SPIES Structure

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The SPIES structure helps you to answer questions related to difficult colleagues and ethical dilemmas. Questions can vary from simple to complex; however sticking to this structure will help you to answer the question confidently. 

Common Questions

  • What would you do if the operating consultant came in drunk into the OT?
  • One of your colleagues come late 20 minutes every day for the last 2 weeks. How would you handle this?

These questions have a very high chance of being asked during your interview. Use the SPIES structure to provide an excellent answer. 


SPIES Approach

Seek Information
Before doing anything, the sensible thing to do is to understand the problem. This will involve dicussing the situation with the relevant individual or with other colleagues, if appropriate. You need to gather information about the situation before doing anything (stupid) about it. 

Patient Safety
Once you have gathered information, the next most important thing is to assess whether patient safety is compromised or not. If the colleague is an immediate threat to patient safety you need to remove them from clinical area and patient care immediately. This can be done by talking to them or in severe situations you can call seniors for help. 

Initiative 
Is there anything that you can do by yourself that will help solving the problem (not worsen it). This depends on the situation that you are facing. 

Escalate 
If the situation is serious for you to deal with i.e., you are too junior to handle it, then you must escalate to appropriate levels of authority. For junior colleagues that would be registrar, and the educational supervisor of that colleague. For consulant that would be the clinical director of the department. GMC comes last along this line. 

Support 
Sometimes people behave in a certain way because there are reasons for them to behave this way. They will need support to deal with those reasons and problems. You can also offer team support to the affected colleague. 


Important Points: 

  • Talk about yourself. Focus on your actions, not of others
  • Be careful with the details. Do not over simplify or over explain
  • Explain what you did and why you did it. The second part is more important!


Question: One of your colleagues come late 20 minutes every day for the last 2 weeks. How would you handle this?  

First, I would have a private conversation with my colleague to understand the reason for their lateness. There may be personal or professional factors that I am unaware of. It's important to gather information before making any assumptions or taking action. 

After gathering information, my next step would be to assess whether the colleague's lateness has compromised patient care or safety. If their lateness has impacted handovers, delayed treatments, or caused any risks to patient safety, I would address this immediately by discussing the matter with them. If the situation were severe, I would escalate it to the registrar for further support.

Depending on the circumstances, I might offer to adjust the team’s workload or arrange a temporary solution, like delegating tasks to ensure patient care isn’t affected. I would also explore ways to support the colleague in improving their punctuality without immediately escalating the issue, if appropriate.

Lastly, I could offer support to my colleague if they are going through personal difficulties. Offering team support could help them manage their situation and improve punctuality over time