very busy shift, the relatives of a recently deceased patient want to see you to discuss things. What do you do? Choose the THREE most appropriate actions to take in this situation A Ask a nurse to talk to the relatives to get an understanding of the type of things that they want to discuss so that you can be fully prepared when you see them B Ask the nurse to let the relatives know that you are aware they are waiting, that you are busy right now but that if they go home you will call them as soon as you are free C Ask one of your juniors to talk to the relatives, to let them know that you cannot see them because you are busy and for them to deal with any queries D Tell the nurse that you will grant the relatives 5 minutes only as you are busy E Inform your Registrar that you need to see the relatives and ask him whether he can cover for you F Tell the nurse to send the relatives to PALS as your involvement with the patient is over G Tell the nurse to find an excuse to send the relatives home as the patient is dead and the matter is therefore less important than the patients that you are currently dealing with

A Ask a nurse to talk to the relatives to get an understanding of the type of things that they want to discuss so that you can be fully prepared when you see them. You are using another team member appropriately; the nurse is already with the relatives and it makes sense that you may want to know more about the relatives request in order to ensure that you can have the relevant information ready when you do meet with them eventually. B Ask the nurse to let the relatives know that you are aware they are waiting, that you are busy right now but that if they go home you will call them as soon as you are free This may be a little inconvenient for the relatives as they would obviously prefer to get answers straight away. But you are being honest with them and there is a feeling that you want to get their queries resolved even if it is only on the phone E Inform your Registrar that you need to see the relatives and ask him whether he can cover for you. Talking to your Registrar may help you to identify a good way around the problem. Also, if you need to go and see the relatives, then this option will make the Registrar aware of the situation and the team will be able to deal with your temporary absence

5 key professional attributes assessed by SJT Commitment to Professionalism Coping with Pressure Effective Communication Patient Focus Working Effectively as Part of a Team All linked to the FY person specification

Commitment to Professionalism Issues of confidentiality e.g. hearing a colleague talking about a patient outside of work Challenging inappropriate behaviour e.g. Consultant speaking to a colleague/patient in an inappropriate way Commitment to learning e.g. need to go to teaching but also needed on the ward

You work on a busy ward with an FY1 colleague. There are many tasks to be completed and the registrar/specialty trainee has said that you and your colleague can go home once the tasks are complete. You have nearly completed your tasks when you are called to another ward on the other side of the hospital. Your FY1 colleague suggests that you call your ward when you are finished, because there will be no need to return to the ward if all the tasks are complete. When you are finished, you telephone your ward but get no answer. Rank in order the appropriateness of the following actions in response to this situation (1= Most appropriate; 5= Least appropriate). A. Continue to telephone your ward until someone answers B. Ask a nurse to contact your ward to say that you have gone home C. Leave a message on the ward answering machine for someone to call you back D. Return to your ward E. Leave the hospital and go home

Answer: DABCE This question is about practicalities of safe hospital working. D: Return to your ward A: Continue to telephone your ward until someone answers B: Ask a nurse to contact your ward to say that you have gone home C: Leave a message on the ward answering machine for someone to call you back E: Leave the hospital and go home

Coping with Pressure Knowing how to respond when you make a mistake e.g. provide wrong medication to patient Dealing with confrontation e.g. angry relative Seeking help when not sure of the correct procedure/best way of doing things

Your Consultant asks you whether you would be interested in doing an audit project. You are already doing an audit project for another Consultant and you know that you will not have enough time to do both. Rank in order the following actions in response to this situation (1= most appropriate; 5= least appropriate). A B C D E Agree you will do it as you don t wish to say no but plan to drag it out until you leave Refuse, saying that you are too busy with another audit project Refuse, explaining that you have another project to do but you ask your colleagues to see if any are interested Say you might be interested but you need some more time to think about it and then secretly hope he/she forgets about asking you again Agree to do the project and mentally plan to give up your half days to complete it

Answer CBDEA C B D E A Refuse, explaining that you have another project to do but you ask your colleagues to see if any are interested It can be difficult to say no to your Consultant especially as you may be needing a reference. However, he/she will respect you more if you refuse on the grounds that you are already doing a project but also that you will ask around to see if anyone might be interested Refuse, saying that you are too busy with another audit project As in C but not as good as you are not seeking a solution to the problem Say you might be interested but you need some more time to think about it and then secretly hope he forgets about asking you again Not a virtuous move so hence is not as good as the first two options but better than the remaining two options Agree to do the project and mentally plan to give up your half days to complete it Making your own life a misery to please another person will only lead to resentment and unhappiness. Agree you will do it as you don t wish to say no but plan to drag it out until you leave This is not being particularly honest nor trustworthy. If you agree to do something you must see the project through.

Effective Communication Gathering information and communicating your intentions to nursing staff or other colleagues Negotiating e.g. for a scan from radiology, extra time for teaching Listening and effectively communicating with an unhappy patient or relative

You see a 50 year old man with advanced lung cancer to discuss treatment options. After hearing about the benefits and burdens of chemotherapy he decides to decline treatment and says he has thought this through very carefully. His wife is shocked and requests you to ignore the foolish man. Rank in order the following actions in response to this situation (1= most appropriate; 5= least appropriate). A Explain to the patient that you will need to take into account the views of his family B Explain to his wife that he does actually have the right to refuse treatment C Document in the notes all that has been explained during the consultation D Empathise with his wife as this must be a difficult time for them both E Ignore the wishes of the patient as no rational person you have ever come across declines treatment!

