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Hi, mom. Hi. So, how are you? Good. How are you doing? Good, good, good. Have you? Is this your thing? Like, have you, um, started it, organized. It, not my team actually. It's a, it's a group of guys who, um, I think it's been led by someone who is trained in radiology at the moment. Mhm. Yeah. So, just trying to help other guys get into radiology. So, just, yeah, organizing programs and, uh, I was just serving as the Academy Officer for DZ. Mm. So, just helping with some of these programs. How's Kent? You've moved? Right. Yeah, I moved to Catherine. Not Kent. Catherine. Sorry. How's King? Yeah. Not bad. It's cool. How's London? Oh, I'm done with London. I'm sick of it. Right. Yeah, it's just, it's, you know, London's nice but there's too many people. It's so crowded. It's just, I'm done with it. It's expensive. It's so expensive. Um, but, yeah, I'm going to finish training and then I'm out, man. Ok. I think I saw you in Acton a couple of times actually. You live? Yeah, I run a lot around that area but I never see. You, you, you do, you see, I saw you the last time I saw you. I think you were probably working with your boyfriend. Oh, ok. He's my fiance now. Yeah, it's possible. Yeah. Ok. I think we are good to go. Yep. Ok. All right. Ok. Just waiting for a few more people and then. Mhm. We can start. Ok. Hi. Good evening everyone. Uh, my name is Loo Abdul. Um, um, I'm the academic officer for EF and today we'll be continuing our educational series uh talking about the situational judgment test components of the A Sary examination. Um Basically, we're talking about the techniques, we're dealing with this aspect of the examination, some guided principles, uh what resources to use. And uh we have a brief look at some sample questions as well and the reasoning beside V Cancers and um to join us today and to tackle this problem, we've got Doctor Sonia Bat uh who's actually done well in this examination. Uh She's currently a G PST 12 Imperial Healthcare NHS drugs in London. Um She'll be helping us with this aspect of the uh of the examination. Uh shortly I will be bringing her onto the stage just to um uh get things going. Ok. So let me just do that now. Ok. Uh So off to you, Sonia. Oh, ok. Hello everyone. I'm Sonia. I can't actually see you but, but II assume you can see and hear me. Um So I'm going to be talking to you about the S JD. Um, I'm just going to tell you a little bit about myself. Um, first I'm, I trained in India, did my medical school in F one in India. I came here in 2021 did my F two stand alone in slough. If anyone's over there, I'm sorry, it's a horrible place. Um, after that I did a year in, um, Imperial Charing Cross with MO and that's how we met. Um I have had the pleasure of taking the S JD twice, once before the situation was once before my UK, the F 25 standalone program and once for the M sra um I II think I did. All right because I'm now a GPS teacher in Northwest London. So I'm just gonna start off the presentation. I'm gonna share my screen. Um OK. Uh If anyone can't see my skin, just, just shout out and if there are any questions at all, just um tell me just, you know, shout them out or we can do questions at the end. So this is what we're gonna cover today. Uh What they're shitty is what you can expect in terms of types of questions, how it's scored. We're gonna looking at some couple of practice questions just to get a feel of what, what they like um some resources and then see if there's any questions at the end. Um So the S JD test or the professional development test is basically um uh it, it's, it's a way to test how you should behave and pose with a challenging professional dilemma. It's nothing to do with your clinical cells whatsoever. Um You should assume that you're working at the level of an F two doctor. This is important in me answering questions and that this is taken from the M SRA S ad website where they say that this test does not contain any knowledge of procedures or policies that would only be applicable to UK specific localities, which means this is not supposed to disadvantage you as an I MG. I think what they, what this means is that all they expect you to do is behave in a professional doctor with the, you know, standard forward facing moral compass. Uh And you should be all right. Um What does the S JD test? So basically the GMC has a guideline called The Good Medical Practice. I'm sure some of you are already familiar. Um If you have trouble going to sleep, you can go through this 30 page document which I've linked here. Um And, and it sort sort of had has um these characteristics that they expect anybody a doctor in the UK to have. Um So mainly summarized it, it, it can be divided into professional integrity, coping with pressure and empathy and sensitivity. And these are the themes that they're testing on you on during um the actual test. Um Professional integrity is things like being honest accepting your own mistakes, acting in the patient's best interest, uh taking responsibility for actions and confidentiality. Confidentiality is really quite important and they do test you a lot um on that. Um Then there's coping with pressure, managing your own emotions, admitting when you need to uh admitting when you're experiencing difficulty, you need some help, remain calm under pressure, you're self aware and you can manage criticism well. And then there's empathy and sensitivity towards patients and colleagues, a patient centric approach acting in an open and non judgmental manner. Um These are broadly the things, the themes that you will find in these questions. Um So there's two main types of questions that will appear in the sat one other rank where there's ranking and there's multiple choice. So ranking questions, you will be given 4 to 5 options and you have to rank them from most appropriate to least appropriate these actions. And this is quite important because this is when it gets a little confusing, you should think of them as discrete options and not something you do chronologically. Um So just see how that particular