BEHAVIORAL INTERVIEWING: TELL A COMPELLING STORY WITH YOUR ANSWER
If you’ve been to a job interview lately—as either the candidate or the interviewer—then you may be familiar with a style of question called “behavioral.” Behavioral interview questions are based on a principle of psychology which states, in essence, that how a person has acted in the past under certain conditions is a predictor of how he or she will respond in the future to the same conditions.
Hence, when interviewers say, “Tell us about a patient you’ve treated who was difficult to relate to, and how you handled the situation,” what they’re really asking is: “How will you handle our difficult-to-manage patients?” So, you might wonder, why don’t they simply ask the question they really want answered? Because that would be too easy for the candidate to manipulate. A doctor could just answer with some kind of neat process, or claim that managing difficult patients hasn’t been a problem. It’s much harder to “game the answer” when asked to give an example.
You can see why behavioral questions have taken root over the past decade or so: Interviewers love being able to assess candidates through the lens of their behavior. Unfortunately, not all interviewers are skilled in interpreting the answers; nor are candidates necessarily good storytellers. As the candidate, you can’t do much about your interviewer’s level of skill, but you certainly can increase your own. Here are five steps to help you develop compelling answers for behavioral interview questions.
STEP 1. Identify good stories in advance of the interview.
This can seem tricky at first—how can you prepare an answer without knowing the question? You won’t be heartened to know there are lists floating around of the top 100 behavioral interview questions. One hundred! That’s obviously far too many stories to prepare before a meeting, especially when the typical interview may contain no more than three or four of this style of question. How would you ever know which questions they might ask? A better strategy is to reverse-engineer the problem: Instead of anticipating the question, start by identifying your ideal stories.
To do this, think deeply about the past five or eight years, to refresh your memory of internships, residency, fellowships, and any other training or field experience that you’ve had. Now ask yourself: When did you persevere during a challenging situation? When were your efforts pivotal to creating a successful outcome? When did you think of an improvement to a process or system that created good results for your team?
Once you have a few examples in mind of times when your work was particularly successful, you’ll have the basis for good stories.
STEP 2. Draft out each story in a STAR pattern.
STAR is a popular acronym which stands for Situation, Task, Action, Result. It’s a tool that can help you keep track of the parts of your story, and ensure that you have enough content to make an impact, while also guiding you to tell the story clearly. Here’s an
example from a neurology fellow whose patient would not follow a treatment protocol, and how the physician handled the problem.
Situation: Patient continues activities that are harmful, and is not adopting behaviors that are healthy. The patient’s family is distraught and is asking for help convincing the patient to cooperate with the treatment plan.
Task: The physician has several concerns to keep in mind, including patient confidentiality, the patient’s right to self-determination, the clinic’s liability, the overall goal of providing good care, etc.
Action: As a fellow still in training, the physician decided to bring the case forward for discussion and review, with the goal of receiving advice for handling the situation. The question of mental health care and therapy support for the patient was raised by the fellowship director, which gave the physician the idea of providing resources to the patient to access this assistance. The idea of a care conference with the family was also raised to let them express their concerns in the patient’s presence. The physician decided to take these steps.
Result: The patient listened to the family’s concerns but also provided some insight about being uncooperative—behavior which was actually rooted in trying to maintain control. Although the patient turned down the option for mental health counseling, the care conference provided enough foundation for communication that the patient agreed to cooperate more fully. The doctor’s relationship with the patient also improved.
STEP 3. Shape the story to be more compelling when it’s spoken aloud.
Although the STAR story above is certainly clear, it’s not very relatable. It reads (and would sound) like a bare-bones recitation, which is hardly compelling in an interview. Here’s one way this STAR draft might sound when revised to be more conversational:
“When I was in my first month as a fellow, one of my first cases in outpatient care was a gentleman whose epilepsy treatment plan called for a fairly high level of personal responsibility. He was a smart man and not someone who seemed self-destructive, but he was pretty much rejecting every part of the plan. He’d agree to things in the clinic, then go home and do the opposite. I was already trying to figure out what to do when I started getting calls and emails from his family. His wife, especially, was very concerned and she was asking for a lot of detail about my conversations with him. I knew I couldn’t go down that path with her, but I needed to do something to manage the situation, while also trying to get him the care he needed. I decided to bring the case up with my fellowship director and I got some good advice. She reminded me of ways I could use a care conference and also brought up the idea of resources he could tap into for mental health counseling that might help him sort out his feelings about his epilepsy. In the end, we had a half-victory in that he agreed to the care conference, but he didn’t want to try the counseling. The conference was a home run, though, because it gave his family an opportunity to really open up about what his behavior was doing to them, and it prompted him to accept some parts of the treatment plan. I was also gratified to have a better relationship with him after that, I think because he trusted me and knew I was trying to provide good care while also listening to him.”
Although that story may look long when you see it printed as one big paragraph, when you time it out, you’ll see that it takes only a few minutes to tell. Adding pauses and intonation changes will increase the length but will be worth the tradeoff. That’s because a more natural sounding delivery will be memorable and interesting to the interviewer.
STEP 4. Anticipate questions your story could answer.
A good story will give you the foundation for at least five or six different behavioral questions. Knowing this, you can prepare a handful of stories, perhaps five, with the confidence that you’ll be able to answer 25 or 30 different questions, just by reshaping the first few sentences of the story. For example, the story above could be used in its current form to answer, “Tell us about a difficult patient that you treated.” But with a little reshaping, it could also be used to answer, “When have you used a collaborative care process with a patient?” or “What have you done to gain a patient’s trust?” or even, “Tell us a situation you’re proud of from your fellowship.”
STEP 5. Practice, practice, practice.
While you can’t be certain which questions your interviewers will ask, you can still practice telling your stories. The ideal process involves three steps: Typing the story into a word processing program so you can shape it easily; then writing it by hand so it lodges more firmly in your memory; and finally, saying it out loud a few times until you feel comfortable navigating the different parts of the story without getting lost. As you already know, the goal isn’t to memorize to the point of sounding rehearsed. But not practicing at all increases the risk of forgetting key points—or forgetting the story altogether. The middle ground is to be comfortable enough telling your story without notes that you know you won’t freeze when a question is asked.
As a final tip, remember that no matter how prepared you are, the interviewer could still ask a question you don’t have an answer for. If that happens, you can always punt: “I’ll need to come back to that question, as I’m drawing a blank for the moment.” Or even, “I don’t have an example that relates exactly, but I did have a situation come up with some similarities. When I was in my first month as a fellow, one of my first cases in outpatient care was a gentleman whose epilepsy treatment plan…” Sometimes it’s not so important that the story matches the question, as long as the story itself is informative and well-spoken. Try it and see: If you master the art of answering behavioral questions, you’ll experience a transformative effect in your interview process.