What is a Situational Judgement Test (SJT)?

The SJT is a measurement method set within the specific context of selection to FY1. It is an invigilated test which will assess the professional attributes expected of the Foundation Doctor, as defined by the Person Specification. All applicants will undergo an assessment comprised of multiple choice questions which have a complex marking key which allows for a range of marks to be awarded rather than one true or correct answer. There are two item types: select three from eight; and rank five actions. For each item, the applicant is asked what an FY1 should do in the given scenario.

More information, including example SJT questions can be found on the SJT pages.

What is the rationale for introducing an SJT?

SJTs are currently used in the selection process for GP training, and they are being piloted for selection into other specialty training programmes including surgery. In the context of selection to the Foundation Programme, the SJT has proven reliability, validity and fairness.

Additionally, the Options Appraisal conducted by the ISFP Project Group found that implementation of SJTs will allow concerns around the long-term viability of white space questions to be addressed. Students will not benefit from SJT coaching as they are not a test of clinical knowledge.

What does the SJT test?

• Commitment to Professionalism
• Coping with pressure
• Effective communication
• Patient focus
• Working effectively as part of a team

The SJT has been designed to test each of these attributes in order to accurately assess the judgement skills required of prospective Foundation Year doctors. Although different doctors, nurses and other members of the healthcare team may encounter similar challenging scenarios, the answers are specifically how an FY1 should handle the situation, and could include taking charge or knowing when to ask for help.

How will the new system be fairer?

The SJT will be taken in invigilated conditions by all applicants at the same time and on common dates, so that all applicants have the same opportunity to succeed. Applicant answers are then machine-marked against a pre-determined scoring key.

The assessments used to calculate the EPM score will be produced using a framework which will be used by all UK medical schools. This will ensure each student is assessed in a more consistent way. More information on how SJTs are fairer can be found on the SJT pages.

How are the SJT items written?

Clinicians who work closely with Foundation doctors are trained to write SJT items mapped against the five professional attributes to be tested (i.e. team working, coping with pressure). This ensures that the scenarios presented are an accurate reflection of what FY1s encounter in their role. The items and the answer keys are then reviewed by psychologists to eliminate ambiguity, and by other clinicians, including FY1 and FY2 doctors, to ensure they are both realistic and fair.

A small number of items are piloted in each SJT paper for use in future recruitment in order to determine item performance before it is used live. Scores on these pilot items are discounted. Items are reviewed continuously to ensure that scenarios are still applicable and realistic.

How is the SJT marked?

There are two item types: select three from eight; and rank five actions. The scoring convention used during the piloting and development of the SJT is illustrated on page 43 of the SJT report and described below (although this is subject to review):

• For select three from eight items: four marks are available for each correct answer i.e. a total of 12 - no negative marking. If you give four rather than three answers, you would score 0 as you have not answered the question. If you answered two rather than three, you would score for the two answers you have given.

For the ‘rank five’ items: each item rank is worth four marks, i.e. a total of 20 marks  - no negative marking. There are points for near misses, to reflect the judgement of ranking, i.e. if the answer is ABCDE and you rank BACDE you would score 3 out of 4 for B and A only, and 4 for C D E, so almost full marks. If you give tied answers, you score 0 for the ties as you have not answered the question.

How much time will need to be spent revising for the Situational Judgement Test?

There is no need to revise for this test as it is not a test of clinical knowledge. To prepare for the SJT you may wish to read Good Medical Practice and familiarise yourself with the attributes being tested by the SJT. The ISFP Project Group and the UKFPO are working together to ensure that familiarisation material is available to all applicants to FP2013 in early June 2012.