option if done in it's in just that uh that particular option, how effective would that be in resolving the situation? Um And then you have the multiple choice questions where you will be given a scenario, there'll be eight options and you have to choose the three most appropriate ones. Um The these three actions together should be thought of as a bunch and together they should fully resolve the situation. So that is quite different from, from the ranking questions. Um How are they scored? Uh There's now 50 questions in the M sra down from 58. Thank God for that. Um There is no negative marking at all answers are compared to a predetermined key. So the closer your answers are the key, the more marks you get, but you don't have to get all the, all the uh ranking done exactly as uh the premeditated key to get all the points. So you will score marks even if you get two out of three or three out of five, that sort of thing. Um So always rank them and, and you know, just, just put down something if you're not sure. Um So I thought we could go through just a couple of practice questions um from each, each type of um uh question mark and then we can see what uh what the GMC, these are all taken from the M sra um practice paper by the way. And um we can see why they have ranked a certain way and that can sort of give you a little bit of idea what they're expecting. Um So I'm just gonna read out the question and give you a few minutes to go through the options. You are a foundation doctor working in a hospital, Mr Ahmed, a 62 year old man is awaiting the results of tests for bowel cancer. The ward clock tells you that seven of his relatives are at his bedside. His eldest has specifically asked you not to disclose the diagnosis to Mr Ahmed that is cancer and he, as he feels that his father could not go. Your consultant calls from the endoscopy suite and advises you that the diagnosis is sigmoid carcinoma ran the following up or a actions in response to the situation. So I'm just gonna give you a few minutes to just go through um the answers. If you'd like, you can put the answers in the chat box and we can um go through what the correct planking is, right? So the answer is A DC and B and we'll go through why that is. So here, this scenario is testing your empathy and sensitivity. That's the sort of um part of good medical practice they're trying to focus on a is the most appropriate. So that's tell the ward clock that you will see the son in the side room prior to speaking to Mister Armed to discuss the reason for his request. Now, this particular uh option addresses the problem. Um like the the it's it's the most accurate way of addressing the problem. You, you ask the son, why does he not want, what is, what is the reason? Uh And at the same time, you're also not breaking that autonomy that Mr Ahmed has to know about his condition. So that's the most appropriate D which is ask Mr Ahmed whether he would like his son to be present when discussing his results again, still a good option because you're talking to the patient, it's a very patient centric approach. You are addressing uh the fact that Im Ahmed has uh autonomy in deciding his own treatment. Uh But you're not really to thinking to the son and um and trying to figure out why he doesn't want his dad to know. So that's less, less that uh uh that's less good from a and then see, has Aral so clear, the bright side as you would need to discuss the findings of the colonoscopy with Mr ah privately. So this is not a great option. So the good thing about this is that you're still respecting Mr Ahmed's autonomy and you're still telling him what's wrong with him, but you're not, you're not taking the relatives um uh request into consideration at all. And option B which is the least appropriate is tell the ward clerk to advise the son that you have to respect Mr Ahmed's autonomy. So this is the least appropriate because a you are not addressing the problem yourself, you're, you're pawning it off to the ward clock which is, which is quite inappropriate. Um And also you're not really uh exploring with the son what the issue is and you're just sort of giving him an instruction that this is what it is hence, um these are, this is how this question would be, right? Um So you've got another one. You're a foundation to doctor working in Respiratory Allen is a fellow f two doctor working in the same ward as you, you see him when you're not at work. Alan tells you that he will refuse to have the seasonal influenza vac vaccination around the following options. I'll give you a few minutes to read through the answers again. Right. So the answers here would be a DA B EDC. So here they're trying to assess your professional um integrity. That's the part of G MCA. Good medical practice. They're trying to assess A which is ask Alan why he's refusing to have the influence of vaccination is the most appropriate because you are exploring the problem. You're asking why um B which is inform Alan about the rest to patient is if you just see it in its, in its um as a, as an isolated option, it is still a good option. You're telling him that um it's, it's a patient centric approach. You're focusing on the patients, but again, you're not exploring what exactly is the issue. Why Alan doesn't want the vaccination an option. E which is tell Alan Alan, the GMC that he should be vaccine says he should be vaccinated against common serious common people diseases. Again, slightly less good because you are telling him what the professional code is, but he's likely to know this anyway, you're not really exploring why he doesn't want this uh vaccination. And also a thing to say about this particular question. So the GMC doesn't mandate that you should be um uh vaccinated against, against uh communicable diseases, but it does advise it. Um So I think if this question said the GMC uh requires you to be vaccinated, it will probably be ranked even lower because that is untrue. And then option D is it is not fair on his F two colleagues. If he gets influenza, they have to cover his work due to sickness also not very appropriate