Dental Core Training (DCT) Situational Judgement Test (SJT) practice paper

A practice paper with answer key and rationales for the Dental Core Training (DCT) Situational Judgement Test (SJT).

Instructions

In this practice paper, you are presented with typical scenarios that a Dental Core Trainee encounters and you are asked questions about dealing with them. When answering the questions please consider yourself to be a Dental Core Trainee. We appreciate you may sometimes feel that you would like more information before answering. Please give your best answer based on the information provided in the question.

Please note the following.

  • The Situational Judgement Test consists of 2 parts. Each part has a different response format.
  • Read the instructions before each part carefully to make sure you understand the response format.
  • Some questions require you to mark more than one option. There is no negative marking.
  • There are 10 questions in this practice paper: 6 questions in part 1 and 4 questions in part 2.
  • Definitions are available for terms which have been marked with an asterisk (*). These definitions are included within the glossary of terminology at the bottom of the document.
  • Within this practice paper, answers and rationales are provided for you to review.

Responses to scenarios are usually actions taken to address the situation. Response options will be realistic, and the "best response" will always be included. For scenarios where you are asked to consider the appropriateness of actions (whether ranking or multiple choice), there will be a mixture of good, acceptable and poor responses to the situation, as judged by the Subject Matter Experts (SMEs). Completely implausible responses are not included as options.

Part 1

In this part you will be presented with scenarios followed by 5 possible responses. Answer the scenarios based on what you should do as a Dental Core Trainee.

This part contains 6 scenarios.

Rank each response in order of appropriateness, from the most appropriate (ranked as 1) to the least appropriate (ranked as 5), given the circumstances described in the scenario. Please do not consider these responses as sequential actions, or in order of priority, but rather as independent actions that you are judging in terms of appropriateness.

Please note that there can be no tied ranks, that is, you cannot give 2 options the same rank.

Question 1

As part of your interim review of competency* as a Dental Core Trainee, you receive Multisource Feedback (MSF) on your work performance from fellow colleagues. While most of the feedback that you received was positive, there was one negative comment about your time management skills which said that you regularly run late on appointments. Although you do sometimes run late on appointments, you think that overall you have good time management skills and that the comment is unfair. While the MSF is anonymous, you think that it was a specific dental nurse who provided that feedback.

Rank in order the following actions in response to this situation (1= Most appropriate; 5= Least appropriate).

  • Option A: Discuss with your educational supervisor* how you can improve your time management skills.
  • Option B: Ask the dental nurse if she provided the negative feedback.
  • Option C: Inform your educational supervisor that you do not think that the feedback is an accurate reflection of your performance.
  • Option D: Ask your fellow colleagues for feedback on your time management skills.
  • Option E: Ask your educational supervisor if other colleagues have commented on your time management skills.
Correct answer

AEDCB

Rationale
  • Option A: Is the most appropriate action as it shows that you are able to handle feedback and recognise who will be in the best position to help you learn different or better time management skills. In this scenario, your educational supervisor is in charge of your learning needs, therefore, they are the most appropriate person to help your development.
  • Option E: This action hows initiative to establish whether your time management skills are a concern to other colleagues. This enables you to determine who your actions have impacted and whether you need to take action. It is not the most appropriate action as it does not actively address your time management skills.
  • Option D: This action shows initiative to collate feedback directly similar to E, however, directly approaching your colleagues may seem confrontational. As a result, you may be less likely to get an honest response. Often, colleagues speak to their educational supervisors when it comes to sharing feedback about DCTs to respect confidentiality.
  • Option C: This action shows a lack of insight and defensiveness to criticism where the feedback may be valid. This could limit you improving in your time management abilities as you do not acknowledge what could be a potential issue.

Question 2

A patient, Jess, arrives for her appointment and tells you that she suffers with extreme dental anxiety following a bad experience that she had as a child. Jess also says that, due to her anxiety, she has not been to the dentist for the past 6 years. You notice that she is reluctant to even sit in the dental chair.

Rank in order the following actions in response to this situation (1= Most appropriate; 5= Least appropriate).

