What to Say When You Don't Understand the Panel's Question

The biggest mistake candidates make with patient conflict examples is treating it like a complaint story rather than a relationship story.

Before we get into today's episode, if you're prepping for your interview, make sure you're signed up to our free 5-day email crash course. It breaks down exactly what you need to do to stand out, and you can sign up via the link in the description. And the Academy waitlist is now open. If you want structured support for your consultant interview, join via the link in the description. In this episode, we're going to look at what to do when you don't understand the panel's question. We're going to consider a scenario where a mum was upset during a consultation, and we're going to give you a tip about how to flex your examples. Welcome to today's podcast. Hi, Becky, how are you?

I'm great, thank you. Great to be here.

Let's get stuck in. So first up, we've got a question from one of our Academy students. So this week's question is, how do I ask the panel to repeat or clarify a question if I don't understand what they're asking me? What would you say?

People are really nervous. It's, you know, it's a natural human thing that when you're really nervous, you're not listening as well as you normally do, and so maybe you didn't catch it or you didn't quite understand it. The panel want you to answer the right question, and they actually want you to have the best opportunity to show who you are in the best possible way. So it's absolutely fine if you don't get it. Just say, I'm so sorry, could you possibly repeat the question? So, you know, if you didn't hear it, just ask them to repeat it. If you didn't understand it, I think also just say, I'm so sorry, I don't quite understand what you're asking me. Could you possibly rephrase it? Um, and I think that that's a reasonable starting point, and I don't think any panel would mind.

No. And what you don't want to do is just assume or take your best guess at what they meant and then do a whole 4-minute answer on completely the wrong topic. Because they may or may not be polite enough to tell you that you've misheard or misunderstood. And so, yeah, if you're not sure, definitely okay to clarify. And particularly, we may have discussed this in a previous podcast episode, but if they use like a term that you don't know or you haven't heard of, or you know, some reports that they're asking you about that you've not heard of, that's, I suppose that's a slightly different scenario, which is that you do understand, you just don't know. And you can also ask to clarify there. They might say they can't give you more information because they might say, well, you know, part of the question is knowing what that means or what that is, but you can still ask. There's no harm in asking and they might point you in the right direction.

Yeah, I think that's fine. Look, I think if you're in this scenario where you actually haven't got a clue what you're being asked, and therefore you can't even begin to start, then you've got to try and pick up some points somehow, haven't you? So even if they, you know, knock off a mark because you needed a prompt or a clarification, that's better than scoring nothing.

Yeah.

So I could— I think it's probably even fine to say, sorry, can I just clarify? Is this a question about clinical governance? Are you asking me about risk here? You know, something like that. And then they might say, yeah, yeah, okay, just, you know, tell us about clinical governance. Then at least you've saved something from it. But I think the key message here is don't just blather on and hope that you're talking about something that they want to hear about, because chances are—

Well, there's two things, isn't it? That's at one extreme, and the other extreme is you just pass. And you just say nothing and you score zero. So yeah, you're wanting to find somewhere in between them that gives you at least, if you don't know what they're talking about, you can at least score a point or two without just completely passing the question.

Yeah. It's not Mastermind. You can't come back to the question.

Well, can you? I don't know.

Um, I, I don't know. I've never had anyone ask.

Oh, people have asked before, like about when you get to the end. If you pass on a question, can you chuck it in at the end before you leave? If they say, have you got any questions for us? This is a bit of a distraction from the topic, but yeah, if they say at the end, have you got any questions for us? Do you think you can just be like, well, when you asked me that question about the something report, I passed, but could I say X, Y, and Z?

That's a risky strategy. I'd avoid it if possible. But I suppose if desperate, you know, desperate times call for desperate measures.

Then the zero you're going to score. But I don't actually know if they would score you because it's already been and gone. It's over. But don't get yourself into that situation is the main thing. You don't need to be pondering that question. So now we're going to look at the golden example. This is one of the 5 golden examples that our students have put to us. We have the one we've got today is a conflict with a patient. What do you want to tell us what we've got?

Okay, so yeah, the scenario is, I was assessing a child with spina bifida who'd come in with bowel obstruction. While taking the history, I asked about folic acid in pregnancy. It was an unnecessary question that wouldn't have actually changed my management, and it visibly upset the mum having to revisit the story behind her child's diagnosis again.

Okay.

Oh, it's a bit awkward for this person, that must have been. What do you think?

