 What is up guys, Karma Medic here and welcome back to another dose. If you don't know who I am, my name is Nasser. I'm a second year medical student at Kings College London and I'm doing this UCAT series to help you guys do as best as you can on your upcoming UCAT test. So in today's video I'm going to be covering the situational judgment section. This section is supposed to be a test of how good of a moral and ethical doctor you're going to be in the future. It's supposed to be a little bit of a personality test I guess. The whole purpose of my series is that I answer these questions live on camera and I walk you through my thought process as I read the question, as I look at the different answers and as I evaluate them. And that way you guys can see what it is that I'm thinking about while I do the questions and hopefully you guys find that useful. If you guys are looking for specific tips on how to answer questions in the situational judgment section, I made a video on this last year. Before we begin I want to thank Medify for partnering with me on this video and on this series. Medify is an online UCAT resource and I've been using their questions and their question bank to answer all the questions I'm doing in this UCAT series. If you guys haven't heard of Medify or you want to check them out I'll leave links in the description below. And without further ado let's jump straight into answering situational judgment questions live on camera. Alright so here we are on the Medify website looking at the situational judgment questions for the UCAT. And quick disclaimer before I get into these questions. I haven't practiced situational judgment UCAT questions since last year when I made a similar video to this one. But I have been a student doctor on the wards and in general practice. And I've been talking to patients, examining them, taking histories from them, talking to their families and everything like that for about a year or so. So yeah I should do really well. I feel ready and prepared for this. So let's just get started. Okay so first question. John is an elderly gentleman who is in a lot of medication after having a heart attack last year. Elderly medication heart attack. He's also taking medication for diabetes and is finding it difficult to manage when taking specific medications. He's worried about his memory. Two is he's also had a stroke four years prior to the heart attack. He comes into cardiology review clinic to check on his condition and this doctor named Dr. Smith states that he is not improving as expected. Dr. Smith inquires further and learns about John's habit of forgetting his medication. Okay. How important are the following considerations for Dr. Smith when deciding how to respond to the situation? So John's forgetfulness could be a sign of an undiagnosed medical problem. Yeah so I'd say absolutely this is very important. It does mention in the blurb that John himself is getting worried about his memory as well. So he's worried about his memory too as he has also had a stroke about four years prior to the heart attack. So the fact that the patient is worried about his own memory is a bit of a worrying sign. And the reason that I say is that it's very important is because it's clearly having a big effect on this patient's health. So because this patient has quite a few comorbidities them forgetting to take specific medications for any of those is going to be really detrimental. And we know in the paragraph that he is forgetting his medications and as the doctor finds out he is not improving as expected. So anything that has an impact on patient health or safety is always going to be very important. Write that down. Make sure you put that in your notes. Okay next. Dr. Smith thinks that patients who don't take their medication are foolish and risking their life. So this is going to be not important at all. And the reason for that is that Dr. Smith or any doctor's personal opinions or personal assumptions or projections that they make onto patients is not important. You treat a patient based on their clinical presentation based on their health situation. You don't treat them based on what you think of them because of their appearances or their actions or anything else. So this is going to be not important at all. John stated that he thinks that he doesn't like taking his medication because there's so many and would like a reduction in the number of pills he takes. So this is actually quite a common problem in the elderly. It's something that we call polypharmacy which means that you're taking a lot of medications. So this is something very important to address. Right. And the reason for this is that if we don't address this then John is probably going to continue as he would saying you know these medications are annoying I don't want to take them and he's going to have worse and worse health as time goes on. We want to address this and reiterate to John how important it is that he takes these medications like we said well like we saw in the blurb he's had a heart attack he's had a stroke. So these medications are going to be very important in preventing from those things happening again and keeping up its overall health. So I think it's very important that we address something like this and since this has a direct impact on patient health and patient safety I'm going to label it as very important over important. John may need to have further checks to make sure his other conditions are under control. Obviously this is going to be in the top half of options either important or very important but I'm going to go with important as it's not I guess it's not like the direct most immediate action that needs to be taken. The first thing that needs