Interview skills and practice

1. Interview skills and practice Edwina Holbeach Michael Kirk Richard Nasra 2018

2. Outline of this lecture 1. Hints and Tips 2. Group practice and discussion of questions

3. Hint # 1 Apply widely • Check the PMCV website • Know your closing dates • Rank as many hospitals as you can • Check all hospital websites for jobs outside the match • Apply rural as well

4. Hint #2 First impressions • Arrive on time • Dress the part –clothes, shoes, hair, nails, jewellery, bags • Body language • Be confident, not arrogant • Smile • Shake hands • Maintain eye contact • Address the panel by name • Turn your phone OFF.

5. Hint # 3 Research the hospital • Look at their website • strategic plans, ethos, population base, vision, missions, commitments, special services • Call your friends that work there • Do a tour • Be able to indicate what it is that makes them desirable to you, and how it fits into your plans for training.

6. Hint # 4 Prepare your answers • Anticipate what questions might be asked • Prepare answers • Practice your responses out loud and with friends

7. Hint # 5 Framework and structure • Sign post your structure – use key words to indicate what you are going to talk about • Makes your story easier to follow • Don’t be cluttered in your story – be focused on your key points • Shows organised thought

8. A framework for Clinical questions • ?Risk Assessment: • ?Resuscitation needed • ABC’s, • triage and prioritise, • ?met call or code blue, • escalate care • Assessment • History, examination, charts, medications, collaborative history, family (but target this) • Special features or risk • Differential diagnosis • Management • Referral/ Notification • Escalationif needed • Inform consultant/ registrar • Inform family/ NOK • Referral to other team • Handover!!

9. A framework for Behavioural Questions • Have examples you can adapt • Consider risk and safety, environment • to yourself, the patient or family, staff • Privacy • How do you approach the problem 1:1 initially • How do you approach the systems issues • Escalation processes • Resources you can draw on • Policies, guidelines, processes

10. A framework for Behavioural Questions • Why do we ask these questions? • Think about what the health service is looking for when they ask these questions • Generally: • Conflict resolution skills • Professionality • Team work skills • Personal wellbeing insight • Hospital Quality/ Risk Management processes • Make sure you have thought of some examples in advance. Take your time to think of a good one before answering

11. A framework for Behavioural questions STAR principle • Situation • briefly outline the story you want to talk about • Task • detail your goal, how you analysed the situation, focus on key tasks • Actions • what you did about it, how you did it, why you did it • Resultand Reflect • what happened

12. Hint # 6 “Show” don’t “tell” • Give examples to show how your skills in that area • Eg “I have good communications skills” is very generic • Give evidence or a story that allows the interviewer to engage with you and understand your skills • How will these skills benefit the organisation or the role

13. Hint # 7 Personalise the answer • Always answer in the “I” or first person • I will …. • I did …… • How you would resolve the problem • It gains rapport and shows confidence

14. Practice Practice Practice

15. Good and Bad examples…

16. Why do you want to work here Qs • Why are you applying for an HMO3 General job at Northern Health ? • Where do you see yourself in 5 years? • I can see you have never worked at St Elsewhere’s Health, what made you apply here? • Northern values are respect, compassion, passionate, dedication. Tell us how you use one of these values in your work?

17. Behavioural Questions • Give an example of when you had to work with someone who was difficult to get along with. How/why was this person difficult and how did you handle it? • Prompt:How did the relationship progress? • Describe a situation where you had a conflict with another individual, and how you dealt with it. • Describe a leadership role of yours outside of work. Why did you commit your time to it? How did you feel about it?

18. You have worked a 13 hours shift (2 hours after when your shift was supposed to end) and are asked to stay back to help in theatre by the Surgeon for an emergency case that is about to start. What do you do? • Prompts: what if it is 11pm and you are rostered to start at 7am tomorrow. • You are an evening cover shift and are on the paediatric ward when the father a 17yo girl telephones and asks for a medical update. She was admitted with abdominal pain for investigation. What do you tell him?

19. Mrs W is admitted with pneumonia. This is on a background of dementia, usually home alone, but some increasing paranoia symptoms noted by the visiting carers. She has been commenced on IV antibiotics, but the nurses page you because she is increasingly agitated and has pulled out her IV cannula. How do you manage this situation? • Prompt: How does the Medical Treatment Act come impact on this situation.

