Approaching Situational-Behavioral/Acting MMI Questions in a Medical School Interview
Throughout many years since its introduction as an objective measure for interviews, the MMI has evolved to incorporate and screen for a candidate’s qualities. The keen interviewee often hears whispers or watches videos about uniquely or challenging MMI stations, such as the publicly available example from Calgary in which an applicant must build a structure using puzzle pieces. Yet, while seemingly frightening, these stations are often the zebra among horses. As of the date of this entry, situational behavioural/acting (SBA) is a highly common MMI question format and this blog will focus on exemplifying and debunking this question type.
SBA stations often include providing the candidate with a scenario and asking them how they would address the circumstances. An example of this can be as follows: “You are a third-year medical student who has just witnessed a nurse pocketing a patient’s personal belonging. What would you do? / (or if Acting) Please enter the room and speak with the nurse”
The situation presented in these stations is sometimes designed to trigger inherent biases or incomplete conclusions. In this case, it is somewhat suggested that the nurse may be stealing from the patient, but basing one’s interactions around this assumption can demonstrate a limited ability to reason with other possibilities. Instead, the prudent candidate should first gather more information if possible in an acting station, or acknowledge the possible presumptions but work to address each possibility.
In practice, a well contemplated response may sound like the following:
“I would first talk with the patient to try to understand what role the nurse plays for them. Perhaps all will become clear immediately with the patient mentioning this particular event. I want to assess for if the patient may be within intimate care of the nurse such as if they were a family member or specialized helper. Secondly, I would like to assess for the patient’s state of mind since this may be a case in which the patient believes that the nurse’s actions are helpful, but in reality, they are being tricked. If nothing arises from this, I would then talk with the nurse in a private setting….”
Other responses can be equally as effective: the main idea is to highlight your reasoning by justifying your actions and outlining your goals.
The major suggestions I can recommend an interviewee to do include;
1) Remain cognizant of and preventing one’s inherent biases from taking over.
Rather, the applicant should work to gather information.
2) Acknowledge gaps in information and create a working plan inclusive of these gaps.
Some stations intentionally leave conditions or situations ambiguous. Showing an initiative to consider different possibilities and creating alternate plans if alternate conditions held true demarcates an individual with strong foresight.
Acting puts the statements exemplified above into practice. However, during acting, you may learn new information about the nurse-patient relationship which forces you to make new decisions. Additionally, skills such as communication, negotiation, ability to manage stress may be tested depending on the actor’s responses and the goal of the station.
