Situational Judgement Flashcards
Beneficence:
You have a moral duty to provide treatment that must have some benefit to the patient
Non-maleficence:
You should not put the patient in harms way
Autonomy:
Every person is an individual and should be treated as such
Consent:
Is required!
Patients need to be informed in order to consent - tell them risk and reward
Patients have the right to deny treatment
Justice:
All resources need to be given out in a fair and equal manner
Providing equal treatment for patients that have the same clinical need
Confidentiality:
Patient information shouldn’t be disclosed to anyone other than the relevant medical personnel in the hospital
Resolving the issue in the most reasonable manner is…
A very appropriate thing to do
Informing someone else of issues thereby preventing this from happening again is…
A very appropriate thing to do
Improving patient safety is…
A very appropriate thing to do
Addressing problems in the workplace is…
A very appropriate thing to do
Consulting a more senior member of staff is…
A very appropriate thing to do
Respecting the dignity and wishes of patients is…
A very appropriate thing to do
Being honest is…
A very appropriate thing to do
Alerting senior staff when something is directly putting patients at risk is…
Appropriate but not ideal (because it will take ages and you need to sort this out now)
Apologising on behalf of another member of staff to a patient is…
Appropriate but not ideal (saying sorry on behalf of the hospital is good as it helps the patient to feel better, but ideally the person who made the mistake should apologise)
Going over the allocated time frame for an appointment in order to support the emotional needs of a patient is…
Appropriate but not ideal
Passing responsibility onto another staff member is…
Inappropriate but not awful (Ideally you should assist the patient yourself, but if you pass the responsibility onto someone else, although not ideal, at least someone is helping the patient)
Involving a more senior member of staff to assist in a task that you could have done on your own is…
Inappropriate but not awful
Refusing to examine any patient who makes you feel uneasy is…
Inappropriate but not awful (regardless of what they have done they all need to be treated equally with respect and dignity)
Not assisting fellow students with any work that you would have been qualified to help with is…
Inappropriate but not awful
Calling off non-academic activities to prioritise university work/hospital work is…
Inappropriate but not awful (you need to have a happy medium, but if something urgent is going on in the hospital then you must attend to the urgent thing in the hospital even if it means cancelling)
Moving on from a problem before it’s solved or ignoring the problem is…
A very inappropriate thing to do
Not answering questions is….
A very inappropriate thing to do
Telling lies is…
A very inappropriate thing to do
Doing procedures that you are not qualified to do is…
A very inappropriate thing to do
Being rude to patients is…
A very inappropriate thing to do
Failing to report cheating in exams is…
A very inappropriate thing to do
Breaking confidentiality regulations is…
A very inappropriate thing to do
Trying to change a patient’s mind once they’ve made their decision is…
A very inappropriate thing to do
Proceeding without consent is…
A very inappropriate thing to do
Delaying vital lifesaving treatment is…
A very inappropriate thing to do
How important is it to … The patient’s feelings and dignity?
Very important
How important is it to consider… If it puts people’s safety at risk?
Very important
How important is it to consider… Maintaining professionalism?
Very important
How important is it to consider… Sticking to the provided timescales?
Important
How important is it to consider… Other people’s opinions?
Important
How important is it to consider… The impact on individuals wellbeing/emotions if you tell?
Of minor importance
How important is it to consider… Potential damage of friendships?
Of minor importance
How important is it to consider… Rank within hospital?
Not important at all
How important is it to consider… If a patient changes their mind time and time again about their consensual obligation
to treatment?
Not important at all
How important is it to consider… Previous confrontations and disagreements?
Not important at all
Explaining to a patient why their surgery is delayed is…
A very appropriate thing to do
How important is it to consider… staff and patient safety?
