The Standardized Video Interview, or SVI
Overview of what you are going to learn about the SVI:
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The Standardized Video Interview (SVI) is an interview format intended to evaluate two key competencies highlighted by the Accreditation Council for Graduate Medical Education (ACGME): Knowledge of Professional Behaviors and Interpersonal and Communication Skills. As with other interview formats, such as traditional interviews or multiple mini interviews, the SVI is intended to evaluate an applicant's non-academic competencies (“soft skills”), particularly with regard to emotional intelligence, interpersonal skills, and maintaining ethical convictions central to the field of medicine. These virtual interviews often act as an intermediary step between the formal application and later in-person interviews. The stated purpose of the SVI is to increase the overall pool of applicants invited to interview, particularly allowing applicants with moderate Board scores, but strong non-academic competencies, to reach the interview stage. After being piloted in, and endorsed by, the emergency medicine program community, the SVI will now be a standard component of the ERAS application for all applicants to ACGME-accredited emergency medicine residency programs, with wider-ranging standardization in other programs a possibility in the near future.
The SVI is an online virtual interview developed by the Association of American Medical Colleges (AAMC). The SVI can be completed on any device that can connect to the internet, including computers, laptops, tablets, or smartphones. The interview can be completed on the applicant's own time, within their own schedule, and in their preferred location. In the SVI, applicants are presented with text prompts for six questions, to which they record a response in audio or video format. These responses are then submitted for scoring by AAMC evaluators. While all applicants are evaluated according to the same key competencies, there is a wide range of possible questions for each student, so the questions will likely differ from student to student.
The two key competencies evaluated via the SVI are Knowledge of Professional Behaviors and Interpersonal and Communication Skills, as studies have determined that those who excel in such areas are likely to be successful residents and practicing physicians. Questions used to determine Knowledge of Professional Behaviors are intended to allow an applicant to display his/her ethical convictions and the ability to maintain those convictions in the context of their professional responsibilities as future physicians. As such, the questions evaluate the following sub-competencies:
- Empathy and Altruism (the ability to understand the suffering of others and the desire to alleviate that suffering)
- Ethics (a clear sense of right and wrong, working to maximize well-being and minimize harm)
- Cultural Competence (the ability to take on multiple perspectives, with particular attention to varying social, cultural, and religious sensitivities and priorities which may differ from one’s own)
- Conscientiousness (mindfulness of the needs of others, careful consideration of the potential outcomes of one’s actions, ability to self-correct)
Interpersonal and Communication Skills questions are intended to highlight a student’s ability to facilitate clear and attentive information exchange, with particular regard to the complexities involved in communicating with patients, their families, and other healthcare professionals. These questions evaluate the following sub-competencies:
- Oral Communication (the ability to speak clearly, attentive to the needs of the listener)
- Emotional Intelligence (identifying and navigating complex emotional terrain)
- Teamwork and Leadership (facilitating collaboration amongst colleagues and effectively leading a diverse and potentially multidisciplinary team)
The interview itself is comprised of 6 questions, presented as text prompts, to which the applicant records an audio or video response. There are two primary types of questions: Behavioral and Situational. For Behavioral-type questions, applicants must reflect on and describe specific life experiences that reflect sound knowledge of the two key ACGME competencies, Knowledge of Professional Behaviors and Interpersonal and Communication Skills. For Situational-type questions, applicants are given hypothetical situations, to which they must apply core concepts of the two key ACGME competencies.
The SVI is completely virtual, and there is no human intermediary during the interview itself. Following a 3-minute introductory video, a technology check, and a practice submission (to ensure everything is working correctly), the 6 questions will be presented individually as text prompts, and applicants will have 30 seconds to review a prompt before responding. After the 30 seconds of reflection time, the student will have 3 minutes to record their response. The 6 prompts and responses must be completed in one sitting. Following the last question, the student will be presented with an optional survey, but the total time spent completing the interview itself is around 21 minutes.
