Different deciders
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Many scenarios will involve students as deciders. Specifically, these are university students who are studying medicine or dentistry.
Most scenarios involving students will state the student’s status, so it will be super clear that they are medical students or dental students.
In some scenarios, you will read only that they are students, though there is often implied context that makes it clear whether they are medical or dental students. For example, if they are interacting with a hospital patient or dealing with a patient’s teeth.
Occasionally, a scenario will include students in a non-clinical context – such as their university classroom or accommodation, or in a public or social setting. In these cases, you should assume they study medicine or dentistry and apply the same professional and ethical standards you would in clinical or educational settings.
Students must uphold the ethical and professional standards of doctors and maintain academic integrity. Students should treat others fairly and with respect in all circumstances.
Students must follow all the university’s rules. They should NOT be involved in cheating or academic misconduct in any way. They must not participate in it, support, condone or encourage it.
In group work, students must participate EQUALLY in completing the work and in group decisions, such as selecting the group leader.
In clinical contexts, students must ensure they are prepared and act professionally at all times.
Creating drama between students is a negative consequence.
Responses that add to the conflict make things worse, so they are usually inappropriate.
Responses that try to resolve the conflict in a fair and reasonable way are usually appropriate.
Any problems among students should be resolved directly and in a timely manner.
Honesty is highly regarded in the medical profession.
Students are expected to reflect on their faults and seek the help they require – this is safe medicine and therefore appropriate.
Someone who is unfit for work, for whatever reason, could put patient safety at risk.
In such cases, it is safe medicine to address the underlying problem or tell a doctor on the team or a supervisor of the situation. Such responses are therefore appropriate.
Some student scenarios will involve cheating or academic misconduct.
In an Importance set, any factor that involves encouraging or participating in academic misconduct will be a D (not important at all).
The most appropriate response in this situation would be to call out the misconduct, so any factors directly related to doing so are usually very important.
When confronting academic misconduct – whether real or potential – other factors such as student relationships will usually be of lesser importance or no importance.
Some student scenarios will involve medical or dental students in everyday situations.
Scenarios without educational or clinical contexts are less common.
Medical students must always be fair, honest and professional.
They are expected to help in an emergency within their abilities. Do not assume this means treating someone in a non-clinical setting as this is not realistic in a real-world sense.
However, a medical or dental student may be able to offer simple help within their level of training and experience that could save a life until paramedics arrive.
The UCAT is highly unlikely to require more specific knowledge of dealing with emergencies in non-clinical settings. The key point is that medical students might help in the absence of a doctor, until emergency services arrive, within your level of experience and expertise.
Walkthrough question
Student deciders
Let’s look at an Appropriateness set where the decider is a medical student.
In some scenarios, the decider is a junior doctor.
Junior doctors are expected to apply ethical and professional principles to deal with the key issues in scenarios.
When answering scenarios with junior doctors as deciders, you are not required to have any clinical knowledge.
Scenarios featuring junior doctors can feature key issues related to any of the ethical principles featured in the GMC’s Achieving Good Medical Practice.
Scenarios with junior doctors as deciders can feature almost all of the key issues found in sets with other deciders.
Remember that junior doctors must:
- Prioritise patient safety and wellbeing.
- Admit when they make a mistake and apologise.
- Recognise the limits of their knowledge and skillset.
- Conduct themselves professionally both in public and private.
- Take care of their own health and develop strategies to deal with pressure.
Junior doctors are more experienced than medical students, so they have slightly different responsibilities.
However, you are not expected to know the exact hierarchy of duties on a hospital ward. For instance, you would not be expected to know the difference of seniority between a Staff Nurse and a Charge Nurse. But you should know the broad difference between a junior doctor and a consultant.
You must focus on the fact that junior doctors, like all caregivers, must conduct themselves in accordance with professional and ethical standards.
Remember that junior doctors must:
- Regard patients as individuals and safeguard their wellbeing.
- Respect a patient’s right to withhold consent and to ask for a second opinion.
- Act quickly when a patient’s safety or dignity is at risk.
- Treat all patients fairly, equally and without bias.
- Uphold patient confidentiality and communicate effectively with relatives.
Junior doctors are qualified practitioners. Even so, they’re expected to take their continued professional development seriously.
Remember that junior doctors must:
- Act on constructive criticism, for example from a senior consultant.
- Be punctual and behave respectfully towards colleagues.
- Welcome opportunities to train or mentor others, including students.
- Reflect on mistakes and recognise the limits of their skills and knowledge.
- Maintain professional boundaries and manage conflicts of interest.
Walkthrough question
Junior doctor deciders
Let’s work through an Appropriateness set where the decider is a junior doctor.
Most scenarios feature students or junior doctors as deciders.
A small number of scenarios you encounter on Test Day might have other deciders, such as consultants, GPs or dentists.
Whoever the decider is, and whatever their level of seniority, the ethical framework underlying the answer logic is always the same.
You need to marry this framework to the specific context of a given scenario. The identity of the decider, including their seniority, is one aspect of the context to consider.
Not every decider in an SJ scenario has a proper name.
Occasionally the decider is identified only as ‘the consultant’, ‘the GP’ or ‘the dentist’.
When faced with one of these scenarios, focus on identifying the key issues and their place in the ethical and professional frameworks that all answer logic in Situational Judgement hinges on.
If the decider is a consultant, GP or dentist, you will likely need to weigh some of the following considerations when evaluating the appropriateness or importance of a response or factor:
- Their accountability for what’s unfolding
For instance, in some contexts, a student decider’s best course of action will be to seek help from the individual responsible for them while on placement. A more senior decider might be expected to take more direct action to solve an issue.
- Their responsibilities towards colleagues
As more senior staff members, deciders like consultants or dentists are naturally expected to display leadership qualities and to create supportive and positive environments for the teams around them.
- Their autonomy in clinical situations
Less senior deciders, especially students, are often expected to work under supervision; a GP or dentist often works independently and thus without direct oversight. When they delegate tasks to colleagues, they must always do so safely, without compromising patient safety.
As always, the specific context in which a scenario is happening – as well as the professional and ethical frameworks – determines the level of appropriateness or importance attributable to a response or factor.
All practitioners are expected to collaborate with others, recognise when issues need to be escalated, and to be aware of the limits of their medical knowledge and skills. These issues may be in play even when the decider is a consultant, GP or dentist.
Walkthrough question
Other deciders
Let’s take a look at an Importance set with a decider who isn’t a student or junior doctor.