Dental Core Trainee

Situational Judgement Test Practice Content

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.

There are two parts in this practice paper, each with a different type of question. Please
read the instructions carefully before attempting the questions.

Please note:

• The Situational Judgement Test consists of two 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.

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PART 1

In this part you will be presented with scenarios followed by five 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.

Note: There can be no tied ranks, i.e. you cannot give 2 options the same rank.

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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.

Response Instructions: Rank in order the following actions in response to this situation (1= Most
appropriate; 5= Least appropriate).
Discuss with your educational supervisor* how you can improve your time
Option A
management skills

Option B Ask the dental nurse if she provided the negative feedback

Inform your educational supervisor that you do not think that the feedback is an
Option C
accurate reflection of your performance

Option D Ask your fellow colleagues for feedback on your time management skills

Ask your educational supervisor if other colleagues have commented on your time
Option E
management skills

Key AEDCB

Question 1
Key Rationale
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.
E This action shows 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.
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.
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.

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B This is confrontational and targeting a colleague. This challenges the anonymous
nature of the MSF and is not an appropriate way to seek further relevant information
to the feedback you received, making it the most inappropriate response.

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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 six years. You notice that she is reluctant to even sit in the dental chair.

Response Instructions: 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 six 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

Key CEADB

Question 2
Key Rationale
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.
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.
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.
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.
B This is the least appropriate action as it is judgemental, shows a lack of empathy, and
ignores the sensitivity of Jess’s anxiety.

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 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.

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

A Deal with the elderly patient’s bleeding temporarily then respond to the call

Reassure the elderly patient that you will return to help him once you have
B
responded to the call

C Ask another dental colleague if they can assist the elderly patient

D Establish how urgent the call is before taking further action

E See to the elderly patient to permanently stop the bleeding, then respond to the call

Key ADCBE

Question 3
Key Rationale
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.
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.
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.
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.
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.

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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.

Response Instructions: 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

Request to be moved to a different community dental clinic with a clinical supervisor

Option D
experienced in placing stainless steel crowns
Speak to Rayan about arranging training sessions within a paediatric department to
Option E
learn how to place stainless steel crowns

Key AEDCB

Question 4
Key Rationale
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.
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.
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.
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.
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.

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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.

Response Instructions: 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

Key ACDBE

Question 5
Key Rationale
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.
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.
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.
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.
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.

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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.

Response Instructions: 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

Suggest that Taylor has the root canal re-treatment first, then has the crown fitted
Option D
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

Key CBDAE

Question 6
Key Rationale
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.
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.
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.
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.
E This violates the patient’s safety and best interests and is a clinically unsound
judgement. As a result, you compromise Taylor’s care.

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PART 2

In this part you will be presented with scenarios, each followed by eight 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 THREE options which together are the most appropriate
response to the situation, given the circumstances described.

Note: There can be no more than three answers, i.e. you cannot put four answers if you
think that more than three are appropriate.

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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.

Response Instructions: Choose the THREE 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

Advise the patient that she can book an appointment for another day with a different
Option G
dentist if she wants

Ask the patient how you can make her comfortable with continuing to have you as her
Option H
dentist

Key BGH

Question 7
Key Rationale
B B, G and H are all appropriate actions in response to the scenario.
B demonstrates candour and empathy for the patient.
G
G&H demonstrate an ability to keep your emotions under control in a challenging
H situation by addressing the patients concerns in a respectful and non-defensive way.
Comments on A does not solve the dilemma as there are no alternative dentists.
the incorrect C, although viable, does not help solve the patient’s immediate annoyance.
response D and E are both defensive answers that may result in adverse outcome.
options F is an irrelevant answer as the patient has not stated that they want to complain.

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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.

Response Instructions: Choose the THREE most appropriate actions to take in this situation.

A Inform Jayden that you have injected the local anaesthetic

B Inform Jayden immediately that the needle has broken inside his mouth

C Advise Jayden of the practice’s complaints procedure

D Seek advice from a more experienced dentist on how to proceed

E Advise Jayden that the procedure may take longer than originally planned

F Ask Jayden if he is experiencing any pain

G Attempt to locate and retrieve the needle

H Stop the procedure

Key BDH

Question 8
Key Rationale
B H is appropriate as it allows B and D to be completed. B is necessary as this
demonstrates duty of candour. D is necessary as it escalates a situation that is it out
D
of a DCT’s competence.
H
Comments on A violates duty of candour and is therefore not appropriate.
the incorrect F shows a lack of clinical insight and does not keep the patient’s safety in mind.
response G is also inappropriate as DCTs would not have the necessary clinical skills to
options retrieve the needle and shows a lack of willingness to seek advice/assistance.
E is similar to G and therefore would not be appropriate.
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.

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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.

Response Instructions: Choose the THREE most appropriate actions to take in this situation

A Reiterate to Yuri the importance of brushing her teeth

B Explain to Yuri that radiotherapy can sometimes affect patients in this way

C Acknowledge to Yuri that you understand it must be very difficult for her

D Advise Yuri about the ways of minimising the impact of radiotherapy on dental health

E Ask Yuri about her experience of radiotherapy

Explain to Yuri that maintaining dental health should take priority over the appearance of
F
her teeth

G Ask Yuri about her other dental issues

H Ask a dental nurse to comfort Yuri

Key BCD

Question 9

Key Rationale

B All these responses demonstrate a patience-centred approach that shows empathy

and a sensitive approach. For example, C shows empathy, B explains the problem to
C
Yuri, and D helps to resolve the issue.
D
Comments on E and G are viable close alternatives; however, they are focussed on a clinical
the incorrect response as opposed to taking a patient-centred approach.
response
options Both A and F are also clinical, however, also disregard’s Yuri’s concerns and lacks a
non-judgemental and courteous approach to the issue.

H would be wrong as it is not for the nurse to comfort the patient in this situation.

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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.

Response Instructions: Choose the three 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

Inform Mrs Fisher that her son will need to give permission for his information to be
Option E
shared

Contact Mrs Fisher’s son to ask him for permission to share the information with his
Option F
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

Key BEH

Question 10
Key Rationale
B 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
E
demonstrate the protection of confidentiality of the son’s information as a patient. As
H part of H, acknowledging the Mrs Fisher’s frustration is also an appropriate action but
data protection guidelines are more important.
Comments on G is the worst action to take as it clearly violates the patient’s confidentiality. All other
the incorrect responses are viable, however, are less appropriate as they do not address the
response dilemma here which is that Mrs Fisher is insisting on you breaking the data protection
options guidelines. A may seem like an appropriate course of action, but given Mrs Fisher is
already frustrated, this may just add to her annoyance.

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 Glossary Terms

Clinical supervisor 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 A trainer who is selected and appropriately trained to be

supervisor 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 A medical treatment facility specialising in emergency medicine

Department and the acute care of patients who present without a prior
appointment.

Interim review of A check halfway through the DCT year with your educational
competency supervisor to check in on your progress. This feeds into the end of
year review of competency.

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