MSRA Situational Judgement Flashcards

You are an FY2 doctor and you notice that a nurse has administered 10-fold the prescribed dose of a medication to a patient who is currently asymptomatic. What should you do first?

Answer: Assess the patient immediately, inform the nurse and senior, and complete an incident form

Patient safety requires immediate clinical assessment, transparent escalation to seniors, and formal incident reporting — delay or concealment are never appropriate.

During a busy night shift, a colleague asks you to co-sign a drug chart for a medication you did not administer or check. What should you do?

Answer: Decline to sign and explain that co-signing implies you verified the medication was given correctly

Co-signing a drug chart implies verification of administration; signing for something you did not witness is dishonest and constitutes a serious documentation and patient safety breach.

A patient asks you directly whether the operation they are about to have carries a risk of death. The consultant has not discussed this. What is the appropriate response?

Answer: Confirm that significant risks exist and ensure the consultant discusses them with the patient before proceeding

Patients have a right to information about material risks; if consent is inadequate the clinician must ensure it is corrected before surgery — deceiving the patient breaches the duty of candour.

You are called to see a patient who is clearly in pain but the nurse says no analgesia has been prescribed. The consultant is in theatre and not answering bleep. What should you do?

Answer: Prescribe appropriate analgesia within your competence and escalate through the registrar

Providing timely analgesia is a patient safety and dignity obligation; if the responsible consultant is unavailable, the registrar or on-call senior should be contacted to authorise appropriate treatment.

A medical student asks you to teach them a clinical skill on a patient who has not been asked for consent to be involved in student teaching. What should you do?

Answer: Obtain explicit consent from the patient before involving the student in any clinical interaction

Patients have the right to decline involvement in teaching; explicit consent must be obtained before any student interaction with a patient, even for observation.

You suspect a colleague who is an FY1 is struggling with serious personal problems affecting their clinical performance. The safest and most appropriate initial action is to:

Answer: Speak privately to the colleague to offer support and encourage them to seek help, and escalate if patient safety is at immediate risk

The GMC recommends a supportive approach first — talking to the colleague and encouraging occupational health or senior support — while escalating only if patient safety is compromised.