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Making the right choice:

Before assessing potential candidates, get familiar with the open position, prepare a list of pertinent questions, and know how to spot red flags in job applications and resumes.
By Marilyn E. Asselin, RN, BC, PhD

Strategies for effective interviews

hoosing the right person for the right position within your organization is a crucial task. A new employee has the potential to positively or negatively impact patient satisfaction, patient outcomes, and the healthcare teams success. A bad hire creates additional burdens on fellow employees and direct supervisors. While theres no guarantee that a candidate who interviews well will be a star performer, managers who use a systematic method of interview-

plete and clear understanding of the open position. By obtaining a copy of the job description and knowing the minimal educational and experiential requirements for the position, you can properly prepare in advance for the interview and adequately critique the candidate. Ascertain the following information about the job: knowledge and skills required, responsibilities, physical demands, emotional factors such as potential stressors and flexibility required, intellectual factors such as judgment and critical thinking, and the amount of supervision required.1 Next, its important to develop a list of competencies that are essential for success in the job. To

ing will be more likely to hire a candidate thats right for the position. What follows are several proven review strategies that provide maximum information during the interview and increase the probability of a good fit between the candidate and your organizations values, goals, and work unit. Preparing for the interview Before interviewing a candidate, ensure you have a com42 Nursing Management August 2006

determine these job-specific competencies, review the job description for evidence of role expectations. Also, identify the critical dimensions of the job in relation to technical skills, critical-thinking skills, and interpersonal skills.2 Generally, technical skills incorporate cognitive skills, psychomotor skills, and a technical understanding of the position. Critical-thinking skills include clinical reasoning and judgment, problem solving, time management, planning, and prioritizing. Interpersonal skills may include team skills, customer service, and communication. Once these skills are identified, its important to

develop a list of professional values, characteristics, and behaviors thatll ensure success in the position. To develop this list, look to the values of the organization, work team, and unit, in addition to departmental goals. Values may include caring, compassion, collaboration, respect, and lifelong learning. The nurse manager may want to identify additional skills needed to accomplish goals that present employees may not possess, such as initiative, flexibility, and a patient-focused approach to care. Leadership behaviors such as delegation, priority setting, and time management might also be appropriate. Furthermore, consider behaviors that may indicate a candidates leadership potential, such as a willingness to step up to the plate for new assignments, lead unit change, and take risks, coupled with a desire for growth and ownership. You may choose to assess a job candidates emotional intelligence during the interview. Emotional intelligence has been identified as a key characteristic of leaders, and is described as the ability to recognize our feelings and those of others while managing emotions in ourselves and in our relationships.3,4 Emotional intelligence also includes components of self-awareness, self-regulation, motivation, empathy, and social skill.3 Researchers believe that behaviors associated with self-awareness may include self-confidence and a realistic self-assessment.4 Self-regulation may be exhibited through trustworthiness, integrity, self-control, and adaptability. Motivation may be expressed through a drive to achieve and willingness to change. Empathy may be exhibited through expertise in building and retaining talent, cultural sensitivity, and service to patients and families. Social skills may be exhibited through conflict management, establishing positive relationships, and team skills.3 43



Develop an interview guide To ensure that you interview a candidate on all critical aspects of a position, its helpful to develop an interview guide based on the values, behaviors, and competencies youve identified as essential to the job position. A guide also ensures that all candidates are asked the same questions. Behavioral interviewing is a crucial facet in hiring the right candidate. It involves asking a series of questions based on key characteristics of the job that probe deep into previous on-the-job experiences or actions.5 This technique is based on the premise that past behavior is a good indicator of how the candidate will perform in the future. A behavioral-based interview question contains several core elements that revolve around what happened, what were the circumstances, what was said and done, and what the outcome was. For example, you may want to assess a candidates ability to adapt to change. A traditional interview question may be, How do you deal with change? A behavioral-based question may be, Tell me about a specific example from your current position in which you faced change. What was the situation, what did you do and/or say, and what was the outcome? These behavioral interview questions prompt candidates to give in-depth responses, providing specific information on how situations were handled. Through the interview questions, identified behaviors can be linked to situational aspects of the job. To develop the interview guide, first list all the values, behaviors, and competencies that are critical to success in the job. For each item on the list, develop a behavioral interview question. Use an interview guide format that allows you to comment on and score the candidates answers to specific questions. When developing questions for the interview, its essential to create several specific questions that gauge the candidates responses in positive as well as difficult situations. This approach will help you get a sense of how the candidate deals with difficult situations. For example, you could ask candidates to describe a situation in which they didnt agree with a co-workers decision. The answer helps you form a more complete picture of the candidates abilities. Behavioral-based interview guides may be developed based on key organizational values or desired behaviors, and can be used across a nursing department or an organization to increase the likelihood of matching a candidates values, behaviors, and characteristics with those of the organization. For example, if the organizational focus over the next year is to enhance the customer service and teamwork skills of its employees, a standard interview guide based on specific behaviors in these categories can be developed for use by all managers. This ensures that employees are hired based on behaviors valued by the organization. An additional step would be to integrate those behaviors into the performance appraisal system.