  • Option A: Direct Jess to anxiety management services.
  • Option B: Advise Jess that she should not have allowed 6 years to pass before seeing a dentist.
  • Option C: Ask Jess if she would like to discuss the specific cause of her dental anxiety with you.
  • Option D: Ask Jess to calm down so that you can safely assess her dental health.
  • Option E: Acknowledge to Jess that it must have taken courage to be here today.
Correct answer

CEADB

Rationale
  • Option C: This is the most appropriate action as it demonstrates empathy, a non-judgemental and sensitive approach to Jess’s anxiety, as well as trying to understand the cause of her anxiety.
  • Option E: Similar to A, this is a courteous response that provides reassurance to Jess and respects her personal circumstance. It is a sympathetic approach however it does not address or resolve the patient’s concerns.
  • Option A: This is a patient-centred action as it is prioritising Jess’s future care and thus demonstrates an acknowledgement to her safety and best interests. However, it shows limited engagement with the patient in terms of establishing rapport and trying to understand the cause of her anxiety for her current appointment.
  • Option D: This action shows a clear lack of insight to Jess’s anxiety and a lack of empathy. This may also result in an adverse outcome.
  • Option B: This is the least appropriate action as it is judgemental, shows a lack of empathy, and ignores the sensitivity of Jess’s anxiety.

Question 3

You are working on in an Emergency Department* when an elderly patient who is experiencing some minor bleeding after having had a dental extraction earlier that day, arrives on the ward. He insists that he needs to be seen to as soon as possible as he is worried about it causing further complications. You know that the elderly patient is on blood thinners and that it would take you about 20 minutes to permanently stop the bleeding. Your bleeper then bleeps with a call relating to another patient. You are unsure of how urgent the other call is.

Rank in order the following actions in response to this situation (1= Most appropriate; 5= Least appropriate).

  • Option A: Deal with the elderly patient’s bleeding temporarily then respond to the call.
  • Option B: Reassure the elderly patient that you will return to help him once you have responded to the call.
  • Option C: Ask another dental colleague if they can assist the elderly patient.
  • Option D: Establish how urgent the call is before taking further action.
  • Option E: See to the elderly patient to permanently stop the bleeding, then respond to the call.
Correct answer

ADCBE

Rationale
  • Option A: This action demonstrates resilience and the ability to prioritise in a high pressure situation. It is important to know how urgent the call is, therefore, a temporary approach to the bleeding, given the detail you are aware of, is the most appropriate action.
  • Option D: This is also an appropriate action, but as you have a patient in front of you who is bleeding, this comes in second place. Only after should you focus on finding out what the call is about.
  • Option C: Although a plausible action, under the high pressure situation of a patient being in front of you, by finding a different colleague, you are ignoring the patient and will be wasting time in attending to the call as well, therefore you are manging your own time ineffectively.
  • Option B: This demonstrates poor decision making and a lack of clinical insight. As a result, this shows a poor response to the high pressure situation and not prioritising the aspects of the dilemma appropriately.
  • Option E: This action shows lack of insight into the clinical priority on whether or not the call coming in is more urgent than the patient. It is clear in the scenario that it will take 20 minutes to permanently stop the bleeding, which is enough time for an urgent situation to develop adversely.

Question 4

You are working in a community dental clinic which sees many child patients daily. You would like to start using stainless steel crowns for some of the patients’ treatment plans, but you are not confident in doing so. You ask your clinical supervisor*, Rayan, if he would be able to teach you more about them. However, Rayan says that he does not have much experience using stainless steel crowns either and does not feel confident to teach you about them. Rayan suggests that you should continue using a different treatment method instead.

Rank in order the following actions in response to this situation (1= Most appropriate; 5= Least appropriate).

