Key point for SJT

Question 1

working through for 48hours VS handing your bleep to switchboard and not telling the registrar

which is more unfavourable?

Answer 1

working through 48 hours

patient safety first!

Question 2

factors:
- lying to consultant about being sick (LYING)
- forging data for audit (DISHONESTY)
- drink coffee and be tired tomorrow (TIREDNESS)
- go to bed and try to finish audit the next morning (RUSHED)
- go to bed and apologise for missing audit results (SORRY)

what order would you do first?

Answer 2

SORRY
RUSHED
LYING
TIREDNESS - this is PATIENT SAFETY issue!
DISHONESTY

Question 3

what must you check before sectioning a patient?

Answer 3

that they have lost insight into the disease/reality

(PS: if they have insight/not confused, then you cannot section them)

Question 4

family asking for you to give medical advice- what should you do?

Answer 4

make very brief history-taking

advise for them to seek medical attention

Question 5

work/life balance VS patient safety

which one is preferable?

Answer 5

patient safety

Question 6

preparing for journal club the next day (ie emergency task) & you have personal plans in the evening

the options:
- making up an ‘unavoidable’ excuse for the evening (LYING)
- telling consultant your evening plans & apologise (HONEST)
- get a junior colleague to do it together (COLLABORATION)
- agree & cancel evening plans (GONE)
- agree & stay up late in morning to do it (TIREDNESS)

what is the right order of appropriateness?

Answer 6

HONEST
TIREDNESS
COLLABORATION
GONE
LYING

Question 7

you think patient has cancer but patient is going on holiday - how to rank in order of appropriateness?

• tell her to cancel her holiday plans as you think it is cancer (BRUTALLY HONEST)
• tell her your concerns of cancer and let her decide her holiday plans (HONEST)
• call fast track to see if they can see patient soon (PRO-ACTIVE)
• prescribe symptom-relief and see patient after her holiday (AVOIDANT)
• order investigations and see patient before her holiday to discuss results (of possible cancer) (SNEAKY - changed to PRO-ACTIVE)

Answer 7

• HONEST
• SNEAKY - changed to PRO-ACTIVE
• PRO-ACTIVE
• BRUTALLY HONEST
• AVOIDANT

Question 8

how young can you prescribe oral contraceptive pill?

Answer 8

16 yo providing Gillick competence

Question 9

what is the legal age for you to have consensual sex?

Answer 9

12yo

Question 10

how to answer ‘rank in order of appropriateness’ question ?

Answer 10

Choose the MOST APPROPRIATE answer first.
Then, think - if I cannot do this option, what is the next BEST THING?

Question 11

you work in GP. mum refuse to bring son to GP for review but you think that home visit is inappropriate.

what would you do?

Answer 11

ask mum to explain her reasons.

tell her that home visit is inappropriate (only housebound patients) and she needs to bring him in as emergency patient if she is worried.

say that home visit will delay review and treatment as you will only come at the end of the day

diagnose over the phone

prescribe any antibiotic

Question 12

when quetioning a colleague’s fitness to practice, what mnemonic to use?

Answer 12

SPIES
seek information
patient safety
intitiative
escalate
support

Question 13

What to do when you suspect neglect in your home visit?

Answer 13

Identify the concern & take responsibility to alert this concern.

Make decision on whether you should refer the concern.

Refer the concern to safeguarding team.

Learn & reflect on how this concern is managed.