Importance questions

Importance sets always have the same four answer choices:

A. Very important
B. Important
C. Of minor importance
D. Not important at all

As you prepare for Situational Judgement, you may find it is harder to decide whether a particular factor has correct answer A or B. These responses are good to consider in responding to the scenario, but the distinction is whether the factor is essential to include in a response (in which case the answer is A) or whether the factor is relevant but less central to a good response (in which case the answer is B).

By comparison, the reasons that a factor could be C or D are more distinctive as we will see.

In any case, you must build your skills at recognising the relevance of factors in relation to the scenario. As always, this is contingent on the key issues facing the decider in that specific situation.

When tackling an Importance set, your first steps are the same as with any Situational Judgement set:

• Read the scenario carefully (including the decider name, so that you know from whose perspective you need to be approaching the dilemma).
• Notice the setting – where the scenario is taking place, who is present or in the vicinity and could potentially overhear.
• Identify the key issue or issues at play.

Then you must compare each factor to the key issues.

The most similar answers in an Importance question are A and B:

• A. Very important
• B. Important

These answers describe a factor that is good for the decider to consider in their response to the scenario. With practice, you will likely find that the A’s and B’s ‘jump out’ as being relevant to a good response, particularly in contrast with other factors that are tangential, irrelevant or bad to consider.

Remember that an Importance set can have multiple A or B answers. In a single set, it is in theory possible that all the factors are essential to consider each in their own right, so every factor is an A. Thus, you cannot assume anything about subsequent correct answers. You must weigh each factor on its own against the key issues in the scenario.

In Importance sets, answer A – Very Important – is correct when:

• The factor is very relevant to a key issue in the scenario.
• The factor has direct bearing on a key issue, whether it repeats essential information from the scenario or provides extra information essential for addressing a key issue.
• The factor must be considered by a clinician or student in order to decide on an ideal response to the situation in the scenario that resolves or improves the situation without causing problems, and without negative consequences for patients, for the profession or for academic integrity.
• The factor is essential for a medical or dental professional or student to take into account in deciding how to respond to the given circumstances.

In Importance sets, answer B – Important – is correct when:

• The factor is generally good to consider but not essential to be included in an ideal response to the situation in the scenario.
• The factor is significant to the key problem, but less central to resolving or improving the situation. At the same time, there can be nothing bad for patients or the profession in the implications of a factor if B is correct.
• The factor is compelling or substantial but not in a way that directly addresses the key issue, yet in a way that means it is good for the decider to include in their response to the scenario, and in a way that does not cause or imply negative consequences for patients, for the profession, or for academic integrity. For example, a factor that does not help to address the underlying problem in a scenario but is otherwise positive or neutral in its effect on a patient or the staff, students or others involved would likely have B as the correct answer.
• The factor is compelling or substantial in a way that could help in addressing the key issue, yet in a way that is secondary to the most vital considerations. Thus, the factor is good for the decider to include in their response, but it is less essential and therefore not required for an ideal response. It could help as part of a good or ideal response, but it is not essential for an appropriate response.

Let’s consider how answers C and D are fundamentally different in Importance questions as compared to Appropriateness questions.

Remember that in Appropriateness sets, correct answers C and D reflect degrees of badness. Both options indicate inappropriate responses that would not help and would likely make things worse. The key distinction in Appropriateness is that C is correct when the response is minimally bad and D is correct when the response is very bad, or is harmful to patients or to public confidence in the profession.

By contrast, in Importance sets, correct answers C and D are most technically ‘not necessarily good to consider’, but with a key divergence in terms of charge:

• Answer C – Of minor importance – is correct when the factor is tangential and not harmful. This means the factor could be considered but is effectively neutral, so it does not matter whether the factor is considered.
• Answer D – Not important at all – is correct when the factor is bad or harmful and must not be considered in a response under any circumstances. The factor would result in an unprofessional, unethical or illegal response, or it is something that is likely to harm patients or damage public confidence in the profession.

In Importance sets, C is correct when:

• The factor is tangential to the key issues in the scenario but any negative consequences from considering the factor in a response to the scenario are minimal.
• The factor does not cause or imply any harm or risk of harm to a patient. Any negative repercussions are usually limited to staff in a clinical setting or students in an educational setting, without broader implications for the profession or for academic integrity.
• The factor is not essential for the decider to consider in their response to the scenario yet also not terrible to consider, with very limited negative implications. For example, if a factor is digressive or inconsequential in addressing a key issue but it does not create a new problem, answer C is likely to be correct.

In Importance questions, the correct answer is D when:

• the factor must not be considered under any circumstances.
• it would be very bad or unethical to consider the factor.
• a response that includes the factor could cause negative consequences to patients or the profession.

With practice, your ability to recognise a D will hopefully become instinctual.

D factors must be excluded from the decider’s consideration of how to respond to the scenario, either because they’re unethical or wholly irrelevant.

In a similar way to very inappropriate responses in Appropriateness sets, if considering the factor is likely to have serious negative repercussions, this is also a sign that the factor is a D.

In both Appropriateness and Importance, D is correct when the response or factor would harm more than help, given the specific key issues in the scenario.

In Importance sets, D is correct when:

• The factor is very bad or unethical to consider, or it’s a factor that could cause negative consequences for patients, for the profession, or for academic integrity.
• The factor has a harmful element, meaning it’s something a clinician or student must not consider under any circumstances.
• The factor may intend to help or improve the situation but will only have the effect of making things worse. Select D if the factor could cause or imply negative consequences for patient health, safety or dignity, or if it could compromise academic integrity or the public’s confidence in the medical or dental profession if it is included in a response to the scenario.