Casper Practice Test: Questions with Answers

One common type of Casper station involves Judgement or Coping under Pressure. These scenarios often present controversial topics followed by questions about your thought process and how you would manage the situation. These stations can feel challenging because there are rarely clear cut answers. This Casper blog provides some advice for tackling these stations, along with sample questions and responses.

APPROACH

Many students struggle with this station because they think the examiners are looking for a “right” answer. In reality, how you communicate your response matters more than the response itself. There are no single “correct” answers as examiners are assessing your reasoning, empathy, and professionalism. Speak honestly about your personal approach and trust your instincts.

ADVICE

• Trust your gut instinct: Focus on your own approach rather than what you think the examiner wants to hear. 
• Explain your reasoning: The clarity of your explanation is more important than the answer itself.
• Consider all sides: Evaluate both aspects of the issue before giving your response.
• Be respectful and empathetic: Show compassion for all parties involved.
• Escalate when appropriate: Recognise when involving a senior or external support is needed and explain why.
• Manage your time: Distribute your time evenly; five minutes passes quickly. 
• Practice typing under time pressure: Comfort with written communication under exam conditions helps performance.

KEY TAKEAWAY

Ethical and pressure based scenarios are designed to be complex and challenging. High achieving candidates stand out by providing responses that demonstrate a holistic understanding of the situation, showing reasoning that considers context, ethics, and practical solutions.

Question 1

You are the attending physician in a busy emergency department. A dishevelled middle-aged man, wearing worn sweatpants and an old jumper, arrives complaining of intense back pain. During your history taking, he insists that only very strong pain medication provides relief. A nurse mentions that this patient often comes to the hospital and is regularly prescribed very strong addictive analgesics.

[Take 30 seconds to think about the scenario]

1. What is going through your mind right now?
2. What would you do in this situation? 
3. How would you handle the patient if he kept insisting on getting prescribed painkillers?

Our Sample Responses

1. What is going through your mind right now?

My main concern in this situation is that the patient is requesting very strong, potentially addictive analgesia and has a known history of frequent visits for these medications. Since I have never spoken to  him before, I want to determine whether his pain stems from an opioid dependence or from poorly controlled chronic pain. I would avoid making assumptions and aim to understand his perspective, as it would be insensitive and inappropriate to accuse him of anything without fully exploring his situation. My goal is to help him, and the best way to do that is by having an open conversation to learn more about his circumstances.

2. What would you do in this situation? 

I would take the patient to a private area where he feels safe, comfortable, and free from judgement so we can speak openly. I would ask about his pain history, how long he has relied on strong analgesics, and whether he has tried alternative pain management strategies. If his pain is due to an inadequately managed chronic condition, I would escalate this to a more senior clinician or pain specialist, as ongoing analgesics alone may only treat symptoms rather than the underlying issue. I would also speak with the nursing staff, as they may have valuable insights from his previous visits.

3. How would you handle the patient if he kept insisting on getting prescribed painkillers?

If he continued to insist on strong analgesia, I would consider whether prescribing it would actually benefit him long term, given the risks of dependence and harm. I would explain, in a clear and empathetic manner, that these medications can be highly addictive and that safer pain management strategies or additional supports may be more appropriate. If I suspected opioid dependence, I would offer a referral to relevant services such as drug and alcohol clinics, provide education about addiction, and encourage him to involve trusted family or friends who can support him. I would also escalate to a senior colleague to ensure he receives comprehensive, appropriate care.

Question 2

A close friend and colleague calls you to share how much he has been struggling emotionally since his recent divorce. You’ve also observed at work that his performance has declined, and he has begun expressing his frustration toward other team members, creating tension within the workplace. Your supervisor, aware of your friendship, asks you to speak with him and address the situation.

1. How would you approach a conversation with your friend to address both his wellbeing and his recent behaviour at work?
2. What steps would you suggest supporting your friend through this difficult time while ensuring that he maintains his productivity and professionalism at work? 
3. If his performance does not improve despite your discussion, what would be the most appropriate next steps?