Consistency is important When considering potential candidates for a specific position, its important to note that the job application should be consistent with the resume. The resume should be neat and in an organized format that provides the reader with a chronological history of career development. Review the job application and resume for evidence of job stability. Additionally, look for examples of professional growth and development such as progression in job responsibilities and/or involvement in professional activities or organizations. In this review, also look for evidence of proficiency in any of the competencies or behaviors that have been identified as being essential to success in the position. While reviewing a candidates past history, remain aware of potential red flags in job applications and resumes that may be signs an employee has work-related problems. Common red flags include unexplained gaps in employment history or frequent changes of employers without acceptable explanation. Listing personal as a reason for leaving prior positions, having blanks on application form questions, and noting dates that dont match are also warning signs. Significant mistakes, evident corrections, and inconsistent dates may indicate poor attention to detail or fabrication.6 When red flags are identified, it may be helpful to do a telephone screen to determine whether to schedule an interview or address the red flags during a face to face interview.6 Involve human resources personnel if you have any questions or doubts about an application or resume. Conducting the interview Good interviews have structure and consist of three parts: an introduction, the actual asking of interview questions, and the closing. Take time to the aim is to make the candidate feel comfortable and provide information about the job. This time also helps candidates determine if theyll be a good fit with the goals and values of the organization. Take time to introduce yourself and state your job title and role in respect to the job position. Then describe how the interview will proceed. If you plan to take notes during the interview, inform the candidate at this time. Provide an overview of the job requirements, responsibilities, and expectations, and briefly discuss department goals. In the second part of the interview, use the interview guide to ask questions of the candidate that assess their ability to fill the position. You can begin by making a general statement such as, Lets begin by having you discuss how you decided to apply for this position and how you feel this position will help you fulfill your career goals. The manager can then ask questions using the interview guide. (See Sample manager interview guide.) When asking the questions, use a statement to lead into the question. For example, you might say that providing patient education is one aspect of this position, and then proceed 45



with a question related to that category. The candidate may also make a reference to one of the interview guide categories when answering another question. When you pick up on that comment, proceed directly into that interview question. The candidates answers to some questions may require additional probing to get specific details of a situation or to better understand the candidates answer. Its important that all questions on the interview guide be asked of all candidates, otherwise itll be difficult to make a hiring decision when comparing candidates. Its recommended that an interviewer ask between 10 to 15 questions.7 Too many questions can overwhelm the candidate. At the close of the interview, clarify any remaining issues or provide an opportunity for candidates to ask questions to gain a better understanding of the job position and expectations. You may want to ask, Is there anything you want to ask me? and Is there anything else you want to tell me about yourself? Review the time frame for making the hiring decision and possible starting dates, describe the next step if any, and provide information on who the candidate can contact with any additional questions.8 Offer additional information about the organization or department, provide a tour, or introduce the candidate to other members of the healthcare team. Additional considerations At all times during the interview, remain aware of nonverbal behavior. Facial expressions and body language often tell us as much as verbal responses. Note-taking is also helpful, but let the candidate know at the beginning of the interview that notes will be taken. Notes provide helpful clues when completing the interview guide and decrease the risk of forgetting information that may be pertinent to hiring the candidate.

Be aware of legally sensitive issues surrounding interviewing and the implications of asking inappropriate questions. Ask the human resources representative to review the interview guide to check for any inappropriate questions. Generally, avoid questions about age, gender, marital status, ethnic origin, sexual preference, mental or physical handicaps, disability, pregnancy, or veteran status.9 Also, in the interview, be wary of candidates who complain about past employers or co-workers, or those who ask the processes for requesting time off for vacation or personal time. Its important to listen and let the candidate talk but not control the interview. Allowing the candidate to control the interview will elicit only positive information.6 Use probing questions until satisfactory answers are reached. The candidate may also make comments about various personal issues. Listen politely, but quickly redirect the candidates conversation back to the job interview. The use of silence is an effective tool for allowing both parties to regroup and think about additional information to provide or questions to ask. In addition, be sensitive to cultural diversity and its impact on the managers impression of the job candidate. Cultural diversity may be represented through race, gender, or ethnic background. Good candidates can be dismissed because managers perceive the candidate isnt similar to themselves or the workgroup.6 For example, job candidates might express cultural differences through eye contact, rates of speech, or voice inflections.6 Additionally, the role of the nurse in some cultures may be viewed as passive compared to a Western cultural view of the nurse as an active agent in a collaborative healthcare team. After the interview After each interview, complete the interview guide and write a brief summary of the candidates