to be tackled is that we check his habit of taking medications and things like that. Okay and then finally John tells Dr Smith that he has been under a lot of stress this year and this has impacted his daily life. Again this is either going to fall in the important or very important category. Now with patients being at the center of the healthcare system you know being patient centered and holistic in the way we approach patients stress and the patient situation at home their mental health are things that are becoming more and more important and that are being taken into account more and more in patients treatment and management. So this is definitely going to be important or very important. I don't know where to put it though between very important important John tells us that he's been under a lot of stress this year and this has impacted his daily life. I'm going to go with very important but I'm interested to see what the distinction between very important and important is in this question. So let's see how I did here. All right awesome five out of five correct. Gonna have a quick read through them and see if there's anything that they said above while I already added. So this is something really important to know down as well. The wishes of a patient is very important for a doctor to consider. Anytime a patient expresses an opinion of theirs or anytime they express a wish that's something that definitely needs to be taken to account definitely needs to be tackled and considered. So write that down as well that's something that's always going to be very important. Okay great first question five out of five I'm feeling good knowing that I'm a good ethical student doctor on to the next question. So Joseph is an FY2 working in a busy A&E ward. If you guys didn't know FY2 stands for foundation year two. So after you finish medical school you have foundation year one and then you have foundation year two and so that's where this doctor is. In any accident emergency he's been working for six days in a row that's tough and is looking forward to finishing his shift and going home. He's promised his friend that he will attend the party that day as he missed the last one due to work and is worried that he's continually letting his friends down. He has almost finished his shift and just has to see one patient Mr. Smith before he goes home. Mr. Smith is very intoxicated with alcohol and appears agitated but requires an urgent blood test. Joseph tries to take blood from Mr. Smith but he becomes aggressive and makes it clear that he does not want to have the blood test. However it is imperative that Mr. Smith has blood taken in order to be treated. How appropriate are each of the following responses by Joseph in this situation. Whether Joseph has to stay at the hospital for another couple of hours in order to get that blood or whether he gets a colleague to take that blood in the next hour or so and he can leave and go home. The end result has to be that this patient gets their blood taken ASAP and so we can improve their health. Also I totally forgot to mention that I did not fix my hair today. I kind of woke up and decided to film this video. Hopefully you guys don't mind. I don't think it looks too bad but yeah anyways back to the questions. Ask his senior consultant to perform the blood test instead. I'd say this is either inappropriate but not awful or very inappropriate and let me explain why. So this patient is under this doctor Joseph's responsibility. So Joseph is the one who needs to take blood from this patient and it's not a case where Joseph is unable to take that blood. It's not that he doesn't have the skills or he doesn't know how to which would be an appropriate time to go talk to a senior consultant. This is just a situation where the patient is being a little bit difficult. So before Joseph goes and talks to the senior consultant, before he escalates the situation and takes it to another person, I think Joseph needs to make a stronger attempt to take blood from this patient. You know either talk to the patient and explain why he needs to take blood or leave and come back in a little bit maybe when the patient has calmed down a bit. Joseph needs to take a little bit more action and try a little bit harder to take blood from this patient before raising this issue to the senior consultant. Now I wouldn't say this is a very inappropriate thing to do because it's not going to lead to any harm or any danger to the patient. So I'm going to say inappropriate but not awful. Continue with the procedure and it's very important that Mr. Smith has a blood test. So Joseph tries to take blood from Mr. Smith but he becomes aggressive and makes it clear that he does not want to have the blood test. So since the patient has made it clear that he does not want the blood test, it would be very inappropriate for the doctor to continue with the procedure. Once the patient, if the patient refuses treatment or the patient says I don't want X done, you cannot force that upon them, you cannot do it anyway, you have to respect their wishes. What you can do is come back and talk to them later or have a conversation with them about why they don't want something to happen and you know maybe you can change their mind by educating them or informing them of something that they didn't know about but it would be very inappropriate to continue with the procedure. If the patient says they don't want it then they don't want it. Ask another junior doctor to complete the procedure so that he does not miss his party. So again, I definitely wouldn't say this is appropriate because like yes we want Joseph to go to this party because he's been working a long time and he really wants to enjoy his