The Standard Scenario-Response Structure
Each item in the PREview exam begins with a short prompt, typically three to five sentences, describing a professional or academic challenge. These PREview scenario examples are designed to be ambiguous enough to require nuanced judgment but specific enough to trigger a particular competency. Following the prompt, you are presented with a series of distinct actions. It is crucial to understand that each response must be evaluated independently. In the actual exam environment, you are not comparing Action A to Action B; you are measuring Action A against an objective standard of professional excellence. This structure tests your ability to recognize the immediate impact of a behavior, its long-term consequences, and the message it sends to colleagues or patients. A common mistake is assuming that because one action is "effective," another similar action must be "ineffective." In reality, multiple actions can be effective, though they may achieve the goal through different mechanisms.
'Most/Least Effective' vs. 'Rating Scale' Questions
While some SJTs utilize a ranking system, the PREview exam primarily uses a four-point rating scale: Very Ineffective, Ineffective, Effective, and Very Effective. This scale requires you to differentiate between a response that is merely acceptable and one that is proactive and comprehensive. A Very Effective response typically addresses the root cause of an issue while maintaining professional relationships and upholding ethical standards. An Effective response might solve the immediate problem but lack the proactive follow-up or relational care seen in higher-rated choices. Conversely, Ineffective actions often involve passive behavior or minor lapses in judgment, whereas Very Ineffective actions involve clear ethical violations, escalation of conflict, or a total failure to acknowledge the problem. Understanding this hierarchy is essential for scoring, as the exam utilizes a consensus-based scoring model where your points are determined by how closely your ratings align with those of a panel of medical school experts.
Identifying the Prompt's Central Conflict
The key to analyzing AAMC SJT practice scenarios is identifying the primary competency at stake before reading the responses. Every scenario contains a "pivot point" where a professional expectation is challenged. For instance, if a peer is not contributing to a group project, the central conflict is not just the workload—it is the competency of Teamwork and Reliability. By identifying the conflict early, you can filter responses through the lens of that specific competency. If the conflict involves an ethical breach, the "Very Effective" response will almost always involve direct confrontation or reporting, whereas a response that merely "minds one's own business" would be rated as Ineffective. Recognizing the conflict allows you to avoid being distracted by "distractor" actions that seem polite but fail to address the underlying professional requirement.
Interpersonal Dynamics and Teamwork Scenarios
Resolving Conflict Between Peers
Interpersonal dynamics in medical education often center on high-stakes collaboration. When a scenario presents a disagreement between students, the exam is assessing your Social Skills and Teamwork competencies. A common scenario involves a peer who is underperforming or behaving unprofessionally. The most effective responses in these cases are those that prioritize direct, private communication. For example, if a teammate is consistently late, a "Very Effective" response involves speaking to them privately to understand the cause and reiterating the team's goals. This demonstrates a commitment to the relationship and the project. Solutions that involve immediate escalation to a professor without first attempting peer-to-peer resolution are often rated as less effective because they bypass the opportunity for professional growth and can damage team cohesion. The goal is to find a balance between accountability and empathy.
Navigating Hierarchies with Supervisors or Residents
Medical training is inherently hierarchical, and many medical school situational judgment test questions explore the tension between a student's junior status and their professional responsibilities. Scenarios might involve a resident giving conflicting instructions or a supervisor overlooking a student's contribution. In these instances, the exam evaluates your ability to communicate upward without being insubordinate. Effectiveness is measured by your ability to seek clarification and express concerns diplomatically. A response that involves publicly challenging a supervisor is typically "Very Ineffective," as it violates professional decorum. However, a response that involves staying silent and allowing a potential error to occur is also "Ineffective." The ideal middle ground—the "Very Effective" zone—usually involves a private, respectful request for feedback or clarification, demonstrating both Reliability and Social Skills.
Effective Communication in Group Projects
Group project scenarios frequently appear in free AAMC PREview practice questions to test how you handle shared responsibility. These questions often focus on the "Capacity for Improvement" and "Service Orientation" within a team context. If a group is struggling to meet a deadline, the exam looks for proactive leadership. A "Very Effective" action might involve suggesting a new organizational system or volunteering to take on additional tasks temporarily to ensure the team's success. Simply doing your own part and ignoring the group's failure is considered "Ineffective" because it demonstrates a lack of accountability for the collective outcome. The scoring rewards students who show a "we-mentality" over an "I-mentality," emphasizing that in medicine, the outcome for the patient (or the project) is the ultimate priority.
