Pattern guide: how DFT SJT answers are keyed
How the test works, and the patterns that decide where an option sits in the key. The same material is in the app under Guide.
How the test works
The DFT SJT is 100% of your national ranking for Dental Foundation Training in England, Wales and Northern Ireland. Scotland recruits separately.
| Length | 56 questions in 105 minutes (about 1 min 52 s each). 50 are scored; 6 are unmarked pilots you can’t identify. |
|---|---|
| Your role | A Foundation Dentist in a training practice, with an Educational Supervisor (ES) and a Training Programme Director (TPD). |
| Ranking items | Rank 5 options from most to least appropriate. Usually actions; sometimes considerations, ranked by importance. |
| Best-three items | Choose the 3 most appropriate of 8 options. |
| Mix | About two-thirds ranking in live papers. |
| Negative marking | None. A blank scores 0. |
The four domains
- Professional integrity: honesty, taking responsibility, putting patients first, challenging wrongdoing.
- Resilience and coping with pressure: prioritising, managing workload and personal pressures, asking for help.
- Empathy and communication: seeing the other person’s view, being patient-centred, explaining clearly.
- Working as part of a team: supporting colleagues, resolving conflict, respecting roles.
Why the marking matters
In a ranking item each option is worth 4 marks. You lose 1 mark for every place it sits from the keyed position, up to a maximum of 20 per item.
| Your ranking | Marks out of 20 |
|---|---|
| Any complete ranking, even fully reversed | at least 8 |
| Random order | about 12 on average |
| Top option correct | at least 12 |
| Top and bottom correct | at least 16 |
| One adjacent pair swapped | 18 |
In best-three items each correct pick scores 4, up to 12. Getting the best and worst options right is worth most of the marks, so secure the ends first and don’t agonise over the middle. Never leave a ranking blank.
The priority order
When two sensible actions compete, the one that serves the higher priority ranks above. This order explains nearly every official key.
- Patient safety: stop harm happening, or getting worse, right now.
- Patient autonomy and dignity: consent, informed choice, being listened to.
- Honesty and integrity: candour, accurate records, no concealment or collusion.
- Confidentiality: share only with consent or clear justification.
- The team: supporting colleagues, resolving conflict fairly, respecting roles.
- You: your learning, development and wellbeing.
- The practice’s convenience: targets, income, keeping things smooth.
Where the order bends
- A competent patient’s choice can beat your view of what’s safest. They may refuse treatment, but they can’t require irreversible treatment you believe is against their interests.
- Confidentiality gives way to serious risk, safeguarding or the law, but not to a relative’s wishes, a minor police query or convenience.
- Your own health moves up when it affects patients. Working while unwell or infectious is a safety issue.
- Supporting a colleague can top the list when no patient is at risk.
- Honesty is never traded away for loyalty, money or a colleague’s secret.
The escalation ladder
The keys reward going up one rung at a time, starting with the person themselves, unless a patient is at immediate risk.
- 0Make patients safe now: stop, pause, get help. This runs alongside every other step.
- 1The person, privately and directly. Explain why it matters, and give them a chance to put it right or self-report.
- 2Inside the practice: your ES for clinical and learning issues, the practice manager for staff matters, the owner for governance, or the relevant lead (safeguarding, infection control).
- 3The training structure: your TPD, or the Dental Dean, when it’s about training or personal circumstances, or when your ES is the problem.
- 4External bodies: the commissioner, the CQC or equivalent, social care, the police.
- 5The GDC: when local routes have failed, or straight away for inherently serious matters such as dishonesty, violence, illegal practice or a cover-up.
Skip the conversation with the person only when it would endanger patients, tip off a wrongdoer or put you at risk. Advice lines, such as your defence organisation or the BDA, are useful at any point. But advice isn’t action, so these options tend to sit in the middle.
Who to go to for what
| Issue | Go first to |
|---|---|
| Your competence, a clinical question, learning, workload | Your ES |
| Personal circumstances affecting training; a problem with your ES | Your TPD |
| A staff member’s conduct, rotas, operations (after speaking to them) | The practice manager |
| Governance, the NHS contract, pressure coming from the practice manager | The practice owner |
| A child or vulnerable adult at risk | The practice safeguarding lead (999 if in immediate danger) |
| Your own legal position after an incident | Your defence organisation |
What top and bottom options look like
Push an option up
- You deal with it yourself, directly and privately.