social life and all those things but at the end of the day the patient's health, the patient's safety is the priority and that's always going to come first. So this doctor Joseph is going to be expected to have to be late to the party or to miss the party in order to complete his duties as a doctor at the hospital. So I would say asking another junior doctor to complete the procedure in order for him to go to the party is going to be inappropriate. Would it be very inappropriate? I don't think so because again it's not going to cause any harm to the patient, it's not going to you know put the patient in danger so it's not a very inappropriate thing to do. That doctor needs to take responsibility for his patients and deal with all of his jobs before he leaves the hospital. Raise his voice and tell Mr. Smith that he must have a blood test to be treated. Very, very, very inappropriate. Definitely shouldn't raise his voice A and B should not be forcing treatment upon this person unless this person doesn't have capacity or is being treated under the Mental Health Act but those are two very different situations. He should not force treatment upon this person now or raise his voice for sure. Leave Mr. Smith to calm down and come back later to take his blood. That's exactly why I said at the beginning. Also call his friend and explain that he will be late. Very, very, very appropriate thing to do. A, you're leaving the patient who it says is agitated to calm down a little bit and then you're going to come back. You're going to take responsibility for this patient. You're going to try to take blood from them. That's correct in itself. And then calling your friend to explain that you will be late. Also a very appropriate thing to do. All right, let's see how I did on this one. So partially correct with one and five being orange. So let's see what one and five were. So I was on the wrong half. So being on the wrong half of these questions is not good. So here I've chosen inappropriate but the answer was actually appropriate. That means that I'm not going to get any marks for this question. Whereas if I had chosen a very appropriate thing to do but the answer was appropriate since both of those are in the same half let's say the top half is appropriate. The bottom half is inappropriate. You would still get partial marks. So deciding between the top half and the bottom half of answers is the first and most important thing to do. And then whether you choose the correct one within that space is less important. Obviously you want to choose the right one but you'll still get partial marks if you don't choose the perfectly correct one. Although his response would make sure that Mr. Smith has the blood test and it's important that Joseph tries to deal with the situation at a direct level before seeking help from his colleagues. So this is what I was saying that he needs to deal with it himself before seeking help. It would be more appropriate for Joseph to try and calm the patient down and explain the importance of the procedure before trying again. So that's what I said before. In retrospect looking at this question generally if you're ever asking your senior or asking someone for help reaching out for help that's generally always going to be an appropriate thing to do. Either appropriate or very appropriate. I remembered this from last year so I should have said that before. Okay and then the fifth question so here for example I would get partial marks. The correct answer was appropriate but not ideal but I chose very appropriate but since I'm in the right half I would get partial marks. So this is better of a mistake than this mistake I made over here. So I guess something I didn't consider is that it's urgent that they get the blood test quickly in order to treat him. I thought incorrectly that he just needed to have the blood test not that he needed it right now. Since he needs it right now then it's less ideal to wait and then come back later. Okay cool. Next question. Eleanor is a first-year medical student interviewing a patient starts to become visibly upset. How appropriate are each of the following responses? So I've actually had a similar situation to this where I was visiting a patient in their home in order to take a history from them and sort of understand how their disease impacts on their health on a daily basis and you know patients are really kind they really want to speak to you they want to offer you tea they want to offer you food they want to offer you gifts and so yeah sometimes you have to draw the line and say no. I mean it depends on a lot of things so let's see what's going on here. So be firm but polite and refuse to accept the gift explaining the reasons behind it. A gift as a box of chocolates okay is not something that is like a big deal you know it's not like this patient gave you money it's not like this patient has given you the rights to their assets or anything like that this patient is simply giving you a box of chocolates you know which probably wasn't all that expensive it's something quite small and it's just a gesture to say thank you in fact it would probably be a nice gesture to accept the gift thank the patient you know and leave it at that because the patient is going to be happy they want to give you this gift they want to say thank you so let's see be firm but polite and refuse to accept the gift at this point the patient has become visibly upset I think the right thing to do would be to accept the gift so be firm but polite and refuse to accept the gift explaining the reasons behind it I'd say this is inappropriate but not awful I wouldn't say it's very inappropriate it's not going to cause the patient any harm so just inappropriate