Intrapersonal and Ethical Dilemma Scenarios
Questions Testing Resilience and Stress Management
The Resilience competency is evaluated through scenarios where the protagonist faces personal setbacks, such as a poor exam grade or an overwhelming workload. These PREview interpersonal dilemmas test your ability to maintain professionalism under pressure. When a student feels overwhelmed, the exam evaluates how they manage their internal state while fulfilling external obligations. A "Very Effective" response involves identifying personal stressors, seeking appropriate resources (like a tutor or counselor), and communicating with stakeholders about any potential delays. Responses that involve "pushing through" without changing strategy or seeking help are often rated lower because they are unsustainable and lead to burnout. The exam rewards self-awareness and the proactive use of support systems, viewing these as essential traits for a long-term medical career.
Scenarios Involving Academic or Professional Integrity
Ethical Responsibility is perhaps the most rigid competency in the PREview scoring rubric. Scenarios involving cheating, plagiarism, or patient confidentiality have very little room for "grey areas." If you witness a peer using unauthorized materials during an exam, the only "Very Effective" responses are those that uphold institutional integrity. This usually involves encouraging the peer to report themselves or reporting the incident to a proctor. Passivity in the face of an ethical breach is consistently rated as "Very Ineffective." The exam logic dictates that as a future physician, you have a non-negotiable duty to protect the integrity of the profession and the safety of patients. Even if the person committing the breach is a close friend, the professional obligation to the Ethical Responsibility competency must take precedence.
Balancing Personal Well-being with Professional Demands
These scenarios often place a student in a position where a personal commitment (like a family wedding) clashes with a professional duty (like a mandatory lab). This tests Reliability and Capacity for Improvement. The exam does not expect you to be a martyr, but it does expect you to handle conflicts with foresight. A "Very Effective" response involves checking the syllabus or policy manual first, then speaking with the supervisor well in advance to request an exception or make up the work. Simply not showing up is "Very Ineffective," while asking for an exception at the very last minute is "Ineffective." The key takeaway for these questions is that professionalism is defined by how you manage your absences and obligations, not just by being present.
Service Orientation and Cultural Competence Scenarios
Interacting with Patients from Diverse Backgrounds
Cultural Competence is a cornerstone of the AAMC's mission. Scenarios in this category often involve a patient whose cultural beliefs or language barriers create a challenge in the clinical setting. The exam looks for responses that demonstrate respect, curiosity, and a non-judgmental attitude. A "Very Effective" response might involve asking the patient to explain their perspective or requesting a professional interpreter rather than relying on a family member. It is important to avoid responses that are dismissive of the patient’s beliefs or that attempt to "force" compliance without understanding the patient's context. The exam rewards the Service Orientation competency, which prioritizes the patient's needs and comfort above the student's convenience or preconceived notions.
Advocating for Patient Needs within a System
Students are often placed in scenarios where they notice a patient is being overlooked or treated unfairly by the healthcare system. This tests your ability to advocate within professional boundaries. If a patient is discharged prematurely or their concerns are ignored by a resident, the student must decide how to intervene. A "Very Effective" action involves bringing the concern to the attention of the medical team in a way that is data-driven and patient-centered. For example, "I noticed the patient is still experiencing significant pain; should we re-evaluate the discharge plan?" is more effective than a silent observation. Advocacy is a key part of Service Orientation, and the exam evaluates whether you have the courage to speak up for those who may not have a voice in the system.
Recognizing and Addressing Personal Bias
Some scenarios are designed to trigger an internal reflection on bias. You might be presented with a situation where a colleague makes a stereotypical comment about a patient. The exam evaluates your ability to recognize this bias and address it constructively. A "Very Effective" response involves calmly pointing out the bias or refocusing the conversation on the patient's individual clinical needs. Ignoring the comment is generally "Ineffective," as it allows a toxic professional environment to persist. These questions are difficult because they require you to balance Social Skills (not being unnecessarily hostile) with Ethical Responsibility (not tolerating prejudice). The most successful candidates are those who can navigate these social complexities without compromising their core values.
System-Based Thinking and Reliability Scenarios
Identifying and Reporting Process Errors
In medicine, a "system error" can lead to patient harm. Scenarios that test this often involve a student discovering a mistake in a chart or a flaw in a clinic's scheduling system. The Reliability competency is paramount here. A "Very Effective" response involves documenting the error and notifying the person responsible or a supervisor immediately. The exam penalizes "work-arounds" where a student fixes the error themselves without telling anyone. While the immediate problem is solved, the system-wide flaw remains, which could lead to future errors. The AAMC values students who understand that they are part of a larger system and that reporting errors is a vital component of quality improvement and patient safety.
Managing Time and Priorities Under Pressure
These scenarios often present a list of competing tasks: a pre-lab report due, a patient needing a comfort measure, and a resident asking for a coffee. The test evaluates your ability to prioritize based on professional impact. Tasks related to patient safety and academic requirements always outrank personal favors or low-impact social activities. A "Very Effective" response involves triaging these tasks and communicating clearly about what can and cannot be done. For instance, telling the resident "I can get that for you after I finish this patient report" demonstrates better Reliability and Social Skills than simply saying "no" or trying to do everything at once and failing. Learning to manage expectations is a core part of the professional readiness being assessed.
