The Decision Framework: Patient Safety First

Every SJT question can be approached with a single, consistent framework: a priority hierarchy that determines what matters most when values and obligations compete. This lesson establishes that framework and shows you how to apply it to any scenario you encounter.

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The Universal Priority Hierarchy

When multiple considerations compete in an SJT scenario, apply this hierarchy from top to bottom:

Priority	Principle	What it means
1	Patient safety	If a patient could be harmed, address this first — always
2	Raising concerns	If you see something unsafe or unethical, your duty is to raise it
3	Following protocol and professional standards	Adhere to guidelines, procedures, and professional expectations
4	Personal comfort and convenience	Your own feelings, relationships, and preferences come last

This hierarchy is the single most useful tool for SJT. When you are unsure about a question, ask: "Which priority level is this scenario testing?" and choose the answer that aligns with the highest applicable level.

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Priority 1: Patient Safety

What "Patient Safety" Encompasses