because it's not a very patient centric approach. You're sort of um uh focusing on how it will affect the workload and how it will affect the team and see s tell Alan, he should get the influenza vaccination again, not helpful at all. Um You know, doesn't really address any of the issues, doesn't really address why he should get the vaccination. Um So this would be how this would be rent. Um So we're gonna do one couple of questions about the about the ranking questions. So out of these, in these, out of these eight options, you have to choose three that are the most appropriate. So you're an F two doctor working in pediatrics, you're just about to leave the hospital after a long day on call. When the nurse asks you to take a telephone call from Sarah Davies her, her three year old son, Ben has been admitted three times in the past month with abdominal pain, investigations have all been normal. Ben has the same pain again this evening. When you speak to Sarah, she wants to know why the doctors have been unable to find out what is wrong with Ben and she is concerned about his health. She is becoming upset. I mean, to be honest, you, you, you probably just leave but for the purposes of the S JT, just think about what is the most appropriate things. I'll let you read through them one, right? So the three most appropriate actions would be ad and H so A which is reassure Sarah that previous investigations have been normal, seems fairly reasonable. You know, you're reassuring the patient, um D which is our to call the GP out of hours service again, entirely appropriate because you're finished with your shift. Um, the GMC in any of these scenarios you will come across more does not expect you to work beyond um, what, what uh is expected of you. Um And this is we have a, so if there is a GP out of our service that is available, I think that's perfectly reasonable. And he asked Sarah more about Ben's abdominal pain. So it's entirely possible that the abdominal pain has changed in, in, in, in how it is, has been and now may have some red flag symptoms. The first thing to do would be, um, to ask a bit more about the pain itself and then, um, decide the steps from there. So, if you think of these three things, um, together they should reasonably re, you know, resolve the situation in, in the world of, sat, not in real life, I don't think. But, um, that's, that's, that's how you should think about these questions. Um, so there's another one, um, you're on a medical ward round when the consultant tells you that your f two colleague Emily is uh, is to perform a pleural tap under. Mr Lucas Emily tells the consultant that she is competent to do the procedure. However, Emily told you a few days ago that this was a procedure that she had not yet performed. You have performed this procedure several times, choose the three most appropriate actions. Ok. Um So the most appropriate here would be BCN H. So B is explain your concerns to Emily again, entirely appropriate. Tell her, you know, why, uh why you think she shouldn't perform the procedure? C is offer help with the procedure again, entirely appropriate. And he just ask Emily to tell her consultant. Um So these three seem entirely appropriate, but if you look at the other options, they are not um quite, quite appropriate. So you can, you can do it the other way around as well. You can rule out the ones that are not, um, that don't quite fit, so insistent performing the procedure yourself again, slightly, not, not, not the best way to deal with it. Um Explain your concerns to the consultant, so you're skipping the step and you're not actually addressing it with your colleague and going escalating it to a consultant which again, GMC does not like explain your concerns with Mr Lucas. Quite strange, why does Mr Lucas care? Um you would probably want to discuss it with the medical team, get advice from the medical defense organization seems a little bit unnecessary to be honest and then bring the issue up at your next foundation teaching session also quite unnecessary and also not very nice. So, um I if you, if you look at this particular option, you can go the other way around and see whi which, which ones fit in, fit in the best. So, um in my two attempts of SAT, um II developed some rules of thumbs that there were, there are no way exhaustive to the SAT at all, but they're just sort of some things to keep in mind when you're answering, answering. Um, the questions, it's important to remember that the SAT is a very subjective test. It doesn't have a clear right or wrong, like uh like clinical problem solving. So it does depend a little bit on whoever's set the question paper. How, what they think the correct thing to do is it is there is a little bit of subjectivity in there. Um The way you wanna look at, it is think of like the best, the most idealistic person, the most, you know, does things correctly kind of person, you know, in your life and like multiply that by 10 and that's who they want you to be. For the S JC, it doesn't really reflect real life scenarios, but, you know, it is what it is, they think it's important. So the first thing that is most one is always explore if there's a question that says this person refuses to do such and such or um doesn't want such and such always the first option would be explore with them. Why? That is the case that will always be the most um appropriate um answer in that scenario, um attempt to resolve the situation yourself first and then escalate. So always try to see what you can do and whichever option has saying um oh II would tell the nurse to do such and such or I would tell uh my colleague to do that would always be ranked below you yourself dealing with that situation. Um Then you, you should ask yourself, does this action directly address the problem at hand? This is more important for the ranking questions. So if you just took that option in isolation, does it actually address directly this problem or is it something that you would probably do in that scenario peripherally? But it doesn't quite address what the problem is. Um Never break