Family Medicine Professional Choices Test (FMProC) is Situational Judgement Test (SJT) that is designed to assess applicants’ judgement regarding situations encountered in the workplace or during training. Applicants are presented with a set of
hypothetical based scenarios and asked to make judgements about possible responses. Applicants’ responses are evaluated against a pre-determined scoring key to provide a picture of
their situational judgement in that particular context.
An example of one FMProC scenario is the following question which request ranking the appropriateness of responses according to your judgement.
Question
Having just been present at code white for which a patient did not survive, you are asked now to inform the relatives of the patient's death. Your work shift ends in 10 minutes. What would you do?
Rank in order the following actions in response to this situation (1=Most desirable, 2=Somewhat desirable, 3=neutral, 4=Somewhat undesirable, 5=Most undesirable).
A. Ask the most-responsible-nurse in the Emergency Department to give the family a some coffee meanwhile you search for a resident who is willing to take this responsibility.
B. Inform the family immediately of the patient's death.
C. Finish writing the notes from the cardiac arrest, compose yourself and arrange to meet the relatives in the family room.
D. Hand over the job to another colleague resident who have not break bad news previously to acquire hand-on experience.
E. Hand over the job to the doctor who is talking over from you.
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Answer:
Response A--> 5:
Sending some coffee to the family is commendable, but here it has a very dishonest purpose, which is to delay th einevitble. In any case it would be better to offer a cup of coffee to the family after the news has been broken rather than before. The main problem with this response however, is that you are asking the nurse to ask someone else to do the work when it is your responsibilty to ensure that the task is handed over.
Response B-->2:
It is important to inform the relatives as soon as you can but you must document the clinical episode and ensure you are 'ready' to face the family.
Response C-->1:
Even though your shift is ending, there are times when as a doctor, you will have to work late. We have a duty to all our patients, both alive and dead, and to teir relatives. It is always essential to document fully any clinical contact with a patient and before breaking bad news, you must ensure you are in a fit state to face the family. You are of no use to them if you are upset, tired or in a rush and you may affect their grieving in the long term if break the news badly.
Response D-->4:
Response E-->3:
It is never ideal to hand over a difficult situation to an other colleague but, if you do decide to hand this task over, it should be to the person who will be responsible: in this case, the doctor taking over from you.