The SVI can be completed online at any time during the application period, though it is recommended that applicants find a private space that is quiet and well-lit before beginning the interview. While, technically, the interview can be completed on any internet-enabled device, we recommend that you treat this as a professional interview, and thus a use desktop computer and professional attire would be ideal.
Each response in the SVI is rated individually, on a scale from 1-5. Lower scores (1s and 2s) indicate that a student has simple, limited, or no proficiency in the competency being evaluated. Higher scores (4s and 5s) are given when a student has proven that they can successfully navigate difficult and/or very difficult scenarios with a high level of proficiency in the competency being evaluated. Each individual response is rated by a different AAMC-trained evaluator, meaning a total of six different evaluators will examine the student’s SVI. After each evaluator has provided a score for their assigned question, the scores will be totalled, and this total is the student’s SVI score. As such, the possible final scores range from 6 (low) to 30 (high)
You should treat the SVI like any other interview format:
a) Practice using realistic mock interviews so you get used to the format and get rid of the fear of the unknown.
b) Seek expert feedback. You'll need someone to provide you with unbiased feedback so you can identify areas of improvement and make changes to your behavior before your actual interview. This has to be an unbiased expert. That means your mom is probably not the best person because she'll probably tell you that you are doing great no matter what!
c) Learn to identify and have a strategy for different types of questions. It's not possible to predict actual questions but if you have a strategy for each type of question, you can answer any question.
d) Gather all the facts. In hypothetical or scenario based questions, first gather all the facts. Find out what information is missing and verbalize that you would do that first. This is the hallmark of a mature professional.
e) Remain non-judgmental at all times. You don't want to make any hasty decisions or say that you did in the past. Rather as a mature professional, you reserve judgement until you have as much facts as possible (see above). This is equally important whether you're diagnosing a patient or during a conflict with a colleague.
f) Tell them what you have learned from past mistakes. It's OK to make mistakes. It's not OK if you haven't learned anything from those experience.
h) Provide specific examples and avoid fluff or generic talk. Admissions committee members are excellent B.S. detectors. Be real and provide specific examples rather than generic stories.
i) Use 'if, then' strategy to address complex problems. This shows that you have complex decisions making capability.
j) Dress professionally! It’s easy to think that a virtual interview would be less formal, since you’re not meeting anyone face-to-face and you’re doing it on your own time, in a space where you are comfortable. But remember: you are on camera the whole time, and someone will be evaluating your response. Therefore, make sure you have a very neutral background, such white wall, and dress professionally – as if you were actually interviewing with another person.
k) Smile! It goes without saying that you should open your responses with a smile just like a real interview. Nothing draws humans to each other better than a genuine smile. This is the best way to make sure the evaluators can see you as their future colleague. Someone who is approachable and easy to get along with.
We'll review several sample SVI questions below, if you have other residency interview formats, check out these sample residency interview questions.
You can also check out our video, How to Ace the Standardized Video Interview (SVI):
Interpersonal and Communication Skills Questions
1. Imagine you must tell a patient that they have been diagnosed with a chronic illness. It is not fatal, but it is debilitating, stigmatizing, and there is no cure. How do you communicate this difficult information?
2. Describe a situation in which a colleague was upset with you over a mistake or error you made. Were you able to resolve the situation? If so, how? If not, how could it have been handled more effectively to come to a resolution?
3. Describe a time when you intervened in a disagreement between two peers or colleagues. Were you able to find common ground or otherwise diffuse the situation? If so, how? If not, how might you have acted differently?
Knowledge of Professional Behaviors (Professionalism) Questions
1. Imagine a patient comes into your office, visibly upset with you. They feel you haven’t given them a complete list of possible options for treating their medical condition, based on information they found in an online support group for people with this condition. What do you say to this patient?
2. A parent brings their 11-year-old child in with a fever and pain in the ear, a likely ear infection. You swab the ear, and the swab comes out bright green, almost as if it had been colored with a green marker. What do you say to the parent and/or the child?
3. While going over your charts, you notice you have made an error in reading a patient’s lab work, leading to a misdiagnosis of an infection. Ultimately, the course of treatment will be no different – you would have prescribed the same antibiotics for either infection, and no other treatment will be necessary if the antibiotics work as they should. Do you inform the patient of this error? Why or why not?
