Table 1 Example items for the clinical problem solving and situational judgement tests

Reduced Vision

You are reviewing a routine drug chart for a patient with rheumatoid arthritis during an overnight shift. You notice that your consultant has inappropriately prescribed methotrexate 7.5 mg daily instead of weekly.

A. Basilar migraine

B. Cerebral tumour

C. Cranial arteritis

D. Macular degeneration

E. Central retinal artery occlusion

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

F. Central retinal vein occlusion

G. Optic neuritis (demyelinating)

H. Retinal detachment

I. Tobacco optic neuropathy

For each patient below select the SINGLE most likely diagnosis from the list above. Each option may be selected once, more than once or not at all.

A. Ask the nurses if the consultant has made any other drug errors recently

B. Correct the prescription to 7.5 mg weekly

C. Leave the prescription unchanged until the consultant ward round the following morning

1. A 75 year old man, who is a heavy smoker, with a blood pressure of 170/105, complains of floaters in the left eye for many months and flashing lights in bright sunlight. He has now noticed a “curtain” across his vision.

D. Phone the consultant at home to ask about changing the prescription

E. Inform the patient of the error