Our Sample Responses

1. How would you approach a conversation with your friend to address both his wellbeing and his recent behaviour at work?

I would begin by acknowledging how difficult this period has been for him and offer emotional support, as his wellbeing is very important to me as his friend. However, I also have a responsibility to be honest with him. I would approach this gently by explaining that his recent behaviour at work has appeared unprofessional and has been creating tension among colleagues. I would reiterate that while I understand he is going through a difficult time and that his feelings are valid and understandable, it is not appropriate to direct his frustration toward others in the workplace.

2. What steps would you suggest supporting your friend through this difficult time while ensuring that he maintains his productivity and professionalism at work? 

I would continue offering emotional support through regular check-ins and encouragement. If I believe this is not enough and his performance remains below expectations, I would encourage him to reach out to other trusted family members and friends for additional support. I would also gently raise the idea of speaking with a therapist or counsellor to help him process his emotions with professional guidance. If he feels overwhelmed by the combination of personal and work pressures, I would help him explore options such as taking some time off, and I would assist his team with any outstanding tasks where appropriate to ensure the workload remains manageable.

3. If his performance does not improve despite your discussion, what would be the most appropriate next steps?

If his performance at work does not improve despite our conversations, I would remind him of the seriousness of the situation and the potential consequences of ongoing poor performance. While I fully recognise that he is going through a very challenging period and that people grieve in different ways, he also has a professional responsibility to meet workplace expectations. I would strongly encourage him to have an open conversation with our supervisor about his circumstances so they can work together to develop a plan that supports his wellbeing while maintaining professionalism and healthy working relationships within the team.

Question 3

You are working a night shift on a hospital ward when you notice that a senior doctor you’ve known for years appears to be under the influence of alcohol. He is unsteady when walking, his eyes are bloodshot, and his speech is noticeably slurred. This behaviour is very out of character, and you are aware that he has been struggling emotionally since the recent death of his wife of 15 years. The ward is currently calm, and it is unlikely you will need his direct support for the remainder of the shift.

1. What is going through your mind right now? 
2. What would you do in this situation? 
3. If nothing bad has happened yet, should he be punished for his actions? 

Our Sample Responses

1. What is going through your mind right now? 

My main concern is the doctor’s ability to provide safe patient care and make sound clinical decisions, as even small mistakes can have serious consequences for patients. I would also want to determine how long he has been in the hospital, which patients he has seen, and any investigations he has ordered so I can review these for potential errors. As someone who has worked with him for many years, I would also be deeply concerned about his mental health and wellbeing, especially given the recent and devastating loss of his wife. While I do not agree with his decision to come to work in this state, I would approach him with empathy and seek to understand his side of the situation.

2. What would you do in this situation? 

I would speak with him privately in a quiet room and gently ask whether he is okay. I would then ask if he feels comfortable sharing what he is going through, acknowledging that this is an incredibly sensitive time for him. I would also need to ask whether he has consumed alcohol or other substances to assess his capacity to practise safely. If I believe he is impaired and has not yet reviewed any patients, I would ask him to either go home early or stay in the staff room for ongoing observation and removal from clinical duties.

3. If nothing bad has happened yet, should he be punished for his actions? 

Although the circumstances contributing to his potential intoxication are tragic, attending work impaired is unprofessional and places patients at risk. Doctors have a responsibility to uphold professional standards and violating these warrants consequences. However, given that this appears to be a first offence and occurred under exceptional emotional distress, I believe any disciplinary action should be balanced with compassion. He should have a formal discussion with a senior consultant to ensure appropriate follow up, a clear plan to prevent recurrence, and access to mental health and bereavement support.

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Need Help?

For more on how to prepare for the Casper test, please see other posts in this series:

1. How to prepare for the Casper test