UCAT Situational Judgement: Appropriateness Questions & Techniques
Understanding the UCAT Situational Judgement Test (SJT)
The Situational Judgement Test (SJT) is the final section of the UK UCAT (University Clinical Aptitude Test), used for medical and dental school admissions. Unlike the other subtests, SJT doesn’t measure cognitive skills – instead, it measures your capacity to understand real-world situations and identify appropriate behaviour in dealing with them. In other words, SJT presents you with realistic scenarios (often ethical or professional dilemmas) and asks you to identify the appropriate actions or responses.
Format: You have 26 minutes to answer 69 questions in SJT. Each scenario is followed by a set of questions (usually 2–6) related to that situation. The questions can be multiple-choice or ranking style.
What’s being tested: SJT scenarios assess qualities like integrity, empathy, teamwork, and ethics. They reflect the professional values expected in healthcare, as outlined by bodies such as the General Medical Council (GMC) and the General Dental Council (GDC). For example, themes such as patient welfare first, honesty, confidentiality, accountability, and respect for colleagues are very common.
Scoring: Your SJT performance is expressed in Band 1 (highest) to Band 4 (lowest). Full marks are earned if your response exactly matches the expert panel’s answer, and partial marks are given if your answer is close. A Band 1 indicates your judgments were very similar to those of experienced professionals, whereas Band 4 means your choices often differed greatly.
Preparation tip: The official UCAT advice recommends reading the GMC’s Good Medical Practice guidelines. This document outlines the principles of professional behaviour (e.g. putting patients first, working in teams, acting with honesty and integrity) and is essentially a blueprint for many SJT questions. Familiarising yourself with these concepts will help you recognise what should be done in a given scenario.
Appropriateness Questions and the Four-Point Judgement Scale
In SJT “Appropriateness” questions, you are presented with an action or response following a scenario, and you must judge how appropriate that action is in context. These questions use a special four-point rating scale in the UCAT. The answer options (from most to least appropriate) are:
🟢 A very appropriate thing to do – The action is an excellent or ideal response. It addresses the situation well, addressing or significantly improving at least one key aspect of the problem.
🟡 Appropriate, but not ideal – The action is okay to do and might help somewhat, but it isn’t the best possible solution. It’s a reasonably acceptable response, albeit with some limitations or better alternatives available.
🟠 Inappropriate, but not awful – The action is not really a good idea and generally should be avoided. However, it’s not absolutely catastrophic – it wouldn’t make the situation much worse, or there may be minor mitigating factors. (In other words, it’s a poor choice, but not the worst thing one could do.)
🔴 A very inappropriate thing to do – The action is definitely the wrong thing to do. It would likely aggravate the situation or violate fundamental principles, and it should absolutely not be done.
This four-point judgement scale is at the heart of UCAT appropriateness questions. It’s important to understand each category clearly. An easy way to think about it is to group them into two broad halves: the first two options are basically “appropriate” responses (acceptable to do), and the last two are “inappropriate” responses (shouldn’t be done). When answering, first decide whether the action is appropriate or not in general – this will immediately narrow down your choices. In fact, you earn partial credit as long as you pick the correct side of the spectrum (for instance, saying something is inappropriate when the best answer was “very inappropriate”). Once you’ve determined the side, consider the nuance: is it just okay or truly ideal? Is it somewhat bad or outright terrible?
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Variations of Appropriateness Questions
Most appropriateness questions follow the format above, asking you to rate a single action. However, you might encounter a few variations in the UCAT:
Appropriateness with Quotes: Instead of an action, you’re judging the appropriateness of a specific statement or reply (usually in quotation marks) that someone might say in the scenario. The same four-point scale applies (often phrased as “a very appropriate thing to say,” etc.), focusing on whether that comment is suitable or not in context.
Most/Least Appropriate: In these, you’ll be given several possible actions (often 3) and asked to choose the most and least appropriate responses. Essentially, you still apply the same principles – identify the best action (most appropriate) and the worst action (very inappropriate). These typically use a drag-and-drop interface in the exam.
Two-Option Format: Recently, UCAT introduced a new question type in which actions are judged as “Appropriate” or “Not Appropriate” (or “Important”/“Not Important” for importance questions). This is basically a condensed version of the four-point scale – you must decide on which side of appropriate vs. inappropriate the action falls. Only a small number of these appear (they were trialled in 2022 and 2023), so you should be prepared for them, but the majority of questions still use the classic four-point scale.