Demonstrating Proactive Problem-Solving
Proactivity is a recurring theme in the highest-rated responses. If a scenario describes a problem that hasn't happened yet—such as a potential shortage of supplies—the exam looks for students who take initiative. A "Very Effective" action is one that prevents the problem from escalating. This might involve notifying a supervisor of the shortage before the supplies run out or suggesting a more efficient way to track inventory. This demonstrates the Capacity for Improvement competency. Responses that wait for the problem to occur before acting are rated as less effective. The PREview exam seeks to identify students who do not just follow instructions but who actively contribute to the efficiency and success of their professional environment.
Building a Response Strategy for Each Question Type
A Step-by-Step Analysis Framework
To consistently score well on AAMC PREview sample questions, you should apply a standardized framework to every item. First, read the scenario and identify the "protagonist's" role and the primary conflict. Second, determine which of the eight AAMC competencies is being tested. Third, for each response action, ask yourself: "Does this action solve the problem? Does it maintain professional relationships? Does it follow ethical guidelines?" If the answer to all three is yes, the response is likely "Very Effective." If the action solves the problem but damages a relationship or ignores a policy, it is likely "Ineffective." This logical progression prevents you from relying on "gut feelings," which can be inconsistent, and instead allows you to align your answers with the institutional logic of the AAMC.
Eliminating Clearly Ineffective Actions First
A useful tactic for the rating scale is to first identify the extremes. Actions that are clearly harmful, dishonest, or passive are usually "Very Ineffective." Actions that involve direct, respectful, and proactive solutions are usually "Very Effective." Once the extremes are identified, the challenge is distinguishing between "Effective" and "Ineffective." An "Effective" action is often a "good start"—it might address the problem but in a partial or slightly awkward way. An "Ineffective" action is often a "missed opportunity"—it might not be harmful, but it fails to move the situation toward a professional resolution. By categorizing the easy ones first, you save mental energy for the more nuanced distinctions that define the middle of the scale.
Prioritizing Actions that are Constructive and Collaborative
The PREview exam heavily favors collaboration over isolation. In almost every scenario involving a team or a patient, the most effective actions are those that involve others in the solution. This reflects the reality of modern medicine, which is a team sport. When evaluating a response, look for keywords that suggest collaboration, such as "discuss," "consult," "request feedback," or "collaborate." Conversely, be wary of actions where the student acts entirely alone, especially when the problem affects others. Even if the student's solo action is well-intentioned, it may be rated lower than a collaborative one because it fails to utilize the collective expertise of the medical team. High-scoring candidates recognize that professional readiness is as much about how you work with others as it is about your individual performance.
Common Traps and Misconceptions in Sample Questions
Avoiding the 'Passive' or 'Avoidant' Response Trap
One of the most frequent traps in SJTs is the "polite but passive" response. In many PREview scenario examples, you will see an option that involves "waiting to see if things improve" or "not wanting to cause a scene." While these might seem like ways to avoid conflict, they are almost always rated as "Ineffective" or "Very Ineffective." In the eyes of the AAMC, passivity is a failure of leadership and responsibility. Professionalism requires active engagement. If a problem exists, you are expected to take some form of constructive action. Candidates who confuse "being nice" with "being professional" often struggle with this exam because they fail to realize that professional readiness sometimes requires the courage to engage in difficult conversations.
Why 'Confrontational' is Rarely the Best Answer
On the opposite end of the spectrum from passivity is aggression. While the exam demands action, it also demands that action be professional and respectful. "Confrontational" responses—those that involve blaming others, using harsh language, or public shaming—are consistently rated as "Very Ineffective." There is a vital distinction between being assertive and being confrontational. Assertiveness involves stating your needs or concerns clearly and respectfully; confrontation involves attacking the other person. When reviewing AAMC PREview sample questions, look closely at the tone of the responses. Even if an action is logically correct, a disrespectful tone can move it from the "Effective" category into the "Ineffective" one.
The Difference Between 'Sympathetic' and 'Effective'
In scenarios involving patients or struggling peers, it is easy to gravitate toward responses that are purely sympathetic. However, sympathy without action is rarely "Very Effective." For example, if a peer is upset about a personal issue and hasn't finished their work, simply "listening and offering a shoulder to cry on" is only partially effective. A "Very Effective" response would involve listening and then helping the peer find a way to meet their obligations or suggesting they speak to a supervisor. The AAMC evaluates your ability to be a professional who cares, not just a friend who cares. Your role in these scenarios is always defined by your professional identity, and your responses must reflect the balance of empathy and duty that defines the medical profession.