Situational Judgement and Clinical Test (SJCT) Information

 This test consists of 2 sections: Section A includes the Situational Judgement questions; Section B will
contain the Situational Clinical Questions.
 The duration of this test is 140 minutes. There are 60 questions to be answered.
 You should answer all questions at the level of a Foundation Year One (FY1) doctor.
 You may sometimes feel you would like more information before answering. Please answer each question
based only on the information provided.
 Section A (Situational Judgement questions) consists of two parts:
 Part 1 (Q1-15) consists of Ranking questions. Rank from A to E in order of priority the five responses to
the situation. This means that you will rank 1 the best option and rank 5 the worst. Marks are available
for near-misses. There can be no tied ranks, i.e. you should not use the same rank more than once. If
duplicate choices (more than one bubble with the same number) are filled, the whole question will be
disqualified and will score zero.
 Part 2 (Q16-30) consists of Multiple Choice Questions (MCQs) three out of eight type. Choose THREE
from eight possible responses, which address the situation best when performed together. You must only
select three options. If more than three bubbles are filled, the whole question will be disqualified and will
score zero.
 Section B (Situational Clinical Questions) consists of two parts:
 Part 1 (Q31-45) consists of MCQs three out of eight type. Choose THREE from eight possible responses,
which best address the situation when performed together. You must only select three options. If more
than three bubbles are filled, the whole question will be disqualified and will score zero.
 Part 2 (Q46-60) consists of MCQs of the True/False type. Each question should be answered on its own
merits whether it is True or False. If both T and F bubbles are filled, the whole question will be disqualified
and will score zero.
 There is no negative marking. You should therefore attempt all questions.
 You should mark the answer sheet clearly as described below.

 A Glossary will be available to clarify any abbreviations.

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QUESTION MARKING AND EXAMPLES
Section A (Situational Judgement questions):
 Part 1 (Q1-15) Situational Judgement Ranking questions. Each correct response will carry 4 marks.
Five correct responses will thus carry a maximum of 20 marks. Marks awarded for incorrectly prioritised
responses will depend on how distant from the model answer the answer given is.

Example question:
A1. Your consultant Dr Pisani calls you on the phone and asks you to prescribe a sedative for an in-patient with
pneumonia who is distressed. He had intended to do this during the ward round but forgot. You check the dose
in the BNF* and notice that the appropriate dose is half that advised by your consultant. You double check with
your Clinical Pharmacist who agrees that the dose prescribed by Dr Pisani is inappropriately high. The ward
nurses tell you that Dr Pisani usually prescribes that dose for his patients and they have never had any problems.
Rank in order the appropriateness the following actions in response to this situation (1= Most appropriate; 5=
Least appropriate).
A. Prescribe the dose as written in the BNF and corroborated by the Clinical pharmacist
B. Ask a senior to review the need of sedation in this patient until you clarify with the consultant
C. Ask the Clinical pharmacist to contact the Consultant to clarify the dose
D. Contact Dr Pisani directly yourself to discuss the prescription
E. Prescribe the dose advised by Dr Pisani

Glossary:
BNF: British National Formulary

 Part 2 (Q16-30) Situational Judgement Multiple Choice Questions (MCQs) three out of eight type.
Each correct response will carry 4 marks. Three correct responses will carry a maximum of 12 marks.

Example question:
A2. A nurse on your ward tells you that she has just administered intravenous metoclopramide to one of your
patients. However, when she was discarding the drug phial, she realised that the date on the phial showed that it
had expired. The patient has not developed any adverse symptoms till now.
Choose the three most appropriate actions to take in this situation.
a) Explain and apologise to the patient about the mistake
b) Write an incident report and send it to the office in charge of adverse drug events

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c) Tell the nurse that there is no need to report the incident as the patient has come to no harm
d) Review the patient the next morning to ensure that no new symptoms have developed
e) Ask the nurse to give a repeat dose of metoclopramide, making sure that the new dose is not expired
f) Advise the patient to remind the nurses to check the expiry dates on any drug he is given from now on
g) Inform the Nurse-in-charge about the incident
h) Find time to check the expiry dates on all drugs in the ward yourself

Glossary:
BNF: British National Formulary

Section B (Situational Clinical Questions):

 Part 1 (Q31-45) Situational Clinical MCQs three out of eight type. Each correct response will carry 4
marks. Three correct responses will carry a maximum of 12 marks.