but not awful accept the gift and say thank you to the patient I think this would be the right thing to do at this point try to calm the patient down this is like when you're in a fight with your girlfriend or boyfriend and you're like just chill out just chill out calm down it's going to be the wrong thing to do so I'm going to go with inappropriate but not awful um I mean actually no so try to calm the patient down yeah there's nothing wrong with that that's only going to be a good thing so calm them down refuse to accept the gift and leave abruptly absolutely not the leaving abruptly part there is what's wrong with this refuse the gift offer to continue visiting her as she seems lonely um so this question is a bit difficult because if if you had to continue visiting this patient like I did for example in my GP then this would be a perfectly fine response because you are going to go back you're not going to continue visiting her because she seems lonely you're going to continue visiting her because she might need a checking up on her health or on her situation or on her medications to see what's going on I'm a little bit confused I'm conflicted for this question not gonna lie let's see so similar to last question let's see the ones that I got partially correct partially incorrect here okay I was on the right half so that makes me happy accept the gift and say thank you appropriate but not ideal so accepting gifts from patients is against GMC guidelines is they can affect clinical judgment and appears unprofessional however in some situations it'd be more unprofessional to refuse so this is what I was trying to get out before hopefully I explained that okay um appropriate but not ideal so here I was on the wrong half okay the response is inappropriate but not awful Eleanor conceded the patient is lonely and simply wants some company she's not causing any harm by continuing to visit her however as she is only visiting the patient for coursework and has asked all the questions she needs then there is no need for her to return it would therefore be unprofessional to Eleanor to continue visiting the patient so this is what I was saying for me for my GP home visits that I did this year I was asked I was asked to return to the patient's homes multiple times to follow up with them so then this would be totally normal but since like it says here that the student has only visited once just for her coursework then it would be unprofessional to continue visiting them so yeah I should have said it appropriate all right let's have a look at the next question gene is a medical student who's on placement on gene is wondering whether to come in to keep her company interesting situation okay how important are the following situations for gene when deciding how to respond that the patient is willing to talk to her very important if the patient does not want to talk to the medical student for any reason whatsoever you need to respect that wish and you need to not go talk to that patient maybe they want some alone time maybe they're just thinking of something else how much the patient wants to talk to you I should say it's very important whether Annette is having a caesarean or natural birth this is not going to be important to whether you go talk to her while she's waiting to give birth or while she's waiting for her partner to come so this is not important at all the Annette's partner is of the same gender as her obviously not important at all whether Annette is with a female partner or with a male partner or with someone who doesn't identify as any gender or whatever is definitely not important you treat patients you talk to patients and everything based on their health and their clinical need and not on anything else whether Annette is in any pain right now very important so of course if Annette is in any pain at all she's probably not going to want to talk to you as much she's probably going to want to see doctors receive some analgesia things like that so I'd say taking into account her pain levels are very important whether Annette has any refreshments that she may like Jean to bring for her if Annette is expecting to receive I guess refreshments from Jean um that is something to take into account so Annette might just want the refreshments but not any company um but the fact that she wants refreshments from Jean means that she she's willing to have Jean in the room she's willing to have Jean come close to her and give her the refreshments so I'd say important but not very important or wait a minute let me go back and read that one more time whether Annette has any refreshments I'm going to say of minor importance okay let's see how to change of heart five out of five correct good thing I had that change of heart this is a minor importance it's a courteous thing to ask her but really right now Jean should be focusing on how she can help lift her mood more direct and effective methods such as talking to and comforting her great on to the next question I love doing situational judgment questions they're honestly so much fun this is like exactly what you will be doing as a second-year medical student you're going to be talking to all these different patients finding yourselves in some strange scenarios you know patients being really happy patients being really angry or sad um and you need to navigate your way through it so I really like this section of the UCount test I think it's really important all right we've got a nice short one here Robert is a junior doctor who's been assigned to spend the next week tutoring a group of medical students Robert notices that the medical students arrive to the hospital looking somewhat scruffy and are not following the hospital dress