No matter the format, the fundamental skill remains: judging the suitability of a response in a given situation. In the next section, we’ll go through strategies to do this effectively.
Tips and Techniques for Answering Appropriateness Questions
Mastering appropriateness questions is all about applying common sense through a medical ethics lens. Here are some key techniques and tips to help you consistently pick the best rating:
Know the Professional Principles:
As mentioned earlier, the scenarios in SJT reflect core principles of professionalism and ethics. Always consider factors such as patient safety, honesty, integrity, respect, and adherence to the proper chain of command. If an action would violate these fundamental principles (for example, hiding a serious mistake, disrespecting a patient or colleague, or putting someone at risk), it’s likely inappropriate or very inappropriate. On the other hand, actions that protect patients, maintain honesty, and seek guidance appropriately tend to be viewed as appropriate. Keeping the GMC guidelines in mind can guide your judgement – for instance, making patient care your first concern, working within your competence, being open and accountable if things go wrong, and treating colleagues and patients with respect.
Pay Attention to Your Role:
Always take note of who you are in the scenario – are you a medical student, a qualified doctor, a dental student, a nurse, or just a friend? The appropriateness of an action can change depending on your level of responsibility. Never overstep your role. For example, if you’re a first-year med student, it would be very inappropriate to independently tell a patient their diagnosis or to challenge a senior in a rude way, because that’s not your place. However, that same action might be appropriate if you were the doctor in charge. Similarly, as a student, you are expected to raise concerns to a supervisor (not handle everything yourself). Always ask: “Given my position, is this action expected or acceptable from me?” If not, it might be inappropriate even if the action would be fine for someone more senior.
Focus on the Action, Not the Scenario Outcome:
Some scenarios describe bad situations – e.g. a mistake has already happened, or someone else behaved poorly. Don’t get distracted by how upsetting or severe the scenario is; your task is to judge the response to that scenario, not the scenario itself. Even if the context is dire (say a patient was given the wrong medication), an action like calmly informing a senior and correcting the error would be very appropriate, whereas panicking or ignoring it would be very inappropriate. The key is to evaluate “does this response help or hinder in this situation?” rather than simply reacting to the emotional weight of the scenario.
Consider If The Action Addresses The Problem (and How Much):
When deciding between “very appropriate” vs. “appropriate but not ideal” (or between the two levels of inappropriate), think about effectiveness and consequences. A very appropriate action usually directly and sufficiently addresses the main issue at hand, even if it doesn’t solve everything perfectly. An action that is appropriate but not ideal might only partially address the issue or be a bit suboptimal (maybe it's helpful but slow, or it’s a correct action taken at the wrong time/minor scope). Similarly, an inappropriate but not awful action might be a misguided attempt that doesn’t really help (or a slight breach of etiquette), yet isn’t disastrous. In contrast, a very inappropriate action often ignores or worsens the main problem and could cause harm or serious fallout. Ask yourself: “Does this action solve anything here? Could it make things worse?” The more an action fails to solve the issue, or the more negative consequences it brings, the more inappropriate it is.
Don’t Assume One Action Excludes Others:
A common pitfall is to think you must choose the single “best” thing and reject all others. Remember that in many scenarios, several responses could be done in real life. When a question asks about one particular action, judge it on its own merits – is it appropriate at all to do? – not whether it’s the absolute best thing or whether another action would be better. For instance, if a colleague is struggling, one option might be “speak to them privately, and another “inform your supervisor.” Both actions could be appropriate to do together. If asked about “speaking to them privately,” you should rate it as appropriate if it’s a helpful step – even if you also think telling a supervisor is important. The question isn’t asking if it’s the only action to take, just if it’s a reasonable action among others. So don’t over-penalise an option for not solving everything on its own. If it’s a good thing to do as part of handling the situation, it’s appropriate.