strengths, weaknesses, and overall impressions of the candidates fit with the organization. Once final candidates have been identified, you may choose to have these potential employees return for a second interview with selected members of the staff. Peer interviewing when hiring staff nurses is an effective strategy.10,11 It provides an opportunity for the professional growth of staff nurses while fostering a commitment to cohesiveness and team building.9 Moreover, it offers the candidate the opportunity to share unique perspectives with the staff or to ask the staff questions.6 When selecting staff for peer interviewing, first determine qualifications for selecting staff to participate in the interview. Qualifications may include, for example, at least 1 year of experience on the unit, clinical competency, excellent interpersonal communication skills, and an interest in participating in the interview process.10 Once staff are selected, its important to meet with the staff to review the resume(s), assist them in identifying behaviors and characteristics of a successful candidate, and help them to frame those behaviors and characteristics into questions to include in an interview guide. Instruct the staff on basic interview skills, confidentiality, and legal considerations. You shouldnt be present during the staff interview.11 At the conclusion of the interview, staff can submit their recommendations. In the event that a consensus isnt achieved on hiring, a meeting is held between the manager and staff to discuss the candidate and reach a consensus as to hire or not hire. The reference check process may be useful in helping to determine the final candidate to hire. The work teams ability to work cohesively and achieve its goals is dependent on hiring the right candidate for the work team position. The manager can increase the probability of a successful fit with the organizations and work teams values and goals by developing concrete, efficient interview skills. NM
REFERENCES 1. McConnell CR. A working managers guide to effective and legal employee selection interviewing. Health Care Superv. 1999;17(4): 77-89. 2. Tracy JS, Summers BG. Competency Assessment: A Practical Guide to the JCAHO Standards. Marblehead, Mass: Opus Communications; 2001. 3. Snow JL. Looking beyond nursing for clues to effective leadership. J Nurs Adm. 2001;31(9):440-443. 4. Goleman D. What makes a leader. Harv Bus Rev. 1998;76(6):93-102. 5. Powers L. Anatomy of an interview. AORN. 2000;72(4):671-674. 6. Duke DJ. A Legal Look at HiringPart I. Nursing Spectrum NY/NJ Edition. May 15, 2000. Available at: http://community.nursing Accessed July 24, 2003. 7. Foster CF, Godkin L. Employment selection in health care: the case for structured interviewing. Health Care Manage Rev. 1998;23(1):46-51. 8. Olsen CA. The interview process: one managers perspective. Home Healthcare Nurse Manager. 1999;3(2):28-32. 47



9. Timmons TJ. Interviewing techniques for hiring quality employees in the OR. AORN. 1998;67(1):222-228. 10. Allen SR, Thrasher T, Wesolowski C, et al.

Peer interviewing: sharing the selection process. Nurs Manage. 1998;29(3):46. 11. Shiparski L. Successful interview strategies. Nurs Manage. 1996;27(7):32F,32H.

ABOUT THE AUTHOR Marilyn E. Asselin is the associate vice president of patient care services at Kent Hospital, Warwick, R.I.

Sample manager interview guideposition: RN staff nurse

Use the following behavioral interview questions as a guide to assess job candidates. Scoring 1 = Does not exhibit desired characteristic 2 = Minimally exhibits characteristic 3 = Satisfactory Job Candidate: _________________________________ Category Patient-focused care Value: compassionate caring Effective patient education Critical thinking: problem-solving, quality driven Leadership: priority setting Leadership: delegation Lifelong learning / knowledge application Team spirit Behavioral interview question Give me an example of a decision that you and a patient made jointly. What factors were involved and how did you arrive at the decision? Tell me about a situation in which you felt you gave compassionate care to a patient and/or family. What did you do? What was the outcome? Give me an example of how you planned to educate a patient regarding his/her diagnosis and treatment plan. What did you do and say to accomplish the goal? What was the outcome? Give me an example of a problem that you encountered while caring for a patient. Describe the situation, your actions to resolve the problem, and the outcome. Tell me about one of your busiest shifts and how you prioritized your care and practice activities. Tell me about a situation in which you delegated responsibility to a co-worker. How did you decide to delegate, what did you say, and what was the outcome? Think of the last time you participated in an educational activity. Describe the type of activity and why you participated. Tell me how you used the information that you learned. Tell me about a time when you helped a co-worker. What was the situation? What did you do and say? What was the outcome? Tell me about a time when you realized that a patient/ family member had difficulty understanding what you were explaining. What was the situation, how did you know there was a problem, what did you do, and what was the outcome? Tell me about a time when you were able to turn an angry or dissatisfied customer (patient, family, or fellow employee) into a satisfied customer. What was the situation? What did you do or say and what happened? Observe candidate. 4 = Strongly exhibits characteristic 5 = Exceeds desired standard for characteristic Date: ___________ Comment on candidates response Score


Customer service: service recovery

Physical presentation (body language, appearance) Unit-specific competencies

Add questions related to specific competencies on your unit.

Total score: ______________ Overall impression of candidate. Would this candidate be a good fit, sharing similar vision and qualities needed to be successful? Manager: _________________________________
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Date: ___________