Very important
Timely responses that directly resolve the problem are…
Very appropriate
Making someone aware of a mistake they made is…
Very appropriate
Providing an apology is…
Very appropriate
Consulting a senior member of staff for advice is…
Very appropriate
Honest reassurance is…
Very appropriate
Written complaints over incidents which are directly putting patients at risk are…
Appropriate but not ideal (might help but won’t harm situation)
Running over appointment time is…
Appropriate but not ideal (might help but won’t harm situation)
Apologising for somebody else’s mistake is…
Appropriate but not ideal (might help but won’t harm situation)
Actions indicating a poor work-life balance are…
Inappropriate but not awful
Talking about patients in a public setting is…
Very inappropriate
Definition of very important =
Vital
The situation couldn’t be solved without consideration of this
Definition of important =
Would help considering this but not vital
Definition of minor importance =
Could be considered but won’t make a difference
Definition of not important at all =
Shouldn’t be considered
Definition of very appropriate =
Will solve or make scenario better
Definition of appropriate but not ideal =
Might help but won’t harm situation
There are better alternatives
Definition of inappropriate but not awful =
Shouldn’t be fine but wouldn’t make situation worse
Very inappropriate
Would make situation worse
Doing another students work/tasks is…
very inappropriate
If you are gonna be late to work you, calling your senior would be…
Inappropriate but not awful - wasting the time of a senior is bad but contacting hospital is good idea
If you are gonna be late to work you due to snow, waiting for weather to settle before driving to work is…
Appropriate but not ideal - you have a responsibility to go to work but it is not ideal to put yourself in danger on snowy/icy roads - it would be better to get public transport.
If you overhear colleagues talking about a patient rudely in a public place you should…
Resolve the main issue immediately = Approach them and point out that their comments may be heard by others.
Do not draw attention/make a scene - that would make the situation worse.
No point apologising on their behalf as it’s better to make the people aware they are doing something wrong and also don’t want to make patients aware if they have not heard.
No point addressing the issue later. It would be appropriate but not ideal to talk to the colleague privately afterwards.
If a colleague has made a mistake…
Address the issue immediately (unless it will undermine the doctor in front of the patient)
Do not go behind someone’s back - address the individual (local)
Go to senior if necessary - If you need to go to the senior then let the person know
Be discrete - avoid confrontation/embarrassing someone
If one student is not contributing equally to your team…
Need to prioritise getting the project done
You shouldn’t cause a scene
Do not escalate and complain to a senior before talking to Ben - causing more harm as it’s creating conflict = very inappropriate
Be direct and immediate - Talk to Ben and ask him why he is not contributing and try and sort out the issue
Undertaking the colleagues work will get the project done but will not sort issues and ignores teamwork as not everyone having an equal contribution = would be inappropriate but not awful
Is it important or not to consider if the patient is hard to diagnose/treat when deciding to treat carry out the task straight away?
Of minor importance - still gonna need to do the task but still need to recognise that the task is difficult. This should affect your action (how you undertake the task) but not affect your decision to do the task or not.
If a colleague posts something that might breach confidentiality you should….
Contact the colleague and advise them to remove the social media post
Do not contact a superior and escalate the situation
Asking a patient to ask you questions later because you are busy is…
Very inappropriate
Addressing on someone’s behalf is…
Appropriate but not ideal
Asking another doctor to give information about a patient who is your friend and not in your care is…
Inappropriate but not awful
If you have to raise a concern against a senior, how important is it to consider how they will mark your work?
Not important at all
How important is it to consider if other people may share the concerns of one person that has made a complaint?
Also how important is it to consider that others have not seen evidence to back up the complaint?
Important
Important
Reminding a fellow student that not doing something that they are anxious about will effect their academic progress is…
Inappropriate but not awful (it is true but will increase anxiety - it would be more appropriate to calm and reassure them)
If someone is anxious giving them privacy to calm down is…
A very inappropriate thing to do
If you think something is offensive, the fact that others do not think it is offensive is…
Of minor importance
When can you break confidentiality?
When another person is at risk
Should you give relatives info about the patient?
If you have patient consent
If confidentiality is breached it is very appropriate to…
Stop breach ASAP - privately explain to person what they did wrong
Deal with in a discreet manner
If confidentiality is breached it is appropriate but not ideal to…
Distract people’s attention to change subject
Confront person about breach
If confidentiality is breached it is inappropriate to…
Ignore problem
How important is it to consider the intent of a person/their rank when they are breaching confidentiality…
Not important at all
When should you self prescribe/take meds without a prescription…
Never!