code not good he's wondering whether to raise this issue with them yeah probably should how important are the following factors for Robert to consider so the medical students might be offended um I mean they might be offended but the more important thing at stake here is you know medical students are representing doctors and the medical field in general and so they need to dress appropriately they need to act appropriately they need to talk appropriately whether they get offended or not it still has to happen going to go with no important at all medical students are fully aware of the hospital dress code this is very important because they're fully aware of it and they're choosing to ignore it so this changes the situation from someone who let's say was not aware of the hospital dress code so that's going to be important Robert has already developed a good rapport with the medical students this is of minor importance it it's not really that important whether he has a good rapport or no rapport at all he still needs to respond to the situation and he still needs to bring it up the students have been asked by the medical school to give feedback on Robert's teaching methods so like maybe in real life Robert might want to be kinder to the students in order for them to give him better feedback but definitely for the purposes of this exam and for the purposes of responding and acting like the ideal doctor you're definitely going to want to say not important at all here the students unprofessional appearance may negatively impact on the impression given to patients absolutely that is the key issue here that patients might get a negative impression of medical schools of medical students of doctors of hospitals and that should definitely not be happening okay let's see all right cool four out of five with one partially correct rubber has already developed a good rapport with the medical students is apparently not important at all this factor should not influence Robert's decision to raise the issue it is a hospital policy of health professionals to adhere to the dress code I can get behind that all right next question so Hannah is a medical student who is on attachment on a busy ward typically the roles of a medical student in her year are to help with some procedures when supervised but mainly to clerk patients and observe the staff on the ward are generally supportive however one day she's asked to perform a cannulation on a patient while the foundation yield doctor deals with more urgent patients she has never been formally taught a technique and is not sure of all the steps carry out the cannulation and hope for the best in this case definitely not because there's a risk to patient health and safety if the medical student is going to carry this out without any training without any guidance just winging it basically definitely not the right thing to do ignore the doctor and carry on clerking other patients rather than risk it again very inappropriate because the doctor has asked for this to happen because this probably needs to happen to send off some tests or to administer some drugs or whatever so this is something that needs to happen the fact that Hannah can do it is important and should be addressed and a solution should be found for it it shouldn't just be ignored so this would be very important very inappropriate thing to do leave a note on the nurse's station about the patient and ask the next nurse you see for advice after clerking patients asking advice is not inappropriate that's appropriate but this is definitely not ideal let the foundation your doctor know that she can't do the procedure very important thing to do you know you need to let them know hey i'm not trained to do this i haven't received training to do this and i cannot do this offer to try and help the doctor on other tasks that she can do very appropriate thing to do you know you say hey i can't do this because i'm not trained in it or whatever i would love to learn if you would show me or blah blah but if you don't have time for that or whatever i would love to do some other tasks that i can help you with that i'm able to do while you take care of this calculation all right four out of five with one partially correct let's see what's going on here ignore the doctor and carol and clerking other patients rather than risk it this is inappropriate because Hannah's not identified anymore all right Joanna is a medical student and talk to the basketball team and explain that she can't attend the game because she needs to study um so this is definitely an appropriate thing to do because she's talking to the team she's communicating with them the fact that she's stressed and she has other things she needs to work on i'm going to say this is not a very appropriate thing to do because the more appropriate thing to do would say that instead of she can't attend the game she should just attend less daily training but maybe she can still go to that big important game so i'm going to say appropriate but not ideal because i think there's a better solution ask the basketball team if she can attend training less frequently so that she can fit in more studying absolutely very appropriate try to ignore the stress big no no generally ignoring or pushing aside or delaying um is going to be inappropriate or very inappropriate make an appointment with her student advisor to discuss how better to deal with her exam stress very appropriate thing to do that's exactly what student advisors are there for uh person personal tutors etc um yeah they're there to help you when you feel like you're a bit overwhelmed or when you need some advice so yeah it's a very appropriate thing to do attend all the training sessions and plan