Use a Two-Step Approach (Appropriate or Not → Degree):
As suggested earlier, first decide which side of the scale the action falls on – appropriate ✅ or inappropriate ❌. This helps ensure you at least get partial marks by avoiding completely wrong ratings. Then refine your choice: if you deemed it appropriate, ask, “Is it ideal or just acceptable?” If you deem it inappropriate, ask, “Is it somewhat minor or truly terrible?” This systematic approach can simplify your thinking. For example, imagine a scenario: “A classmate didn’t prepare for a group project, and you consider telling the teacher immediately.” First, decide whether that action is generally appropriate. Telling the teacher addresses the issue (the classmate’s lack of preparation) and might be justified if it affects the project – it’s not unethical or harmful, so it leans toward appropriate. But is it ideal? Perhaps talking directly to the classmate first would be better, so going straight to the teacher might not be the best first step – thus it might be “appropriate but not ideal” on the four-point scale. By contrast, doing nothing at all about the unprepared classmate might be inappropriate (neglects the issue), but not the worst (unless the project fails) so maybe “inappropriate but not awful.” This two-stage kind of reasoning can clarify your judgment.
Be Aware of Common Traps:
Some actions are almost never appropriate in professional scenarios. For example, lying or covering up a mistake is usually very inappropriate (honesty is crucial). Ignoring a serious problem or failing to act when someone could be harmed is also typically very inappropriate, because you must raise safety concerns. Confrontational or rude behaviour (like shouting at a colleague or “berating” someone) is inappropriate – even if you’re upset, professionalism requires composure. On the flip side, immediately escalating every minor issue to the highest authority can be “inappropriate but not awful” if it bypasses simpler solutions or proper channels. Recognise these patterns: actions that ensure safety, follow protocol, and show respect tend to be appropriate; actions that risk safety, break rules, or show disrespect tend to be inappropriate. With practice, you’ll start spotting these red flags and green lights quickly.
Trust Your Instincts – Don’t Overthink:
SJT questions can sometimes feel subjective, and it’s possible to over-analyse them. Remember that they’re designed to be answered with basic ethical common sense, not trickery. Once you’ve eliminated clearly wrong options, go with the answer that feels right based on the scenario and principles – your intuition as a well-intentioned future professional is usually on target. Overthinking might lead you to second-guess yourself and invent unlikely complications that aren’t in the scenario. Keep it simple: the exam isn’t trying to trip you up with obscure technicalities. If an action seems obviously good, it probably is at least appropriate; if it feels plainly wrong, it’s likely inappropriate. Also, remember the partial marking scheme – even if you’re unsure between two adjacent options, as long as you’ve got the right general side, you’ll score most of the points. So don’t agonise over one question for too long. Aim to be decisive.
Practice with Sample Questions:
Finally, the best way to sharpen your situational judgement is through practice. Use the official UCAT question banks and practice tests (available free on the UCAT website) to get used to the style. Practice helps you identify common themes and learn from explanations. After practising, review your answers – if you got something wrong, read why the correct answer is what it is. Over time, you’ll notice patterns (for example, how scenarios involving patient safety always prioritise action, or how scenarios about team disputes value communication and fairness). By test day, you’ll have an internalised sense of what’s appropriate in different situations.
Conclusion
Appropriateness questions in UCAT SJT are all about judging actions through the lens of a responsible, ethical medical professional. By understanding the four-point scale and applying the techniques outlined above – from using the GMC’s guidelines to methodically breaking down each response – you’ll become much more confident in tackling these scenarios. Remember, the UCAT isn’t looking for perfection or genius, but for sound judgement and awareness of professional values. With practice and a clear approach, you can reliably assess what’s appropriate or inappropriate in any given situation. This will not only help you score highly (ideally, that coveted Band 1!) but also prepare you for the kind of thinking you’ll use as a medical or dental student and future practitioner. Good luck, and trust yourself – with the right preparation 🤞, you’ve got this!
References
UCAT Consortium. Test Format and Scoring. (Accessed 2026) – Situational Judgement is a 26-minute subtest with 69 questions, scored in bands 1–4. Full marks are given for an exact match to the correct answer, and partial marks for answers that are close. It measures the ability to identify appropriate behaviour in real-world scenarios.
UCAT Consortium. Candidate Advice – Tips for the Situational Judgement Test. (Accessed 2026) – Recommends reading the GMC’s Good Medical Practice guide to understand the principles behind SJT questions.
General Medical Council. Good Medical Practice (updated 2024) – Outlines core professional values for doctors, including putting patient care first, working within your competence, being honest and acting with integrity, and treating colleagues and patients with respect. SJT scenarios are often based on these principles.
BluePeanut UKCAT Guide. UCAT Situational Judgement – Question Types and Strategies (2025) – Defines Appropriateness questions as those where you “rate how appropriate a particular action is in response to the scenario.” Emphasises that scenarios test ethical reasoning aligned with the expectations of organisations like the GMC and GDC.
