Common SJT Scenario Types and Quizzes – Introduction (MSRA SJT)

Common SJT Scenario Types

Common SJT Scenario Types MSRA

Common SJT Scenario Types MSRA

This guide deconstructs the Common SJT Scenario Types MSRA. In the Professional Dilemmas paper, success is not just about medical knowledge; it is about recognising the specific “Game Mechanics” of each question format, from ranking tasks to resolving ethical clashes.

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Welcome to the Common SJT Scenario Types section.
This page teaches you how the MSRA SJT structures its questions, how to approach different formats, and how to think in a consistent, GMC-aligned way — regardless of the scenario.

These are the five scenario types you’ll encounter:

  • Best of 3 (Single Best Answer)

  • Rank 5 from Best to Worst Action

  • Situations with No Perfect Option

  • Multiple Correct but Prioritisation Required

  • Professional Dilemmas with Conflicting Priorities

Every type rewards safety, honesty, fairness, competence, communication, documentation, escalation and dignity — but the strategy differs slightly by format.

Below is the complete, high-yield MSRA playbook.

🌟 Universal Priorities (Work for ALL Scenario Types)

Think of these as non-negotiable SJT behaviours.

1. Immediate Safety First

  • ABCDE priorities

  • Time-critical harms

  • Safeguarding

  • Capacity red flags

  • Suicide/violence risk

  • Sepsis, ACS, anaphylaxis, stroke window

2. Early Escalation

  • Inform the right senior early

  • Safeguarding team / site manager / consultant

  • Don’t delay escalation “to gather more info”

3. Create Capacity

  • Delegate safely

  • Divert non-urgent bleeps

  • Set a regroup time

  • Allocate tasks with clear ownership

4. Communicate Clearly

5. Document + Plan

  • ODT (Owner–Deadline–Threshold)

  • Legal basis for sharing info

  • Clear follow-up plan

6. Equity & Dignity

  • AIS adjustments

  • Avoid assumptions

  • Respect identity, beliefs, disability, literacy

7. Learn & Close the Loop

  • LFPSE / PSIRF if safety event

  • Brief reflection

  • Share learning appropriately

Golden Tie-Breakers (Use When Two Options Look Good)

These rescue you when two answers seem equal:

  • Prevent irreversible harm first.

  • Pick actions that buy time or widen the safety net.

  • Prefer specific actions over vague intentions.

  • If two actions are both safe → choose the one that creates capacity.

Scenario Type 1: Best of 3 (Single Best Answer)

You’re given 8 options.
Pick the three most appropriate actions — not in order.

What the exam wants

Three independent, immediately actionable, risk-reducing steps.
Not a sequence puzzle.

Mini-Algorithm

  1. Identify all actions that reduce risk in the next 5 minutes.

  2. From these, keep the actions with escalation or capacity creation.

  3. Add one action that clarifies plan/documentation if it doesn’t delay safety.

Auto-Green Flags

  • “Attend/review now.”

  • “Call registrar/consultant/site/safeguarding.”

  • “Follow sepsis protocol / ECG now / treat per guideline.”

  • “Use professional interpreter.”

  • “Document plan clearly (ODT).”

  • “Same-day safeguarding referral.”

  • “Divert non-urgent bleeps.”

Auto-Red Flags

  • Delay (“later today”, “wait and see”).

  • Unsafe delegation (HCA assessing chest pain).

  • Dishonesty.

  • Using family as interpreter.

  • Public blame.

  • Editing notes retrospectively.

Mini-Phrases That Signal Good Options

  • Stabilise

  • Escalate

  • Delegate safely

  • Time-box

  • Document

  • Safeguard

  • Professional interpreter

  • Candour

Scenario Type 2: Rank 5 from Best to Worst Action

Order 1 = best → 5 = worst.

What the exam wants

A ranking based on time-criticality, risk reduction, then clarity of communication.

Ranking Ladder

  1. Immediate life/limb-saving actions (ABC, sepsis, anaphylaxis, ACS, stroke, K⁺ 6.5).

  2. Risk-containing enablers (escalation, isolation, safeguarding referral, create capacity).

  3. Core communication (professional interpreter, candour, mental capacity steps).

  4. Documentation/coordination (ODT, handover, updating records).

  5. Admin/nice-to-have (routine calls, non-urgent tasks).

Fast Checks

  • If two options are both “good”, pick the one that prevents deterioration fastest.