Imagine you must tell a patient that they have been diagnosed with a chronic illness (e.g. Parkinson’s, multiple sclerosis, fibromyalgia, or diabetes). It is not fatal, but it is debilitating, stigmatizing, and there is no cure. How do you communicate this difficult information?
My top priorities in this situation would be approaching the patient with a sense of empathy, ensuring I have a clear and robust understanding of the condition and how best to manage it, and options for support that I could provide the patient – including gathering any literature, support group contacts, or other concrete resources to offer. This is a life-changing event in many ways, which may have an effect not only on how the patient feels in their day-to-day life, but how they are able to perform their duties at work, and how or whether they are able to participate in social or recreational events. As well, this is something that may have repercussions for the patient’s family and friends, so I want to ensure the patient has a full picture of this, while also providing appropriate support, information, and practical ways to manage symptoms.
I would first attempt to prepare the patient by bringing them to a private and comfortable location. I would begin by asking the patient for their understanding of the health issues they have been experiencing, so I know how to guide the conversation. Following this, I would let them know that I have to share some difficult information, but that I will be there to support them as best I can. I would want to ensure the patient is informed properly, so that they can be empowered and play an active role in their treatment, so I would provide the patient with straightforward materials, translating any lab work or other tests into language they can understand, and offering an objective definition of the illness in question. I would assure them early on that this illness is not fatal, but they will need to adjust their lifestyle, perhaps take medications, and take other actions to minimize symptoms. After this initial disclosure of information, I would ask the patient if they have any questions, while also affirming that this is difficult news that they may not be able to fully process now, and so returning in a few days to continue the conversation would be an acceptable response.
Once I’d answered any questions posed by the patient, I would begin to present them with some options for treatment (as applicable), including possible referrals to specialists, if necessary. I would again ensure that I avoid or explain jargon or overly technical terms, so that the information is accessible to someone outside the medical field. I would provide them with the literature and other information I had gathered for them and I would ask them to take a few days to review these and then return to my office. At this point, I would again express my empathy for the patient, and suggest they go home to discuss this with their family and/or friends. I wouldn’t want to overload the patient with information, so we would continue the discussion in a few days.
A parent brings their 3-year-old child in with a fever. As soon as you enter the room and greet the family, the parent reports that the child has been tugging at their ear, feeling unwell in general, and that this is a likely ear infection – they say it happens “all the time”. What do you say to the parent and/or the child?
The first thing I would want to do is take a step back and ensure that I’m not jumping to any conclusions, based on the parent’s report of a likely ear infection. I would need to gather as much information as possible, to ensure I’m providing the patient with appropriate care and that I’m being as objective as possible. The parent has reported that the child does have a fever and pain, so there is likely something medical taking place. The child is experiencing discomfort, and it’s possible that the parent is also affected by this discomfort, so my highest priority is determining whether the child is ill, understanding what is causing these symptoms, and providing an appropriate course of treatment or recommending a specialist if the issue is beyond my scope of practice.
I would conduct a standard clinical exam, just like I would with any patient. I would begin by confirming the child’s fever (obtain a set of vitals), checking the ears, nose, and throat for discharge, and asking the child if they could describe the pain they are feeling. I would not want them to be scared, so I would listen closely to what they say, and ensure my own tone of voice is soothing and pleasant. I would ask the parent how long the symptoms had been present, and if there was any other information to add, besides what the child has said.
The patient’s health is my key concern. If this is an infection which requires treatment, it could spread or be quite damaging in other ways, and if it is viral, I can recommend a course of supportive management as we await results. I would send a sample of any discharge to a lab for evaluation, and I would refer the patient to a specialist if I deem it necessary. Even if the fever was not confirmed during my examination, I would still take these actions, because I don’t want to make assumptions, and the child may have been given medicine to reduce the pain and fever. In the meantime, I would recommend some basic home measures that could be taken to reduce the symptoms, such as over-the-counter medications to help with comfort.
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