20. Questions • You are on a cover shift and asked to see Mr W who is 3 days post laparotomy w adhesiolysis for SBO, you are asked to see him due to reduced conscious state. What would you do. • You are in the Emergency department when Ms W comes in. She is a 61 year old female with a history of obesity, Type 2 DM and has presented with sudden onset chest pain. What would your initial management be?

21. It is 8pm at night and ward staff page you to see Mr K who is a 38 year old male in hospital for treatment of subacute bacterial endocarditis. He is a known IVDU. He has been in hospital for one week. He is angry with how a student nurse spoke to him and has been yelling at her and the senior nurse a the staff station saying he is leaving. How do you handle this situation? • What are they looking for in this case? • Conflict resolution and Communication skills • Safety for staff- immediate and delayed (welfare/ debrief for nursing student after the event) • Discharge against medical advice process: • Risk assessment- especially need for IV Antibiotics in IVDU patient- IV line in the community? • Capacity assessment • Documentation • Escalation/ Notification (ie- notify treating consultant and ID team- when?) • Follow up plan- ?GP/ Clinic etc

22. Mrs Halima is a 91 year old Arabic speaking women who is from home with her family who provide support for domestic and personal ADLs. She has presented to hospital with abdominal pain and a CT scan reveals metastatic cancer, unknown primary. Your consultant asks you to arrange a liver biopsy of a lesion to determine primary origin of her cancer. The family request that Mrs Halima not be told she has cancer. What would your approach be to this situation and request? • What are they looking for in this case? [this is a REALLY hard one for a clinical question!] • Cultural awareness (this is not an uncommon request!) • Exploration of why family made this request- don’t assume it is cultural! May be that the patient actually has advanced dementia and won’t be able to understand the discussion. • Balance between cultural awareness and legalities of provision of care/patient autonomy • Communication skills around above • Consent process for liver biopsy • Consideration as to whether Liver biopsy is ultimately needed (will chemo be an option)

23. Questions • You are called to the ward to see Mrs W. She is a well 62 year old female with no past medical history who is due for discharge today after having had a fractured finger pinned. The nursing staff inform you that they have accidentally administered the wrong medication to her- she has received 25mg metoprolol that was meant to be given to Mrs M in the bed next door. What do you do? • What are we looking for: • Open disclosure • Apology • Risk assessment for managing complication of error • Prevention of repeat error: Riskman, exploration of how this occurred.

24. Can you tell us about the most stressful situation you have found yourself in at work? • Prompts: How did you handle it? What could you have done differently? What did you do for self care after the event? • Tell me about a situation where you had to solve a difficult problem. What did you do? • Prompts: What was the outcome? What do you wish you had done differently? • What is the most difficult decision you have ever had to make at work? • Prompts: How did you arrive at your decision? What was the result?

25. Questions • Describe a situation that required you to do a number of things at the same time. • Prompts: How did you handle it? What was the result? • Tell me about a time when you worked with a colleague who was not doing their share of the work. How did you handle it? • Tell me about a time when you had to work on a team that did not get along. What happened? What role did you take? What was the result?

26. Questions • Can you tell us about a time when you decided that the condition of a patient you were treating had deteriorated to a point where there was no further curative treatment possible and the patient was going to die, and the patient and family should be told • Tell us about a situation where your directions were incorrectly carried out by a member of nursing staff

27. GOOD LUCK!PRACTICE!!!

28. References • http://biginterview.com/blog/behavioral-interview-questions • This site has a number of examples of how to answer some tricky questions like What is your greatest weakness? Where do you see yourself in 5 years? Why do you want to work here? • https://www.monash.edu.au/students/career-connect/apply-for-a-job/interviews-sample-questions.html

29. Extra questions…

30. Questions • Can you tell us about a time when a patient or family member complained about their care in the hospital or clinic • Can you tell us about a time when you were required to take a leadership role to resolve a conflict situation within a workplace • Can you tell us about a time when you had to organise the discharge of a patient with complex problems from hospital

31. Questions • Please describe a time when you experienced difficulty in obtaining an investigatory procedure for a patient, such as a CT scan. • Can you tell us about a time when you made a mistake that had an impact on a patient • Tell me about a time when an experience, inside or outside of medicine changed the way you practice

32. Questions • Did you turn up to all the education sessions this year. If not, why not. What do you think can be done to improve junior staff attending? • When was a time you working in a team that did not work well and how was it resolved? • Tell us a time you received negative feedback and what steps you took to improve on it

33. Questions • Your post op Hartmanns procedure patient has low urine output. How do you manage this?