It's a communication issue because clearly they shouldn't have said it. I mean, I know that is their reflection is that that actually wasn't necessary to say because they're kind of leading that up in the example. They realized it wasn't— it wouldn't change the management. One thing I would say is that when you're trying to tell the story, I would take out all the judgment stuff about it was unnecessary, it wouldn't change the management. Because that's stuff that really should come into the after part. That's you thinking back to why it happened, how it happened, how you handled it, what you did with it. So I'd keep the story just about the story, like, this is the facts of what happened. I don't know if I'd use this example as a conflict, 'cause I think the focus of the conflict example is, can you show that you can resolve conflicts with families? And the focus of this example is going to be I mean, it's a mistake, really. It's probably a mistake example better than a conflict example, because the focus of this is going to be how bad you feel and why you did it and how you resolved that with them. I don't know. So I don't think it's really the best. I would say not the best example. And then the other thing is it's a bit distracting because it's such a clanger to say in a conversation, and clearly they know that. So it does— focus a bit more about your communication skills than your conflict resolution skills. What do you think?

Yeah, I think I agree. I think, yeah, what we're looking for is that you can demonstrate steps of active de-escalation and just resolve conflict yourself. And I think this is probably a bit—

ouch!

It's potentially a good mistake example. Because what it does give you is that opportunity to show some real vulnerability.

Because it's an honest mistake, and you can show nice reflection. You know, they clearly realized immediately that— so it doesn't, in that sense, it doesn't make you think this is a bad communicator. It's someone who just said the wrong thing in the moment and reflects on it. And then I think a good focus would be your reflection on the— on how you resolved it, how you rebuilt the relationship with the family, and So it could be a nice mistake example.

Yeah, I mean, often we say to people, you know, don't use a communication example as your mistake because, you know, being a poor communicator in healthcare is a deal breaker. But it's also the case that we're all humans and we've all said something wrong in the moment, and it's how you repair that relationship. I think if this student can deliver the example in a way that demonstrates vulnerability, insight, growth and learning and all of those things, and they've come out the other end a better communicator as a result, then I think this could actually work really well for them. But it does, it does depend on how it sounds out loud coming out of their mouth. And, and that, that's why you have to practice this stuff out loud, because sometimes the way it sounds in your brain is not at all the way it sounds when you say it.

And a lot of it, what, what I, um, Often the conversation I have with our students is taking a step back and thinking about what the example says about you and how you're talking about it says about you, which is why the whole, you know, if it's a conflict with a colleague and you're just saying how you were right, it's showing something that you don't need to show to the panel and that the panel might feel a certain way about you. So just think about how it comes across. And so yeah, I think This could be— this, I don't think you'd come across badly, um, necessarily. I think you could present the example well, but I would use it as a mistake instead of a conflict. Great. Okay. And then we've got our interview question. This is where we kind of think through an interview question that's come up. So this interview question is, how would you handle a situation where a patient's family disagrees with the treatment plan you're recommending? What do you think about this as a question? Do you like it? You don't? What do you think?

I quite like it, um, because I think it's— it's something that comes up in practice. It's a, it's a chance for you to showcase, you know, who you are day to day and how you just navigate the tricky stuff that we have to deal with. Potentially it's an opportunity for you to show how you role model that behaviour to others and how you train others to do that too. And it's a chance for the panel to see a bit of who you are. So I quite like these kind of reflective questions that give a bit of insight into who the person is, because I think that what the panel is getting here is, who is this person going to look like as one of my colleagues?

Yeah.

And are they somebody that I wanna work alongside with? So I quite like it.

I do as well. I think it can lend people to going off in one particular direction. So I think the first thing is that this is a hypothetical. So you need to be able to recognize the difference between a hypothetical and a tell me about a time when. So it would be different from tell me about a time when a family disagreed with the treatment plan you were recommending. And so because it's hypothetical, you have to think of broad steps that you would— like a broad approach you would take to this case, to a case like this. Whereas if you pick one specific example, you will end up talking about how you address that specific example, and you potentially could miss broader steps. So I think it's important to just remember it's hypothetical and take a step back. But I do think in these sort of hypotheticals, you can give a line about your experience. You could give a specific example, but it would need to be very short. And not get you— not get distracted into your whole answer being about that. Or just a bit of context. So you could say, well, actually, this happens pretty commonly because, you know, I work in a paediatric emergency department, and often there's families that have come in and want antibiotics for their child, whereas I don't think it's indicated. So it's quite a common scenario, and this is the broad approach I take. So something like that gives the panel a bit of context that you're— what you're thinking about, that you're thinking along the right lines.