- You find out more first: feelings, causes, specifics.
- You take ownership of your patient, your error, your learning.
- You’re honest and open, even when it’s uncomfortable.
- You act on safety risks urgently.
- You involve the right senior at the right time.
- You give a colleague the chance to put it right.
- You add a practice-wide fix.
Push an option down
- Doing nothing, or waiting to see.
- Colluding, concealing, going along with it.
- Confronting or blaming in public, threatening.
- Being dismissive or judgemental to a patient.
- Workarounds that bypass the system or move the problem.
- Handing your problem to someone else.
- Delaying action on a serious finding.
- Putting your own image or comfort at the centre.
- Escalating before the local route has been tried.
- Working beyond your competence.
Usually last: whatever harms or abandons a patient, conceals something, or is dishonest.
Usually middle: getting advice, only documenting, only reflecting, asking peers, giving up your own time.
Traps and reverse traps
Options that look good but rank low
| Option | Why it’s lower than it looks |
|---|---|
| Apologising before you know what’s wrong | Explore first, then apologise for what actually happened. |
| Going to the manager before speaking to the colleague | It skips local resolution and damages trust. |
| Reporting a senior before they’ve had a chance to reconsider | Premature, unless the harm is serious and ongoing. |
| Phoning your defence organisation | You get advice, but nothing is done. Usually middle. |
| Staying late, or doing a colleague’s work | Fatigue, and the cause isn’t fixed. |
| Asking for longer appointments or a different nurse | It moves the problem instead of solving it. |
| “Monitor it and report if it happens again” | It leaves the current problem unaddressed. |
| Reflecting or informing your ES in an “immediate” question | Right eventually, but safety steps come first. |
| A vague letter, or one that leaves facts out | Still dishonest. |
| Deleting or “tidying” records | Records are corrected with an audit trail, never removed. |
| A disclaimer or form as the fix for a safety gap | Paperwork doesn’t make an unsafe situation safe. |
Options that feel harsh but rank high
- Telling a patient honestly that a finding may be serious, together with an urgent referral.
- Telling the employer when a colleague won’t disclose something that puts patients at risk.
- Stopping a procedure because the patient seems distressed.
- Declining a request for treatment that isn’t in the patient’s interests, and explaining the alternatives.
- Politely refusing a senior’s instruction you believe is wrong.
Technique
Ranking items
- Read the instruction line first. Is it about actions or considerations? Does it say “immediate”?
- Name the principle at stake.
- Predict the ideal response before reading the options.
- Find the best option, then the worst.
- Order the middle three using the priority order and the ladder. If you’re stuck, direct action beats seeking advice, which beats passivity.
- Judge each option on its own, as if it were the only thing you’d do. It isn’t a sequence of steps.
- Commit and move on. A near miss still scores.
Best-three items
- Eliminate first: three or four options are usually clearly poor.
- Choose three that cover different ground: the immediate problem, the person’s needs, and a follow-up or root-cause fix.
- When two options do the same thing, usually only one is keyed.
Considerations items
The affected person’s immediate needs → facts relevant to the decision now → general duties → your own feelings or reputation → anything tangential.
Thinking errors that cost marks
- Answering as a student or as a senior partner, instead of an FD at your stage.
- Adding facts that aren’t in the scenario.
- Picking what you would do rather than what you should do.
- Rewarding an action that’s right but not needed yet.
Quick checklist
- Is anyone at risk right now? The safety action goes first.
- Whose problem is this? If it’s yours, own it.
- Do I know enough? If not, explore before you act or apologise.
- Am I being asked to hide, bend or ignore something? Never collude.
- Have I spoken to the person directly and privately? Do that before escalating, unless it’s unsafe.
- Who is the right next person? ES, TPD, practice manager, owner or lead.
- Does this fix the cause, not just the incident?
Rule of thumb: picture the action written into the notes and read by the patient, your ES and the GDC. The action all three would be comfortable reading usually ranks highest.