Situational Judgment Tests: Guide to the Medical School Application (2023)

What are Situational Judgment Tests?

The two situational judgment tests (SJTs) you should be aware of when applying to medical school are the Casper, offered by Acuity Insights, formerly known as Altus, and the AAMC PREview. Altus is also the developer of the multiple-mini-interview (MMI). These are often completed as part of the secondary application process, but you can typically take them as soon as you know you will be applying to a school that requires them. 

If you only have one school on your list that requires an SJT, it may be worth waiting until you’ve actually submitted your primary application in case you decide not to apply to that school. 

Both tests present you with hypothetical, but realistic scenarios and center around ethical questions. Many students say that the Casper in particular is very similar to an MMI, which makes sense seeing that the creators are one and the same. The interpersonal and intrapersonal qualities evaluated by SJTs are hard to evaluate in any other part of the application. 

All About Casper

What is on Casper?

Casper involves 14 scenarios. Each of these will present you with a video or paragraph of some scenario and ask you three open-ended questions about the described situation. You’re allotted five minutes to respond to each scenario. The test takes 90 to 110 minutes, and there is an optional 10-minute break between the video and typed sections, as well as an optional 5-minute break during the typed section. There is no set right or wrong answer. Casper is scored by individual people, working from set criteria for each section. Instead of one rater scoring your entire assessment, each section will be scored by a different assessor. 

How to Prepare for Casper

There’s no one way to prepare for Casper, and the most important thing is to be familiar with the test and what you can expect while taking it. The most important thing is to be a good person and be yourself. You don’t have to be the greatest person to ever live or be an expert on ethics. You just need to be somewhat in line with what’s expected of you as a future physician and be able to explain your thought process. 

There are also example scenarios you can find online that will give you an idea of what to expect. Spending some time thinking about how you would respond to the example scenarios should be the majority of the prep you need. 

Listen to a Casper Episode

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Do I Need to Type Quickly?

One of the biggest concerns students have about Casper is being asked to type out a response under time pressure. You will want to be reasonably comfortable with typing, but you don’t need to break any record speeds. You are also not scored on your spelling and grammar, so you should feel free to focus on getting your thoughts down over how they sound. You’re not writing a college-level paper. There’s also no set format, so if bullet points are what it takes to get your thoughts down, then do that. 

When Do I Take Casper?

You want to take it early in the cycle. Schools that consider Casper part of the secondary process may not consider your application to be complete until they have received your score. The turnaround between taking the test and sending your scores to schools is around three weeks. 

Where Do I Take Casper?

You take Casper at home, on your own computer. They require that you have a functional webcam that is on, uncovered, and pointed at you. You need to be dressed appropriately, but there is no strict dress code. You can find information about this and check whether your computer meets the requirements at

How Much Does Casper Cost?

It costs $10 to register for the test and an additional $10 per school you want your score released to. They waive fees for those who qualify for fee assistance through AMCAS or AACOMAS; they will waive the fee. The best place to confirm costs is on their website

Will I Get My Score Back?

During this past application cycle, Altus began sending students their quartile scores. This means students knew whether they scored in the upper quartile, median, or lower quartile of other test takers from the same day. 

How is Casper Used?

As with so many things in this process, the answer is that it varies. Some use it in the place of secondary essays, and some will use it in addition to those. The most accurate information on this will be on each school’s website. 

Some schools may use it to decide who is invited for an interview, and some will use it as part of the post-interview evaluation. It is just one aspect of your application that may add or detract but will not be the single deciding factor. 

All About AAMC PREview

What is the AAMC PREview?

The PREview is the situational judgment test created by the AAMC, and it was first used in 2020. It was trialed at a small number of schools during the 2020-2021 cycle and is being required or recommended by a few schools during the 2022-2023 cycle. 

Similarly, it presents realistic, hypothetical scenarios that reflect things you may experience as a medical student or physician. The most significant difference between Casper and PREview is that PREview is multiple choice. 

What is on the AAMC PREview?

The PREview includes 30 scenarios and a total of 186 questions. There are also experimental questions that won’t be scored. You are asked to rate a response to a scenario on a scale of 1 (very ineffective) to 4 (very effective).

Which Schools Use the AAMC PREview?

The list is still relatively short, currently, but that can change. The best place to find the list of participating schools is on the PREview website.

How Do I Prepare for the AAMC PREview?

There’s no specific preparation you need to do, but the AAMC does offer a practice test on their website. This may help alleviate some of the nerves around taking an unfamiliar assessment. 

How is the AAMC PREview Scored?

Students are given a score from 1 to 9 and a percentile rank. This is the score that is sent to both schools and students. If you void, you will not see your score, nor will medical schools. 

When Should I Take the AAMC PREview?

The test is available now to 2022-2023 applicants, so you should plan to take it as soon as you know you’re applying to schools that require it. You can find dates online. 

Where Do I Take the AAMC PREview?

Like the Casper, you also take it on your own computer at home. You will also be required to have your webcam on. You can check the technical requirements on the AAMC website. 

How Much Does the AAMC PREview cost?

There is a flat fee of $100 dollars to take the test and receive your score. This fee is waived for FAP recipients. 

How is the AAMC PREview used?

This will depend on the school, and is likely to shift throughout time since it is such a new assessment. Schools may give more information on how it fits into their review process on their website. 

Helpful Links and Resources

The Changes to Casper and Altus in 2021

Guide to Applying to Medical School: the Core Competencies