Answer: DBCAE D Empathise with his wife as this must be a difficult time for them both This is the best overall option. The lives of both husband and wife have been turned upside down by recent events. They need support through this difficult time B Explain to his wife that he does actually have the right to refuse treatment Adult competent patients have the right to decide how much weight to attach to the benefits, burdens, risks and the overall acceptability of any treatment. They have the right to refuse treatment even where refusal may result in harm to themselves or in their own death C Document in the notes that all has been explained during the consultation It is good medical practice to keep clear. Accurate and legible records of decisions made and information given to patients A Explain to the patient that you will need to take into account the views of his family Not true E Ignore the wishes of the patient as no rational person you have every come across declines treatment Doctors are legally bound to respect a patient s decision

Patient Focus Identifying that a patient s views and concerns are important and they should have input into their care Considering that a patient may have different needs from others around them Spending time trying to understand a patient s concerns and empathising with them

A nurse asks you to assess a patient who wants to self-discharge from the ward. The patient is still on the ward and has undertaken only part of the investigations he was meant to undertake for lung cancer. He is very agitated and anxious, and borders on aggressive, which is making the nursing staff feel threatened. Choose the THREE most appropriate actions to take in this situation A Spend some time listening to the patient s concerns B Tell the patient that you are sorry that he is upset C Tell the patient that you understand how he feels D Explain to the patient that it is perfectly normal to be anxious about a possible diagnosis of lung cancer E Explain to the patient that it is important that he completes all the tests F Explain to the patient that if he leaves he could be putting himself at risk G Offer the patient help for his anxiety

Answer: ABE A Spend some time listening to the patient s concerns Listening to the patient is a sensible thing to do. He is clearly anxious and it would help if you could determine what worries him so much. The tests are also not so urgent as to stop you spending time with the patient (in an emergency situations you may not have so much time to spend listening). B Tell the patient that you are sorry that he is upset Saying that you are sorry he is upset will help demonstrate empathy without sounding condescending and patronising. This is therefore also a viable option. E Explain to the patient that it is important that he completes all tests Explaining the importance of completing the tests would be a very constructive approach and would also help steer the conversation away from the emotions. Your aim should be to focus on the end result (i.e. getting the patient to complete the tests) without being coercive. Option E achieves this.

Working effectively as part of a team Recognising and valuing the skills and knowledge of nursing and other staff, when faced with a disagreement about a patient s care Consulting with colleagues about how to share workload fairly Offering assistance and support to colleagues in a variety of situations

You are called by medical staffing. They ask if you can cover a night shift as a colleague has called in sick. You are unable to accept as you have made plans to go to the theatre. While waiting to go in you see the doctor who has called in sick in the line ahead of you. Rank in order the following actions in response to this situation (1= most appropriate; 5= least appropriate). A Inform your consultant of the incident the next day B Discuss the situation with other junior doctors in your department the next day C Do nothing it is not your problem D Tell your colleague that you will cover for him if he pays for your ticket E Inform your co-worker that his is irresponsible and unethical, and that were it to happen again you would be obliged to inform your consultant

E Inform your co-worker that his is irresponsible and unethical, and that were it to happen again you would be obliged to inform your consultant You are making your colleague aware that his actions are wrong and allowing him a chance to explain himself/make amends B Discuss the situation with other junior doctors in your department the next day Someone else may have a useful suggestion as to how to approach this problem. The problem affects everyone on the rota so it makes sense to discuss it together A Inform your consultant of the incident the next day If you feel unable to tackle the situation yourself, by informing someone in a position of responsibility, it allows the problem to be addressed C Do nothing it is not your problem This does not address the situation at all. As his action affects you and all of your colleagues, it is your responsibility to do something about it. D Tell your colleague that you will cover for him if he pays for your ticket This is unethical. Not only are you condoning his behaviour, your are asking for a bribe as well.

Common Themes Patient safety is always your first priority. If patient safety is at risk you must act now. Never lie or do anything fraudulent Blaming colleagues is unprofessional Putting yourself in danger ultimately effects patient care Patient confidentiality is to be protected at all times (or as GMC guidelines dictates)

Generalisations Ignoring a problem or just leaving it to someone else is generally a bad idea Generally asking for help or involving a senior is a good idea If you have an issue with a colleague, generally talking to them first is a good idea If there are multiple issues requiring attention categorise them as 1. Emergency, 2. Urgent 3. Routine

On the day don t forget: 2 x HB or 2B pencils A pencil sharpener An eraser Your ID Your SJT booking confirmation email (if you applied through the Eligibility Office). You may also wish to bring with you a transparent ruler as an aid for completing the answer sheet. There will be a name card on your desk with your FPAS number on it.

Credits & resources UKFPO Website: http://www.foundationprogramme.nhs.uk/pages/home -UKFPO SJT practice paper and video. -The SJT monograph explores the attributes in the FY1 person specification -SJT validity test and technical reports BMA http://bma.org.uk/developing-your-career/foundation-training/foundationprogrammeselection-process BMJ Learning SJT online e-learning module GMC Good medical practice in action: http://www.gmc-uk.org/guidance/case_studies.asp GP Specialist Recruitment Assessment https://gprecruitment.hee.nhs.uk/resource-bank