to reset the exam in a few months absolutely not you should never plan to reset the exam you should plan to pass the exam with flying colors if you happen to fail and need to reset it that's fine but you should never plan to reset the exam all right four out of five one partially correct the response is inappropriate but not awful time out of studying to relieve stress is important including basketball together make sure i'm more stressed this is inappropriate really i mean okay all right next question how important are the following considerations for claude the fact that he has confidentiality of the husband's health of course very very important he should not talk about the husband's health or cancer diagnosis or anything like that with anyone besides uh besides the husband and of course to the healthcare team and anyone in charge of his the husband's health but i mean to the general public to the general people he should not be talking about his health claude is feeling a little tired at the moment and wants to go home so i'd say this is this is difficult so i'd say this is of minor importance because i mean we don't know why the wife is crying yes it's very likely that she has just learned of her husband's diagnosis but we don't want to make that assumption we don't know if that's the case she might be crying for a totally unrelated reason i guess it's it's not important at all the more important thing is this person who you see is crying and is upset and you want to see what's going on with them so that's the priority here his bus is leaving shortly and speaking to this lady may cause him to miss it again for the same reasons not important at all he can always take the next bus he can take an uber he can take the tube whatever the level of distress that the lady is feeling it's important maybe not very important regardless of the level of distress she's in right now we can see that she's crying so she's at the level of distress that would require his attention anyway and so he should go see her no one else is around currently i'd say that that is important if her husband was there or if someone was already consoling her or something like that then you know maybe you wouldn't have to approach the situation but if you can see that she's alone um then yeah you're definitely gonna want to go talk to all right nice cheeky little five out of five hopefully my reasoning was like easy to follow and understand and yeah next question dr smith is working in a rural gp practice and is currently in a consultation with the patient dr smith becomes visibly upset not that i've seen thousands and thousands of patients but i have definitely seen this happen once or twice and heard about it happening a lot more anyway how important is it for dealing with situation that miss green is upset um it's important it's definitely not of minor importance it's important to take into account you know how you're going to tell her that she's has incorrect inhaler technique and how you're going to talk about it in fact it might be very important yeah i'd say it's very important the miss green lives very far away from the nearest hospital also very important because that means that she is less likely to quickly get to hospital if she's having an asthma attack if her life is in danger and she doesn't have good inhaler technique so that's very important the miss green disagrees and says she's using her inhaler incorrectly not important at all the fact that she disagrees i mean maybe of minor importance the fact that she disagrees doesn't change the situation that she's using incorrectly doesn't change the situation that she needs to be told how to use it correctly um although it does change how you would talk to her and stuff so i'm going to say of minor importance yeah the miss green has an extremely severe type of asthma super super super important i mean if she has a severe type of asthma that means it's even more important that she knows how to use the inhaler when to use the inhaler etc though the gp practice is very busy and dr smith's next patient has been waiting for 30 minutes um this is important but uh this patient clearly definitely needs to be taught how to use this inhaler she's gone to any many times um you know her life is at risk if she doesn't know how to use the inhaler properly and if she doesn't use it when she needs it so yes people are going to have to wait people might be upset but it's very important that dr smith takes the time to explain to mrs green how to use this appropriately so i'm gonna say this is important but not very important i wouldn't say it's of minor importance but yeah i'm between important or of minor importance sometimes the wording in these questions kind of trips me up the gp is very busy i'm gonna go with of minor importance it's of minor importance that they've been waiting it's either important or of minor importance let's see 50 50 um so let's see damn it damn it so close so close so it was important fine and i remember in in some other questions i've done patients waiting has been important so don't say that it's of minor importance patients waiting is going to be important all right guys and i think that is going to be it for me that's where i'm going to cut off this video for answering situational judgment test questions live on camera if you guys have enjoyed this video please do leave a like on it leave me a comment down below don't forget to subscribe to my channel if you want to see more medical school content from me also cheekily follow me on instagram if you don't do so already and anyways guys i hope you've had a fantastic day good luck with your u-count practice and your u-count exams and i'll see you guys in the next one peace