A nurse situational judgement test presents realistic ward situations and asks you to rank possible actions from most to least appropriate. This guide explains what the Viewpoint Nurse SJT measures, how its linked format works, a generic worked example, what the research says, and how to use the results well.

Why rapport matters in nursing

Clinical knowledge and technical skill are essential in nursing, but they are not enough on their own. Patients who feel listened to are more likely to say what is really worrying them, to describe symptoms accurately and to follow their care plan. Building that trust, often in a few minutes on a busy shift, is a skill in its own right.

The Viewpoint Nurse SJT assesses therapeutic rapport: helping a patient relax, trust you and speak openly so that you can understand and support them. It is one of a range of empathy-based SJTs developed following Norfolk, Birdi and Walsh's journal publication on the role of empathy in establishing rapport [1]. It measures communication skills, empathic sensitivity and related aspects of building rapport.

How the format works

The test is set in a hospital. Candidates imagine they are a locum nurse starting an early shift, with around 15 minutes for each of 4 patients in single-bed side rooms. The test follows 4 visits, each with 4 linked steps, giving 16 steps in all. Because the steps are linked, each situation develops as the visit goes on, much as a real conversation does.

At each step, candidates rank 4 possible actions from 1 (most appropriate) to 4 (least appropriate), giving each action a different rank. The test is untimed, so candidates can focus on judgement rather than speed.

A worked example

The following is a generic illustration written for this article, not an item from the Viewpoint test.

You enter the room of an older patient admitted yesterday. He is sitting with his arms folded and says, "Nobody tells me anything in here." Four possible actions are:

• A. Explain that the doctors will be round later and he can ask them then.

• B. Sit down at his level, introduce yourself, and ask what he would most like to know.

• C. Reassure him that everything is fine and he is in good hands.

• D. Check his chart first, then come back to talk to him.

Most experienced nurses would rank B first. It acknowledges his frustration, shows respect, and invites him to say what matters to him. D could be sensible, but walking away at that moment may confirm his feeling of being ignored. A passes the concern on to someone else, and C dismisses his feelings without finding out what they are, so it would usually be ranked last.

The aim is not to find a single trick answer but to show the judgement that skilled, empathic practitioners use.

What research says

Situational judgement tests are widely used in healthcare selection. Patterson and colleagues' review of SJTs in medical education found good evidence that well-designed SJTs predict later performance, are accepted by candidates and can assess interpersonal qualities that are hard to measure with knowledge tests [2]. Norfolk, Birdi and Walsh set out a model in which empathy supports rapport through understanding the patient's perspective and communicating that understanding, which underpins the design of the Nurse SJT [1].

The research also points to limits. SJTs measure judgement about what to do, which is related to but not the same as how someone behaves on a ward. That is why they are best used alongside interviews, references and clinical assessments.

Using a nurse SJT well

For employers, the Nurse SJT can be used early in recruitment to give consistent evidence about candidates' interpersonal judgement, or in development to open a conversation about patient communication. Interpret results in bands from Very Low to Very High and explore them at interview. For example, a candidate whose result sits in a lower band might be asked to describe a time a patient was frustrated and how they handled it.

For candidates, read each situation and all four actions before ranking. Think about what would help the patient feel heard and safe to speak openly, and remember that the order of all four actions matters, not just the first.

See the Nurse SJT page, our Nursing Comprehension Test, or our article on the benefits of SJTs.

Frequently asked questions

How long does the Viewpoint Nurse SJT take?

It is untimed. There are 16 linked steps across 4 patient visits.

Does it test clinical knowledge?

No. It assesses therapeutic rapport and interpersonal judgement, not clinical knowledge.

How do I answer?

At each step you rank 4 actions from 1 (most appropriate) to 4 (least appropriate), using each rank once.

Can I prepare for it?

You cannot learn the answers, but reading carefully and thinking about what helps a patient feel heard is the best preparation.

References

1. Norfolk, T., Birdi, K. & Walsh, D. (2007). The role of empathy in establishing rapport in the consultation: a new model. Medical Education, 41(7), 690–697.
2. Patterson, F., Zibarras, L. & Ashworth, V. (2016). Situational judgement tests in medical education and training: research, theory and practice. AMEE Guide No. 100. Medical Teacher, 38(1), 3–17.