confidentiality. Um Unless there is a risk of harm to the other person. So these, these, I think there is some recent changes to go through the guideline. But apart from um scenarios like HIV or D VLA, um you don't really break confidentiality um for the patient or if you know, if a relative ask them or anything of that sort, um, forget about hierarchies entirely. So if you, there will be questions like you, the consultant comes in and you smell alcohol on their breath like you, you don't think of it as I can't escalate, I can't talk to my consultant about this. The first most appropriate option would be I'm gonna, you, you try to address that with the consultant, so there's no hierarchy really. It's your responsibility as per the GMC to um speak of, you know, to address any kind of um growing practice that is happening. Um And the SEC, the, the next one is pretty much sort of similar in that line. Um You take responsibility when you're witnessing wrong practices. So whether it's a colleague or it's a senior or it's a nurse um uh basically on them if necessary, but like address it with them and sort of, you know, don't just let it go even if it's like small things like somebody's missing teaching for um something that's not work related, silly things like that always take responsibility in the ranking questions, all options should go together. So when you go through the three options that you have selected. They should sort of make sense as, as a bunch and they, it, it won't happen. That one just seems, um, odd. Um, the odd one out than, than the other two. And the last is I think, follow your gut. So all of these, like I said, in the beginning, uh, are things you would do with, as somebody who is, you know, a safe doctor with a very reasonable sort of understanding of what is right and what is wrong. Um There will be scenarios, especially uh when you start doing questions that there will be 22 or three things that you will feel like, oh, I'll probably do both of these, which is entirely true. You would in a real life scenario, do two of those options put together. But again, ask yourself the questions um previously, is this addressing the issue? Is this uh am I exploring the problem and follow your God on what seems more right than wrong? Um So resources. Um So I did quite um so, so in my, I did SJ twice and the first time that I did it, I had no experience of NHS whatsoever. Um And I was quite, quite worried about it. What was quite helpful at that point was this third point which is 12 to 20 Rules A S JD. It's a youtube series. It's two Im GS who have made these like videos of basically these Rules of thumb, sort of similar to the ones that I mentioned in the previous slide and they helped me quite a lot to, um, sort of have a, have a baseline understanding of what they were expecting. So I would recommend that if, if, um, you know, there's, you, you don't think you have a base baseline understanding of the S JT. Um, for the M SRA I did the past medicine question bank and the EED Question Bank. I think the, uh, e past Medicine Question Bank was slightly more useful than em mea. But I think the things that I found the most useful are these first two, the M SRA and the UK FP O practice test. So these practice tests, they don't have very many questions. I don't think there may be about 20 or 30 each. Um, but they are set by the GMC and like I said before, because there's subjectivity, the question banks that are sent set up by past medicine and other sort of these, um, these websites, they, they will always be slightly different to what is set by the GMC because again, it depends on what the, what the, um, person who's setting the question thinks is right. But with these question banks, because they're coming directly from the, from the GMC, they are the most reliable. Um, and the, the explanations that they have put down for the questions are very good to sort of understand what exactly it is that they're looking for um the UK FP O S practice as the questions will be different to what you will expect in the M sra. They have things like you have to rank them as rank answers as extremely desirable, undesirable, that sort of thing. That's not what do you need to pay attention to. But again, they have explanations for those answers and that's the bit that is helpful. So that is probably my uh these two probably are, are the gonna be the most useful. But like I said, just remember, there is a little bit of luck and a little bit of subjectivity that goes into this test. Um It's not something that you should rely on for your M SRA score. Your clinical problem solving test is what you should rely on your M sra score. Both the times I did, I thought I came out thinking this was absolutely horrible. I failed it, but I ended up doing all right. So like, don't, don't think about it too much, just do the best you can and you will be all right. And that's it. If you have any questions, let me know. I will stop sharing my screen um right. Any questions at all? I don't know how it works. My um Thank you. So for that very uh informative and stimulating uh presentation uh over the next couple of minutes, we'll be taking questions. Uh You can just put your questions in the chat. If you've got any ones, please. I had, they did a very good job but nobody understood. I think we'll have to see. Right. I don't think there are any questions. Um, but if there are just, just, you know, uh, my husband number, whenever if there's anything that you need to know, let me know. I can give my other, I can give you the slides my, if anybody wants them. Yes. Ok, I'll be fine and that's it. Ok. Uh And in the absence of any questions, uh thank you everyone for attending this, this session. Uh I hope it's been quite um useful and um with regards to um the examination process itself, uh it's like she said, uh there are quite a number of resources she has attached to the, to the slides that we can also uh use in our preparation and uh wish everyone all the very best. Uh Thank you very much. Ok, thank you. Thank you. Thank you. Goodbye. Hm J II. Do I like though.