This is your Clinical Interview. You have 2 minutes to read the following clinical vignette. After this, you will be allocated 15 minutes for your clinical interview.
You are the SHO in the Emergency Department. You are asked to see a 28 year old man who has presented with dizziness. He is otherwise fit and well. The triage nurse asks you to review him in the triage bay urgently because his observations are abnormal.
His observations are:
HR 180bpm
BP 90/62
SpO2 99% on room air
RR 31bpm
Temp 36.8C
This mock contains more questions than you will be able to go through in a 15-minute interview. This is reflective of the real interview where interviewers are given an option of a few questions they can ask the candidates in the 15-minute time frame. Questions in red are mandatory.
You should choose a range of questions over the course of the 15 minutes that will enable you to assess the candidate on the following four domains:
It is your duty to keep track of time so that you are able to ask a reasonable spread of questions that allow the candidate the opportunity to score points in all four domains. Aim to spend about 5 minutes on each of the three assessed domains.
You can only ask the questions verbatim, as they are written. You may repeat the question if the candidate seeks clarification. For the ABCDE assessments, you may confirm findings with the candidate (for example: yes, the airway is patent. Or ‘there are no added breath sounds to auscultation’).
Mandatory question at start of interview:
“Have you read and do you understand the clinical vignette?”
Proceed to interview once candidate has confirmed this.
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What team members would you like to involve in the management of this case and what roles could they play?
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– Senior ED colleagues (ED Registrar or consultant): to advise about management of the patient.
– Junior ED colleagues: to help with scribing and carrying out practical tasks related to patient care.
– ED nurses and healthcare assistants: help with attaching patient monitoring, cannulation, blood-taking, or processing a VBG sample.
– Outreach nurse specialists: often valuable facilitators in the management of acutely unwell patients who can offer practical and some clinical help.
– Porters: to help physically transfer the patient to a monitored bay (most likely resus).
– Cardiology registrar: their presence is not immediately indicated. However, in a young patient with what appears to be a tachy-arrhythmia without any other underlying cause, it is likely they will require cardiology follow-up.
Airway | Look | No obvious obstruction |
Feel | Breath is felt from patient’s mouth | |
Listen | No added noises | |
Measure | N/A | |
Treat | Patent airway, nothing to treat | |
Breathing | Look | No cyanosis |
Feel | Equal bilateral chest movement | |
Listen | Normal breath sounds throughout | |
Measure | – SpO2 99% on room air. RR 31bpm. | |
Treat | No current indication to treat breathing | |
Circulation | Look | Flushed skin |
Feel | Warm peripheries, regular pulse. No peripheral oedema | |
Listen | Difficult auscultation | |
Measure | – Capillary refill 2 seconds. HR 180bpm, BP 90/61mmHg | |
Treat | – Large bore IV access, blood samples (Troponin, FBC, U&E, CRP, LFTs), VBG | |
Disability | AVPU | Alert. GCS 15/15 |
Blood glucose | 7 mmol/L | |
Abdomen | No abnormalities | |
Pupils | Equal and reactive to light | |
Exposure | Look | No abnormalities |
Feel | No abnormalities | |
Treat | N/A |
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Have you ever had to lead a high-pressure situation and how did you deal with it?
Do not get tunnel vision due to the scenario you have been presented. High-pressure situations are not confined to acutely unwell patients or cardiac arrests. You may also have had to take the lead on a high-pressure family discussion, project, teaching programme, or interaction and conflict with colleagues.
You should aim to spend no more than 30 seconds on describing the pressure of your situation and the rest of your answer on how you overcame the pressure. Reflect on how the pressure made you feel or react.
Your interviewers will be keen to hear about what tools you use to deal with stepping up to leading under pressure. Some tools to deal with leading high-pressure situations include asking for appropriate help, going back to basics (e.g., ABCDE with an acutely unwell patient; information-seeking instead of blame in a conflict), communicating clearly, drawing on the rest of your team’s talent and skill to overcome a problem, and being open to suggestions from other team members.
Is there a role for workplace-based assessments in training?
– Do not fall for the common mistake of talking generally about assessments. This is an interview about YOU, so talk about how you use workplace-based assessments to improve your training opportunities and experience.
– Workplace-based assessments are widely used throughout anaesthetics training.
– Be aware of recent anaesthetic curriculum changes since 2021 that have seen a transition of assessments from a ‘box-ticking exercise’ (eg. signed off for central line insertion) to more holistic assessments of a trainee’s competence (eg. feedback on management of a patient with difficult vascular access requiring central venous access).
– Assessments form a vital role in monitoring a trainee’s progress, providing formal constructive feedback and forming evidence of training progression throughout the year.
– These tools are not meant to ‘test’ if a trainee is competent to carry out a particular task independently. Instead, they are meant to provide feedback on how a trainee can continually improve their practice regardless of which stage of training they are at.
– Give examples of how you use workplace-based assessments in your current practice to complement your training and improve your own clinical or non-clinical skills.
– Talk about what kind of feedback is useful and how, as you become more senior in your own career, you intend to provide meaningful feedback and assessments for the juniors you will be supporting. This shows reflection not just on how you receive feedback but also on how you give feedback in assessments.
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Decision making | Reflective practice | Working under pressure | Global rating |
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Scoring system:
1 = unsatisfactory
2 = weak
3 = typical
4 = very good
5 = outstanding
See a guide to the scoring matrix section of this question bank.
1. What domains did the candidate give very good or outstanding answers for?
2. What domains do you think the candidate could work on?
3. Please provide feedback on the candidate’s style of interview. Consider their eye contact, body language, pace and clarity of speech. Do they have any tics, habits, or quirks that do not come across well in their interview?
Don’t be afraid to give honest feedback!
It can be tempting to give generic positive feedback to your partner, e.g. ‘that was really good, I wouldn’t change anything’ . Both of you will benefit from constructive criticism. Think of any way your partner may be able to improve. Reciprocal constructive feedback is the key.
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