Anaesthetics Clinical Judgement Guide 2027

How to approach it

What a strong answer needs to show

Know the official function

Clinical Judgement gives five minutes' reading and a 15-minute interview. Two assessors independently score Clinical Judgement and Decision Making, Reflective Practice and Working Under Pressure, with equal domain weighting, then each adds a global rating.

The scenario develops: assessors introduce information at different points.
The station is worth 50 of the 100 raw interview marks.
A safe answer shows how information changes action rather than defending the first plan.

Use reading time to build a working map

Do not write a full script. Mark the physiological threat, missing information, immediate actions, help required and two or three dangerous possibilities.

Separate what must happen now from what can follow after stabilisation.
Write escalation triggers and the people or teams you may need.
Leave space for new observations, investigation results or human-factor problems.

Make judgement and decision making visible

State the problem, start a structured assessment, treat reversible threats and explain why your priority is safest. Entry-level reasoning matters more than unsupported specialist detail.

Use ABCDE when the patient is unstable, but apply it rather than merely naming it.
Give a short risk-weighted differential and the information that would distinguish it.
Say what you will reassess and how quickly.

Working under pressure means organising help

Calm performance includes recognising workload and competence limits, delegating clearly and escalating early. It does not mean trying to manage a crisis alone.

Name who you would call, why they are needed and the urgency.
Use closed-loop communication and allocate tasks to available team members.
If help is delayed or the patient worsens, state the next escalation route.

Reflection must change later practice

If asked what you learnt, identify a specific gap or feedback point, what you did about it and the behaviour that changed afterwards.

Acknowledge uncertainty or an error without performing self-punishment.
Separate personal learning from system learning where both contributed.
Give evidence that the change was applied, taught or rechecked.

Know the serious-concern boundary

The official guidance allows clinical-lead review and possible veto for genuine safety, probity or behaviour concerns, including dangerous decisions or very low station scores.

Do not exceed competence or delay urgent senior support to appear independent.
Protect the patient when hierarchy or workload creates pressure.
Escalate unsafe requests and document through the appropriate clinical route.

Use a new finding to revise the explanation without abandoning assessment

Brief fictional illustration: a patient in recovery remains drowsy and hypotensive, and a nurse reports fresh blood in the surgical drain. The additional finding increases concern about bleeding; it does not establish the full cause of deterioration.

Reassess current physiology and the response to care already given, with the recovery team and early senior anaesthetic help. Obtain relevant operative information and involve the surgical team for the possible bleeding concern; do not finish a diagnostic discussion before addressing immediate risk.
Explain what changed: blood loss now needs urgent clarification, but airway, breathing and other reversible threats still require assessment. Avoid replacing one premature diagnosis with another.
State what review or response you need from each team and what will be reassessed while help arrives. Work within your competence and local emergency procedures; the example does not prescribe a fluid, transfusion or airway regimen.

Original practice questions

Questions worth practising aloud

These are original preparation prompts written around published domains and entry-level expectations. They are not recalled interview questions.

You are the first doctor to review a patient in recovery who is drowsy, hypotensive and tachycardic. Talk through your immediate priorities.
The blood pressure remains low after your first measures and the surgical drain now contains fresh blood. How does this change your plan?
An acutely unwell patient needs urgent surgery, but new information suggests a major increase in perioperative risk. What would you do next?
Two deteriorating patients require review at the same time. Explain how you would triage, delegate and maintain oversight.
A senior asks you to perform a task that you have not been trained to do independently. The department is very busy. How would you respond?
Your working diagnosis appears less likely after a new investigation result. Talk through how you would reassess rather than anchor on the first explanation.
After a difficult case, a colleague tells you your instructions were unclear. How would you reflect and change your practice?
A planned intervention is not improving the patient's condition. What information and thresholds would prompt further help or a different strategy?

Common mistakes

Where otherwise good answers lose clarity

Reciting ABCDE without saying what you would find, do or reassess.
Locking onto one diagnosis before the scenario evolves.
Giving anaesthetic drug or airway detail beyond your competence instead of safe general acute care.
Saying 'I would escalate' without naming the person, reason or urgency.
Using reflection as a closing phrase rather than showing changed behaviour.
Reading prepared notes while missing the assessor's new information.

Preparation plan

How to practise this deliberately

Practise five minutes of reading followed by a full 15-minute evolving scenario.
Ask a partner to add information that challenges your first diagnosis or priority.
Rehearse concise ABCDE application, risk-weighted differentials and explicit reassessment.
Prepare two real reflections where feedback led to a specific later change.
Review the hub's on-call and perioperative workflow guides for realistic escalation context.
Use paper notes as a map, then maintain eye contact and respond to the question asked.

Continue into practice

Practise the answer, not just the reading

Spoken Anaesthetics CT1 practice is launching soon. At launch, choose a Question bank prompt, work on your answer and use structured feedback to improve it. Explore the practice experience while you prepare with these free questions.

Explore Anaesthetics CT1 practice

Official source

Check the live recruitment guidance

Interview formats can change between cycles. This focused guide should be used alongside the official source below and the full Anaesthetics CT1 guide.