  • Unsafe delegation & dishonesty = always bottom.

Scenario Type 3: Situations with No Perfect Option

Choose the least harmful and most transparent action.

Playbook

  1. Stabilise (or prevent foreseeable harm).

  2. Escalate early.

  3. Proportionate workaround (short-term consent, rapid review, interim plan).

  4. Document rationale (capacity/best interests; legal basis for sharing information).

Look For

  • Time-limited plans

  • Review points

  • Best-interests decisions with capacity reassessment

  • “Share without consent if risk” + clear documentation

Avoid

  • Coercion

  • Long delays “until morning”

  • Keeping secrets in safeguarding

  • Public confrontation

Scenario Type 4: Multiple Good Options (Prioritisation Required)

Several actions could be done — but the SJT wants your ordering.

Filter Good → Best

  • Will harm occur if this waits 15–30 minutes?
    → Higher priority.

  • Does this create capacity for more safety?

  • Is there a time window (e.g., antibiotics, ECG, potassium)?

Typical Order

Time-critical → enablers/capacity → key communication → documentation → admin.

Scenario Type 5: Professional Dilemmas with Conflicting Priorities

What the exam wants

Strong integrity + GMC-aligned decision-making.

Priority Hierarchy

  1. Patient safety + dignity

  2. Candour & honesty

  3. Fairness & equity

  4. Organisational goals

  5. Personal convenience

Good Responses Often Include

  • Politely refusing unsafe shortcuts

  • Offering a workable, safer alternative

  • Escalating persistent pressure

  • Documenting concerns and mitigation

One-Minute Answer Builder (Use Before Selecting Answers)

S – Safety: What prevents harm right now?
E – Escalate: Who must be informed now?
A – Assign: Delegate safely with clear responsibility.
C – Communicate: Interpreter, candour, consent, safeguarding.
D – Document: ODT + legal basis + plan.

Mnemonic: SEACD.

ODT Micro-Template (Documentation)

Owner – who is doing what
Deadline – by when
Threshold – when to escalate urgently

Example:
“Nurse Patel to cannulate by 14:20. Reg to be called if BP < 90. Regroup 14:30.”

Common High-Yield Traps (ALWAYS Low Scoring)

  • Using family as interpreters

  • Waiting for consent when there is active safeguarding risk

  • Editing notes to hide an error

  • Public blame or shaming colleagues

  • Unsafe delegation

  • First-come-first-served instead of risk-based triage

  • Delaying high-risk reviews for admin

  • Ignoring AIS reasonable adjustments

  • Failing to escalate due to fear of upsetting colleague

Quick Spotters — Strong Options Often Contain These Phrases

  • “Review now / attend immediately”

  • “Follow protocol / treat per guideline”

  • “Call registrar/consultant/safeguarding/site manager”

  • “Use a professional interpreter”

  • “ODT plan documented”

  • “Same-day referral / lawful basis recorded”

  • “I’m sorry this happened — here’s what we know and what we’ll do next.”

Tie-Break Examples

Safety vs Communication

Safety always first — unless communication is the safety action (e.g., interpreter needed before consent).

Escalation vs Documentation

Escalate first, document after.

Two Safety Actions Both Good

Choose the one that:

  • prevents deterioration faster, or

  • widens the safety net.

10-Second Ethics & Law Ping

  • Consent/Capacity: maximise capacity; best interests only if necessary.

  • Candour: open, honest, apologise, next steps, document, LFPSE.

  • Safeguarding: share without consent if risk; record lawful basis.

  • Equality: AIS adjustments, accessibility, no discrimination.

Mini Mnemonics Recap

  • SEACD – Safety, Escalate, Assign, Communicate, Document

  • ODT – Owner, Deadline, Threshold

  • PACE – Pause, Assign, Clock, Escalate

  • FAIR – Find facts, Address behaviour, Include adjustments, Record & refer

References

FAQs

Q1: What are the common SJT scenario types in the MSRA?
Best-of-3, Rank-5, dilemmas, prioritisation and conflicting priorities.

Q2: How can I improve at MSRA SJT scenario questions?
Use safety-first frameworks, escalate early, apply SEACD, avoid unsafe delegation and delays.

Q3: What is the best approach to Best-of-3 questions?
Choose three independent, immediately actionable, risk-reducing steps.

Q4: What is the fastest way to revise SJT formats?
Use mnemonics (SEACD, ODT), review frameworks and practise high-yield scenarios.

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