Note: Due to the introduction of the Preference Informed Allocation process and a computer-generated rank, the Situational Judgement Test (SJT) is no longer required for application to the Foundation Programme and has been removed from the FP2024 application process. More info here.
Dr Suzanne Reilly and Dr Vivienne Ralph are SHOs who helped to design our SJT preparation course. They share their experiences and tips for conquering the SJT.
Our year was the first to sit the SJT so the resources available to help with preparation were limited. We were reassured, however, that this was an exam that you couldn't revise for.
This is simply not true. Thorough, organised and focused preparation is the key to success! Practising questions with peers and revising the common themes in the form of multiple choice questions is extremely beneficial. If we'd had the option of a revision course to consolidate all the information it would have greatly supported our preparation. The MDU course is unique in that it's offered by doctors with experience of the exam, backed up by medico-legal experts.
When sitting the exam it's vital to identify what each question is assessing. Understanding the job role of an FY1 and knowing what will be expected of you will help you decide what your answer should be and will keep you focused.
The SJT lasts two hours 20 minutes. Although this sounds like a generous amount of time, don't be fooled. Like many others we struggled for time, and some people were unable to complete all the questions.
Here are our top five tips:
- Practise, practise, practise! Time yourself and discuss answers with friends.
- Review and test your knowledge of Good medical practice (2013).
- Don't spend too long on a question if you get stuck - move onto the next one. You'll get more marks by attempting more questions.
- Familiarise yourself with the answer sheet and how to fill in the boxes correctly.
- Finally, we would definitely recommend going on a revision course a month or so before the exam.
The Situational Judgement Test (SJT) for the national FP 2016 application process takes place on two dates (4 December 2015 and 8 January 2016).
The SJT is designed to assess your approach to work as a foundation doctor as defined by the FP 2016 Person Specification. It measures your judgement in choosing appropriate responses and your ability to recognise the most important concerns in any situation.
Your marks will be used to award you a number of SJT points. These will be combined with your points for the Educational Performance Measure (EPM) to give your application score. The EPM and SJT components are equally weighted in the total application score so it's vitally important you perform well in both.
However, as the SJT score is reported to two decimal places and the EPM score is reported as a whole number, it's often the SJT that determines your position compared to others with similar scores.
The MDU is running a course in November to help final year students prepare and practise ahead of the SJT - more details below.
The SJT is paper-based and answers are machine-marked against a predetermined scoring key. There are two types of questions - ranking responses to situations in order of priority, or selecting the most appropriate actions.
Although the SJT's content tests your qualities rather than your clinical knowledge, you can still revise and prepare
The test assumes you'll have some knowledge of the job of an FY1 and you'll be asked to respond as such. The scenarios aren't designed to test your clinical knowledge. Instead, they assess your aptitude and attributes compared to the essential characteristics expected of an FY1. The test covers five core domains - commitment to professionalism, coping with pressure, effective communication, patient focus and working effectively as part of a team.
Although the SJT's content tests your qualities rather than your clinical knowledge, you can still revise and prepare. Being familiar with the different style of questions and the format of the exam can definitely help to reduce stress. It's also important to understand how the marking scheme works and to have practised under exam conditions.
An example of both types of question is shown below.
Q1 - ranking question
Whilst taking a history from Mr A, a 63 year old diabetic patient who is being admitted as an emergency with a black toe, he asks you if he is going to lose his leg.
Rank in order the following actions in response to this situation (first = most appropriate, fifth = least appropriate).
A. Explain that you can't feel his foot pulses and there is a possibility he may lose his leg.
B. Reassure him that everything will be okay.
C. Tell Mr A that you need to take a full history and complete an examination as well as arrange some further tests. Once the test results are back a senior doctor will discuss the results with him.
D. Advise Mr A that you will need to discuss his case with your registrar before you can answer his question.
E. Tell Mr A that there is an expert limb fitting centre locally, so he shouldn't worry about losing his leg.
Answer: C, D, A, B, E
The GMC's guide Good medical practice (2013) says you have a duty to listen to your patients, take account of their views and respond honestly to their questions (paragraph 31). You must also recognise and work within the limits of your competence, whilst adequately assessing the patient's condition (paragraphs 14 and 15a). Assess and investigate the patient before giving them information on their condition, and seek support from senior colleagues when developing a management plan for patients.
Q2 - multiple choice question
Whilst rewriting a patient's drug chart, you notice that one of your colleagues has prescribed enoxaparin for a patient who is also on warfarin.
Choose the top three most appropriate actions from the following list:
A. Immediately rewrite the drug chart without the enoxaparin, and call your colleague to tell them you have corrected the error.
B. Complete an incident form.
C. Tell your colleague and suggest that they might want to inform the patient's consultant.
D. Tell the patient.
E. Ask the nursing staff and the pharmacist why they hadn't spotted the error.
F. Rewrite the drug chart without the enoxaparin and hope no-one spots the error.
G. Discuss the incident with the consultant in charge after reviewing the patient and their recent blood tests.
H. Rewrite the drug chart without the enoxaparin and ensure that the old chart is clearly marked as an old chart so that the error will not be repeated.
Answer: H, G, B
Your first concern should be the care of the patient, and the error should be corrected. Assess the patient thoroughly, document that assessment and then tell the doctor in charge of the patient about the error and the patient's current condition. To keep patients safe you must contribute to adverse event recognition. Because there is a duty of candour, the patient needs to be told of the error and an apology offered, but this would usually be done by a senior doctor. Your colleague will also need to be informed so they can reflect on the error, but the first priority is to the patient.
Making your mark
The SJT paper consists of two-thirds ranking questions and one-third selecting questions. Four points are given for each correct choice in the selecting questions, meaning a total of 12 points are available for each question, but if you choose more than three responses you won't get any points.
The marking scheme for the ranking questions is more complex, with a maximum of 20 points available for each question if you rank the responses in the correct order. You'll get four points for each response ranked correctly. There's no negative marking so it's in your interests to rank all the responses, and points are also awarded for near misses. The UKFPO website gives a fuller explanation of the marking in its SJT FAQs section.
The MDU offers the following advice to students before sitting the SJT:
- Familiarise yourself with the person specification for a foundation doctor, which can be found on the UKFPO website.
- Review the GMC's core guidance document 'Good medical practice' (2013).
- Practice the different types of questions under exam conditions so you understand the time constraints and get used to the formats. More sample questions are available from the UKFPO website.
- Read the questions and the instructions for completing the answer sheet carefully.
- Familiarise yourself with the marking scheme and answer all questions directly onto the answer sheet. There is no negative marking.
The MDU is running a course to help final year students prepare for the SJT. The course is being run on 7 November at King's College Waterloo Campus, London.
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