Mm-hmm.

that this is an everyday kind of situation for you and you've got experience. And so, that then sets up the rest of the answer to show, all right, well, she's coming from a place of knowing what she's talking about here, rather than it just being an idea that you've thought about or an abstract thing that you're just pulling out of the air. So, I think that's a good strategy to start with.

Yeah. And I think also, just remember that you're trying to show a bit of senior-level thinking here as well. So, you can talk about what what you do with that patient and family in front of you in terms of handling the conversation, and then sort of thinking about the bigger picture. So think about, you know, what's the— you know, how do you make these decisions? Are there any kind of framework that you use? You know, if you're— is there a safeguarding element here? Is there a capacity element here? Is there, you know, any other frameworks that you use around your decision-making? And, you know, how do you sort of think about escalation if that's appropriate? So just kind of Taking a sort of zoomed-in approach to how you deal with this in the moment, and then a sort of bigger picture approach to show that you understand the wider context, because that's consultant-level thinking rather than just my one patient.

And there's a big difference between the family that doesn't want— that wants antibiotics and you don't want to give it, and the family that doesn't want some significant treatment And you feel it's essential. So it's like a big— you can have a big example of this where you're involving the legal team, and— or you can have a small example where you resolve it yourself between the family. And yeah, I think just acknowledging that there's a range is probably helpful as well, because it shows that you, yeah, you can think about the types of situations where this might come up.

Yeah, I, I— so I like it. I think there's an opportunity to show quite a lot of The way that you think, who you are, how you interact with families, how you see the future.

You love a reflection.

People should start asking this more. It's great. I love a reflection question.

Okay, so then let's look at our tip and trick of the week. So we're going to talk this week about how to flex your examples. And I think this is something that we try to encourage our students to do. And it can be hard to do because we've got the 5 golden examples that they think of. And so you get very focused, like you're fine if they ask you about a mistake or duty of candour or whatever. But then they ask another version of, tell me about a time when, and people can struggle to relate that to one of their golden examples. But you can flex them quite easily if you just take a pause and a step back. What sort of ones have you seen come up where people can kind of flex them?

So, one that's come up that I quite like is, tell me about a time when you underestimated the emotional impact of something you said or did on a colleague. Now, I've subsequently asked this in a few mock interviews to people, and often people are like, oh my gosh, I've got nothing. But actually, the people that do this well are the ones who think, okay, hang on, I have got an example I can use. I can either— I can probably flex my conflict with a colleague example. You know, you can talk about— you will just focus on the more emotional side of it, you know, and how you supported that colleague and got through that together. Or, I mean, or if you were using, as we discussed earlier, that example around— oh, that was with a patient. But if you had something similar with a colleague where, you know, something had landed badly and that was a mistake that you were thinking of using, then equally you could flex that example as well. I think it's just a case of just taking a moment and thinking, right, hang on, I've got the catalogue of examples that I've prepared here. Can I flex one of these appropriately and make it fit this and just focus on a different aspect?

Because it's, um, I think it's, it's much better to choose an exact— use an example that you have prepared, that you've thought about, that you know is safe, that you know is good to use, and also you know how to talk about it, rather than suddenly going to, oh my goodness, this isn't one of the 5 golden examples. I need to think, why did Becky tell me to just prep 5? I need to think of something else. And so, then you're like, try and pluck whatever comes into your brain first, which is probably not the best one. And if you can instead just think, okay, come on, something out of these 5 golden examples, there's so many different elements. You're just pulling out the duty of candor part, but it's also a difficult conversation. It's also a safety incident. It's also whatever, giving someone difficult news.

Yeah.

It could be giving negative feedback to a colleague if you then had to go and explain what happened to the colleague. So, just think a bit more broadly about it, and then you will pretty much be able to flex these for any example they ask you, because you've got a range of them, there's different elements to it, and that's usually a much better way to approach it.

Exactly. And particularly with that duty of candour example, I often think that that's a really flexible one, because, as you say, it's got all of those elements. It's also managing risk. It's also learning from incidents. You know, you could probably talk about DATIX reporting in there. You could talk about, you know, wider team learning. There's so much that you can get out of that one example if you've prepared it appropriately and you understand all of the component parts to it. That's why we are so painfully retentive about getting people to prepare these examples and to really understand all of the different steps involved in them.

So yeah, just practice. Practice looking at different scenarios and then thinking, how can I flex my 5 rather than how can I find another example to answer this? And I think that will help you prep better. Cool. Okay, we're going to wrap up there. Thank you for another lovely episode. I will see you next time.