  • Option A: Speak to your educational supervisor* for support regarding your learning needs.
  • Option B: Attempt to try to place stainless steel crowns yourself.
  • Option C: Continue to use a different treatment method as suggested by Rayan.
  • Option D: Request to be moved to a different community dental clinic with a clinical supervisor experienced in placing stainless steel crowns.
  • Option E: Speak to Rayan about arranging training sessions within a paediatric department to learn how to place stainless steel crowns.
Correct answer

AEDCB

Rationale
  • Option A: This is an appropriate action to take as you are escalating to the most appropriate supervisor, which is the educational supervisor, thus you demonstrate that you are willing seek advice or assistance where appropriate.
  • Option E: This action demonstrates that you are taking responsibility for your own learning needs. It is appropriate to identify and suggest that to your clinical supervisor.
  • Option D: This action is not ideal as it demonstrates a lack of professionalism in understanding the complexity of such a request. Whilst it is possible, it is an unreasonable first response to the situation.
  • Option C: Following the clinical supervisor’s advice is a neutral action. It does not demonstrate a professional initiative for your learning needs and does not work on your weaknesses.
  • Option B: This immediately becomes a patient safety issue as there is a risk of an adverse outcome by performing a procedure that is not within your competence.

Question 5

Whilst checking your appointment list for tomorrow, you see that you are scheduled to treat a curved root canal. The last time you attempted this procedure on a different patient, you found it particularly difficult, and another dentist had to finish the procedure for you. You are not confident that you will be able to perform the procedure successfully.

Rank in order the following actions in response to this situation (1= Most appropriate; 5= Least appropriate).

  • Option A: Discuss your concerns with your educational supervisor*.
  • Option B: Request that a different dentist perform the procedure whilst you observe.
  • Option C: Asked to be supervised during the procedure tomorrow.
  • Option D: Ask a senior colleague for advice on how to better perform the procedure.
  • Option E: Perform the procedure as planned.
Correct answer

ACDBE

Rationale
  • Option A: This is the most appropriate action as your educational supervisor is able to give you the most relevant advice. You are demonstrating that you know when to seek assistance from in a suitable source, to help your development and to ensure you perform the procedure safely.
  • Option C: This action demonstrates that you are taking initiative to seek assistance from a suitable source which will enable you to perform the procedure without compromising patient care as you are being supervised.
  • Option D: This decision does show some initiative to request guidance on how to perform the procedure. However, as it is an informal request for guidance and you will not be supervised in the procedure, there is also an element of concern for patient safety.
  • Option B: Although a plausible action, this demonstrates a decision that does not allow you to progress your training and apply your knowledge. This also shifts the responsibility of the treatment which is not necessary for procedures within your competence.
  • Option E: This action is inappropriate as you are aware that you are not confident to complete the procedure but have not sought out advice, guidance or supervision to ensure patient safety when completing the procedure.

Question 6

You are in an appointment with a patient, Taylor, who would like to replace his discoloured front tooth with a crown. After taking an x-ray, you notice that the root canal filling is too short and there is evidence of a chronic infection at the end of the tooth. You inform Taylor that he will need root canal re-treatment first, but he tells you that he cannot afford to pay for both treatments and only wants a crown fitting. You are aware that if you fit the crown now, without root canal re-treatment, it is likely to fail.

Rank in order the following actions in response to this situation (1= Most appropriate; 5= Least appropriate).

  • Option A: Advise Taylor to seek the opinion of an alternative dentist.
  • Option B: Explore with Taylor how he could find a way to pay for both treatments.
  • Option C: Explain to Taylor the risks of having the crown fitted now.
  • Option D: Suggest that Taylor has the root canal re-treatment first, then has the crown fitted when he can afford to pay for it.
  • Option E: Agree to fit the crown, explaining to Taylor that he does so at his own risk.
Correct answer

CBDAE

Rationale
  • Option C: This action is the most appropriate as it focuses on the patient’s safety and best interests. You are complying with a duty of candour, having identified the risks, the patient must be informed of these to ensure they can make an informed decision.
  • Option B: This is a reasonable action as many practices have payment options, therefore you are demonstrating an understanding of Taylor’s personal/financial circumstances whilst keeping his safety and best interest in mind tailoring his treatment plan accordingly.
  • Option D: This action is viable as it shows a willingness to adapt the timelines of the treatment plan by taking into consideration Taylors personal circumstances. This action is a clinically sound judgement with patient’s safety and best interest in mind.
  • Option A: This action is plausible as patients are always welcome to seek a second opinion as it reassures the patient that you are not forming a treatment plan on finances. However, the treatment plan as stated in the scenario is clinically sound, and it is likely that alternative dentists will agree with the plan.
  • Option E: This violates the patient’s safety and best interests and is a clinically unsound judgement. As a result, you compromise Taylor’s care.