Example question:
B1. You are called to review a 65 year old male on the ward. He had been admitted the day before for investigation
of intractable low back pain for which he has been on NSAIDs*. He is now complaining of severe abdominal pain
and distension. On examination you notice that he looks pale and is very tender all over the abdomen.
Choose the three most appropriate actions to take in this situation.
a. Prescribe glycerine suppositories
b. Arrange for an urgent erect chest x-ray
c. Take urgent bloods whilst establishing intravenous access
d. Start him on intravenous hyoscine butylbromide
e. Keep the patient on oral fluids only
f. Start an opiate analgesic to relieve the pain
g. Organise an urgent US of the abdomen
h. Ask the bed manager to immediately transfer to a surgical ward
Glossary:
NSAIDs: Non-steroidal anti-inflammatory drugs

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  Part 2 (Q46-60) Situational Clinical MCQs of the True/False type. Each correct response will carry 2
marks. Five correct responses will carry a maximum of 10 marks.

Example question:
B2. You are called to see a patient with respiratory distress. He is a 76 year old male who was admitted with
acute exacerbation of COPD. His heart rate is 100/ minute, regular, BP* is 150/85 and oxygen saturation is 88%
on air. He is conscious but tachypnoeic and distressed.
Which of the following actions would be appropriate?
A. Immediately give the patient high flow oxygen.
B. Take an arterial blood gas.
C. Administer IV* aminophylline.
D. Give the patient 24% oxygen until you assess further.
E. Administer a benzodiazepine to calm him down.
Glossary:
BP: Blood pressure
IV: Intravenous

Correct answers:
A1: 1: D 2: B 3: C 4: A 5: E
A2: ABG
B1: BCF
B2: A: False B: True C: False D: True E: False

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General Examination Instructions

ANSWER SCRIPTS INSTRUCTIONS

 This sheet should not be folded or crushed. The sheet should be handed in at the end of the test. No
examination material (mark sheet, question paper, pencil, sharpener and rubber) shall be taken out from
the hall/room at the end of the examination.
 Use only the pencil provided to mark the correct answer.
 Do not leave any stray pencil marks on the sheet. Ensure that answers which have been marked
unintentionally or that have decided to change, be firmly erased.
 Bubbles should be shaded properly. The correct shading method is shown below:

TEST INSTRUCTIONS:
1. Please switch off any electronic devices and keep them in your bags.
2. No electronic devices are to be used during the examination.
3. Keep your desk clear from any item which has nothing to do with the exam e.g. mobiles, bags, textbooks.
4. Keep your id card/passport on your desk for checking purposes.
5. Please insert your candidate number in the space provided on the answer sheet and question booklet.
6. You will not be allowed to enter if you are more than 30 minutes late from the start of the examination.
7. Please ensure that you are aware of fire exits present in the hall/room.
8. Please write your name, your candidate number, and sign the front page of your booklet.
9. Please check that your three digit candidate number appears on the front page of your booklet and your answer
sheet.
10. Please do not remove any printed material (question paper or answer booklets or part of them) from the
examination hall/room.
11. You will not be allowed to copy any test material to take out of the exam room in any form. You may be
disqualified from the exam if you attempt to do this.
12. It is strictly forbidden to talk to, read the work for or attempt in any way to communicate with, other
candidates whilst the examination is in progress. Please exercise vigilance to ensure that no other candidates can
attempt to copy your work. The examination board has tools to identify copying of answers or collusion between
candidates to share answers. If such situation arises all identified parties will be investigated. Breaches of these
instructions, or misbehaviour in any other way relating to this written examination, including continuing to write
after the allotted time, may lead to suspension from the examination. Any attempt at cheating or colluding to gain
advantage, may lead to permanent suspension from the examinations board.

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If a candidate is suspected of cheating during the examination they will be asked to stop and leave the
examination by the Chief Invigilator.
13. Scrap paper is not provided but you may use any empty spaces on the question paper.
14. You must use a ‘clear’ mark for each answer. It is very important to fill in the whole ‘circle’ selected as your
answer. Ensure that only the exact number if answers per question are selected. Any answers marked by accident
must be erased immediately.
15. The invigilator will check each candidate’s answer scripts during the last 30 minutes of the examination to
ensure that answer sheet is duly signed and that index number is correct.
16. If you wish to visit the rest rooms you may raise your hand and wait until an invigilator can escort you. You
will not be permitted to leave the examination room unless you are accompanied by one of the invigilators.
17. You must not leave the examination venue during the first 30 minutes or the last 15 minutes of the
examination. At the end of the examination, you may not leave the examination venue until all question papers
and answer sheets have been collected. Under no circumstance are examination papers or part of allowed outside
the examination room.
18. No extra time will be allowed during the examination. You must stop writing immediately when asked to do
so.
19. Please take all your belongings with you once the examination has ended as instructed by the Chief Invigilator