Today’s post is based around a difficult Multiple Mini Interview question (MMI):
''How would you act if you saw a neighbour in your community hitting a small child with force?"
Wowzers, a tricky one!
This is a complex ethical situation with a vulnerable person at the centre, a great topic to discuss in terms of getting you ready for an MMI, but also in terms of safeguarding in general.
I have a wonderful candidate called Lindsay who has kindly lent me her answer which I’ll go through in this post. I hope this will give you a lighter heart when it comes to MMIs because they can be a gift for student midwives to be.
I know that many candidates and even some admissions tutors will say there’s no way you can prepare for MMIs.
But I disagree and think this is a bit defeatist!
It's often helpful to have a bit of background in terms of what this type of interview is.
This type of interview was put together for selecting medical students. In the USA, it was noted that traditional interviewing techniques were not great at predicting which students would go on to complete the course and to treat their patients with compassion and empathy.
So instead of being quizzed about their medical knowledge and current grades, they got put through a ‘circuit’ of tasks, scenarios or role plays where they’d be asked things like:
How would you talk to a friend who was considering suicide?
Do you think unproven alternative medicine should be legal?
Do you think home schooling should be allowed?
The same type of interview is now being used to assess future student midwives in some UK universities.
In a midwifery MMI you'll be assessed on your respect for diversity, ability to promote equality, intellectual curiosity, advocacy, respect for privacy and dignity, communication skills, your knowledge of the role of the midwife and your empathy and compassion.
The reason I believe you can and should prepare for these type of interviews is that if you’ve never done anything like them before then they can throw you really off balance.
This is because:
• You’ll likely be asked questions that have seemingly nothing to do with midwifery and if you're unprepared you'll waste emotional energy
• Interviewers are often briefed not to give you much feedback or answer questions during a MMI…disconcerting when you’re not expecting it
• There are no right or wrong answers you can give, but if you settle on an answer or particular course of action, you’ll need to be able to justify it
• Some candidates struggle to know what they’re ‘allowed’ to mention, for instance, are you allowed to bring your own experience into answering a question? Are common sense suggestions ok or are you supposed to stick to ethical stuff?!
If you’re aware of the type of question that can come up and that you are allowed to answer in any way you would find helpful, and you know the point is to gracefully play with ideas and suggestions, you’re going to do a lot better than if you walked in blind.
If you’ve practised discussing this kind of question out loud, with your answer taking five minutes or so, you’re going to perform even better.
And if you’ve had a good look into some feedback to see the type of answers that can be given, and what could be improved, you’re likely to be one of the most prepared candidates there.
So let’s have a look at the question again.
''How would you act if you saw a neighbour in your community hitting a small child with force?"
A good answer to this might include discussion of:
• Pragmatic, common sense suggestions like calling the police if the child was in immediate danger, the NSPCC (National Society for the Prevention of Cruelty to Children), keeping a record of events
• Observation. Does the child seem frightened or are they reacting normally around their parent? Are they playing, interacting with curiosity, or are they frozen and scared?
• Identifying why it’s so important to safeguard: children often can’t protect their own rights
• Why it might/might not be the best thing to approach the parent in the moment. If a parent feels under threat or criticised are they more likely to be more abusive, 'taking it out' on the child at home?
• How cultural differences don’t matter; it may be tempting to see what you’re witnessing as down to differences in parenting style but the situation should be judged on the violence and risk
• If you were a student midwife or midwife you would have even more responsibility to act on this and would know more about safeguarding procedure
• This might be a cry for help, this could be the start of that parent getting help
• Consideration of the fact that this might be the ‘tip of the iceberg’, this parent might be acting with even more violence at home
• Empathy and compassion, we don’t know why this parent is acting in this way. (Being able to care for a huge spectrum of clients, not all of who are parenting well, will be important as a student midwife. Working with people rather than judgement will be key)
Lindsay’s response to this question was:
If I thought the child was in immediate danger I would likely ring the police, as it is against the law to hit a child with such force as to leave a mark.
If I thought the child's life was in danger I'd step in myself. Depending on what the police would do I would probably next call the NSPCC and ask their advice and keep a log book of things I see/hear as (if I remember correctly) that would class as a legal document and could be used in court.
As this family are my neighbours I would try to befriend them as sometimes a little extra support is all a person needs and it's possible that this could be a onetime assault brought on by stress.
I would attempt to inform the family of help available to them such as home start and other volunteer services. Hopefully through befriending the family will learn to trust me and recognise that I don't judge them because of their struggles but am compassionate towards them and only want to see them prosper.
Having four children myself I understand how stressful parenting can be especially if your sleep is constantly disturbed or you're relationship becomes strained. I believe the best thing for the child would not be removed from the parents but for the parents to be truly supported and not criticised.
Who knows?! This could be a long line of generational physical abuse. It would be an honour to end that with this family.
The feedback I’d give to Lindsay's answer is:
• Lindsay has good comprehensive ideas in terms of how to address the situation with the NSPCC and the police
• She would also step in if she felt the child's life was in danger. This is a personal decision, no-one can tell you if it's right to put yourself in the way of harm for the good of someone else. But feeling she would act in this way in commendable
• Lindsay’s suggestion in terms of social support for this family, and 'befriending' them is lovely and show compassion and empathy
• However, it might need some further clarification. If you’re a student midwife or midwife, might it be complicated to be friends with someone who has a child abuse situation ongoing? It might still be absolutely the right thing to do, but it’s worth thinking about whether this family will lean on you as a friend and whether that’s ok for you professionally – will you always be working within you ‘sphere of competence’?
If you're not a student midwife, might much of your time be spent supporting this family? Again, a very commendable thing to do and it might help a lot. But do you need to consider the impact on your life and where your efforts might be best spent? Again, it's not a wrong answer, just a complex suggestion that may benefit from further clarification
• I love the fact Lindsay is seeing things from many people’s point of view in this situation, she is concerned for the child but also trying to feel things from the parent’s perspective. Often compassion and understanding are very helpful in supporting new behaviours being adopted, as seems to be indicated for this parent
Overall I think Lindsay did really well!
As long as you give a selection of pragmatic problem-solving ideas, you try and think from the point of view of everyone in the situation, and you protect the most vulnerable person in the situation your answer will be good.
You don't have to give a 'perfect' answer as they don't exist especially in situations as complex as this.
The admissions tutors are more interested in your reasoning process than anything else. And with this type of interview, there's no bias as you'll be seen by many interviewers. You don't need to have done loads of midwifery reading to do well.
Every candidate I've talked to about MMI days says they've been a lot of fun, too!
A note on the competition:
As we know, even if you’re bright, motivated and have passion for the wellbeing of women and babies there are still far fewer places to train than there are aspiring midwives.
My philosophy on all this is that even if you have setbacks, failure is part of life. If you never fail at anything, to me that means you aren’t trying to live a brave enough life…
You either win or you learn something, right?! And many excellent midwives I’ve worked with have had to try a few times to get their place.
You know this, you’re a midwife to be! You’re aware of the toughness and beauty of this path.
But also, there’s a lot you can do to increase your chances and you can control the resources you put into preparing to be a midwife.
Put the effort in and do the preparation and you’re putting yourself on a path that means you’re far more likely to be successful.
Huge thanks to Lindsay for sharing her answer with us!
P.S. If you enjoyed this post and would like more help on MMIs you might want to check out this MMI workshop. Midwifery interview don't have to be scary - well, not *that* scary, anyway!