Part 2

In this part you will be presented with scenarios, each followed by 8 possible responses. Answer the scenarios with what you should do as a Dental Core Trainee.

This part contains 4 scenarios.

For each scenario select the 3 options which together are the most appropriate response to the situation, given the circumstances described.

Please note that there can be no more than 3 answers, that is, you cannot put 4 answers if you think that more than 3 are appropriate.

Question 7

You are reviewing the notes for your next patient. When the patient arrives, you begin discussing with her the appropriate treatment for the several cavities that she has. The patient looks confused and says, “I didn’t know I had any cavities” and you realise that you have been reading the wrong patients notes. You explain your error to the patient, who is noticeable annoyed and requests to be seen by a different dentist “who is competent”. You have felt particularly tired today and you are aware that no other dentists are available today.

Choose the 3 most appropriate actions to take in this situation.

  • Option A: Inform the patient that no other dentists are available today.
  • Option B: Apologise to the patient for your mistake.
  • Option C: Ask the patient if she would like to speak with a senior colleague.
  • Option D: Reassure the patient that you are competent, acknowledging you made an error.
  • Option E: Inform the patient that you have been very tired today.
  • Option F: Advise the patient about the complaints procedure.
  • Option G: Advise the patient that she can book an appointment for another day with a different dentist if she wants.
  • Option H: Ask the patient how you can make her comfortable with continuing to have you as her dentist.
Correct answer

BGH

Rationale

Options B, G and H are all appropriate actions in response to the scenario. B demonstrates candour and empathy for the patient. G and H demonstrate an ability to keep your emotions under control in a challenging situation by addressing the patients concerns in a respectful and non-defensive way.

Comments on the incorrect response options

Option A does not solve the dilemma as there are no alternative dentists. Option C, although viable, does not help solve the patient’s immediate annoyance. Options D and E are both defensive answers that may result in adverse outcome. Option F is an irrelevant answer as the patient has not stated that they want to complain.

Question 8

You are attending to a patient, Jayden, who is due to undergo a tooth extraction. You have administered a local anaesthetic injection in Jayden’s lower jaw, ready to commence with the procedure. As you remove the syringe from his mouth, you realise that the needle has broken inside his mouth. You cannot see the needle in the patient’s mouth.

Choose the 3 most appropriate actions to take in this situation.

  • Option A: Inform Jayden that you have injected the local anaesthetic.
  • Option B: Inform Jayden immediately that the needle has broken inside his mouth.
  • Option C: Advise Jayden of the practice’s complaints procedure.
  • Option D: Seek advice from a more experienced dentist on how to proceed.
  • Option E: Advise Jayden that the procedure may take longer than originally planned.
  • Option F: Ask Jayden if he is experiencing any pain.
  • Option G: Attempt to locate and retrieve the needle.
  • Option H: Stop the procedure.
Correct answer

BDH

Rationale

Option H is appropriate as it allows B and D to be completed. B is necessary as this demonstrates duty of candour. Option D is necessary as it escalates a situation that is it out of a DCT’s competence.

Comments on the incorrect response options

Option A violates duty of candour and is therefore not appropriate. Option F shows a lack of clinical insight and does not keep the patient’s safety in mind. Option G is also inappropriate as DCTs would not have the necessary clinical skills to retrieve the needle and shows a lack of willingness to seek advice/assistance. Option E is similar to G and therefore would not be appropriate. Option C is an irrelevant option as although something has gone wrong, there is not a case of negligence, and the patient has not indicated an intention to pursue a complaint.

Question 9

A patient, Yuri, who has recently had radiotherapy for cancer treatment attends the clinic. Her recent cancer treatment has caused her to have a range of dental issues. As a result of this, Yuri, has found it difficult to brush her teeth properly which is affecting her dental health. Yuri is very upset about the appearance of her teeth. You are aware that there are ways of minimising the impact of radiotherapy on dental health.