When maintaining professionalism it is very appropriate to…
Talk to someone privately about their behaviour
Apologise
Avoid further escalation
When maintaining professionalism it is inappropriate to…
Be rude
Cause a scene/undermining colleagues in front of patients
Ignore offensive comments
Wait to see if someone does something inappropriate again before acting
Being inconsiderate of the workload others face
Expect people to accommodate you without notice
When maintaining professionalism important factors to consider are…
Patient safety
Patients may be watching
Patients need to be able to trust doctors
Policy and rules
When working in a team it is very appropriate to…
Raise concerns about a problem politely and privately
Resolve issues diplomatically and professionally
Make sure everyone has a voice, work is evenly distributed and work is completed on time
Compromise to reach common decisions
When working in a team it is inappropriate to…
Create conflict
Ignore concerns
Escalating situation and involving tutors
Allowing personal issues to affect the group
Reassigning tasks without informing people
Excluding people
When a patient refuses advice/medication you should…
Respect patients wishes but explore their feelings and provide advice
Do not be forceful or deceptive
When faced with a conflict of interest…
Be honest and declare it
Be prepared to exclude yourself from decision making
When mistakes happen it is inappropriate to…
Ignore mistakes
Not report them even if they didn’t cause harm
Ignore policy
Do something you’re not competent at
When mistakes happen it is not important to consider…
No one noticed the error or that it was a minor error
Person responsible isn’t available or that they’re a superior
Someone else might fix the mistake
When a young boy is lost but you are busy dealing with something else it is…
Very inappropriate to…
Inappropriate but not awful to…
Appropriate but not ideal…
Very appropriate to…
Very inappropriate = take the boy to the play area and continue with your task
Inappropriate but not awful = Ask someone else to deal with the boy
Appropriate but not ideal = ask other patients where the boys mother is (not biggest concern)
Very appropriate = assist the boy and comfort him
How appropriate is it to tell a friend whom has failed an exam that they are likely to find the exams easier next time?
Inappropriate but not awful (doesn’t deal with the situation and is not supportive)
As a medical student you are in a public place and there is a medical emergency but no one else is responding. When deciding to help, how important is it to consider…
- That a doctor may respond?
- That people around are getting anxious?
- That as a medical student she may not be able to help?
- Of minor importance
- Of minor importance
- Of minor importance
If a patient is complaining about a nurse, how appropriate is it to…
- Ask the patient to explain?
- Ask the nurse to leave?
- Very appropriate
2. Very inappropriate
A student receives negative feedback. How appropriate is it to ask others if they also got negative feedback?
Inappropriate but not awful
When deciding to do a task (e.g. talking to a patient) after a long shift, being tired is…
Of minor importance
Learning from feedback is…
Very important
If you are not in a state to perform a procedure, the fact that the patient’s procedure will have to be postponed is…
Of minor importance
As a medical student, if you do not know how to do a procedure how appropriate is it to…
- Ask your superior to provide instructions and supervise
- Ask if your superior could show you how to do the procedure
- Ask if a fellow student would like to do the procedure
- Appropriate but not ideal
- Appropriate but not ideal
- Inappropriate but not awful
As a medical student you are on placement in a hospital with a fellow student. The doctor supervising you asks the other student to make sure something is done. The next day the doctor asks you why it was not done. How appropriate is it to…
- Tell them that it wasn’t you they had asked to do it
- Inform the doctor you will do it straight away
- Speak to the other student about why they didn’t do it
- Appropriate but not ideal
- Very appropriate
- Appropriate but not ideal (there may be a reason why)
Colleague has a drug problem, you advise them to get help and they ignore it, they then come into work under the influence:
Very appropriate response = report them to a senior
Appropriate but not ideal response = refer them to a counselling service without their consent
Inappropriate but not awful = advise them to get help again (was ineffective first time so probably won’t help), ask another colleague what to do (could come across as gossiping), advise them to take a day off (won’t solve the problem)
You are preparing to observe your first surgical procedure. You are feeling almost sick with dread and nerves, but knows you needs to ‘get over it’ at some point.
Take a deep breath, keep calm, and go to the observation =
Appropriate but not ideal
You are preparing to observe your first surgical procedure. You are feeling almost sick with dread and nerves, but knows you needs to ‘get over it’ at some point.
Tell someone you are feeling unwell and don’t go =
Appropriate, but not ideal
You are preparing to observe your first surgical procedure. You are feeling almost sick with dread and nerves, but knows you needs to ‘get over it’ at some point.
Tell someones how you are feeling and ask their opinion =
Very appropriate
You are preparing to observe your first surgical procedure. You are feeling almost sick with dread and nerves, but knows you needs to ‘get over it’ at some point.
Ask if you can attend an observation on another occasion =
Inappropriate, but not awful
You are preparing to observe your first surgical procedure. You are feeling almost sick with dread and nerves, but knows you needs to ‘get over it’ at some point.
Attend the observation but leave if you feel any worse =
Very appropriate