Choose the 3 most appropriate actions to take in this situation.

  • Option A: Reiterate to Yuri the importance of brushing her teeth.
  • Option B: Explain to Yuri that radiotherapy can sometimes affect patients in this way.
  • Option C: Acknowledge to Yuri that you understand it must be very difficult for her.
  • Option D: Advise Yuri about the ways of minimising the impact of radiotherapy on dental health.
  • Option E: Ask Yuri about her experience of radiotherapy.
  • Option F: Explain to Yuri that maintaining dental health should take priority over the appearance of her teeth.
  • Option G: Ask Yuri about her other dental issues.
  • Option H: Ask a dental nurse to comfort Yuri.
Correct answer

BCD

Rationale

All these responses demonstrate a patience-centred approach that shows empathy and a sensitive approach. For example, option C shows empathy, B explains the problem to Yuri, and D helps to resolve the issue.

Comments on the incorrect response options

Options E and G are viable close alternatives; however, they are focussed on a clinical response as opposed to taking a patient-centred approach. Both options A and F are also clinical, however, also disregard’s Yuri’s concerns and lacks a non-judgemental and courteous approach to the issue. Option H would be wrong as it is not for the nurse to comfort the patient in this situation.

Question 10

During a consultation appointment with a patient, Mrs Fisher, she asks you whether her son attended his dentist appointment after college last week. When you check the system, you see that her son did not attend his appointment and also that he turned 18 years old a few months ago. You inform Mrs Fisher that, due to patient confidentiality and data protection, you are unable to share this information with her, as her son is now an adult. Mrs Fisher becomes noticeably angry and demands that you tell her whether her son attended his appointment or not.

Choose the 3 most appropriate actions to take in this situation.

  • Option A: Direct Mrs Fisher to a copy of the practice’s data protection policy.
  • Option B: Advise Mrs Fisher to speak with her son directly about his appointment.
  • Option C: Apologise to Mrs Fisher for being unable to answer her question.
  • Option D: Ask your supervisor whether you should share the information with Mrs Fisher.
  • Option E: Inform Mrs Fisher that her son will need to give permission for his information to be shared.
  • Option F: Contact Mrs Fisher’s son to ask him for permission to share the information with his mother.
  • Option G: Inform Mrs Fisher that if she does not calm down, she may be asked to leave.
  • Option H: Acknowledge Mrs Fishers frustration about her son’s appointment.
Correct answer

BEH

Rationale

Data protection guidelines are quite clear in that as the son is an adult, without his consent, you cannot discuss patient details. As a result, the correct responses clearly demonstrate the protection of confidentiality of the son’s information as a patient. As part of option H, acknowledging the Mrs Fisher’s frustration is also an appropriate action but data protection guidelines are more important.

Comments on the incorrect response options

Option G is the worst action to take as it clearly violates the patient’s confidentiality. All other responses are viable, however, are less appropriate as they do not address the dilemma here which is that Mrs Fisher is insisting on you breaking the data protection guidelines. Option A may seem like an appropriate course of action, but given Mrs Fisher is already frustrated, this may just add to her annoyance.

Glossary terms

The below are definitions for terms throughout the practice paper which are indicated with an asterisk (*).

Clinical supervisor
Definition A trainer who is designated and appropriately trained to be responsible for overseeing a specified trainee’s clinical work in a clinical environment, providing constructive feedback during that training period, and informing the summative judgment at the end of that clinical training period and/or series of periods.
Educational supervisor
Definition A trainer who is selected and appropriately trained to be responsible for the overall supervision and management of a specified trainee’s trajectory of learning and educational progress during a clinical training period and/or series of periods. Every trainee must have a named educational supervisor.
Emergency Department
Definition A medical treatment facility specialising in emergency medicine and the acute care of patients who present without a prior appointment.
Interim review of competency
Definition A check halfway through the DCT year with your educational supervisor to check in on your progress. This feeds into the end of year review of competency.