First Name *
Last Name *
Hostility
1. Do you ever get very angry? How do you control your anger? *
2. Have you ever hit someone in anger? How often? Provide details about the last time it happened. *
3. Have you ever lost your temper? With a patient? Provide details about the last time. *
4. Have you ever had to tell someone off? How often does this happen? Give me an example. *
5. People are often bothered by allot of work rules. What do you do if you don’t agree with them? *
6. Do you ever curse at work or with patient? *
Conscientiousness
1. How high are your personal work standards? Please give an example. *
2. Do you think that others have higher standards than you do? *
3. Has your work quality ever been an issue your boss or client? *
4. How do you pace your work? How important are deadlines to you? What happens if you miss one? *
5. Do you see a difference between the way you dress and how your co-workers dress? Explain. *
6. How often do you find yourself unmotivation at work? What do you do to keep yourself going? *
7. How important is your job to you? What are the things that really matter to you? *
8. Tell me about how you keep you workspace clean and organized? *
Integrity
1. Almost everyone has called off sick now and then as a mental health day, how often do you? *
2. Tell me of an instance when you had to lie a little bit to protect yourself at work. *
3. Tell be about something that you may, at one time have exaggerated or lied on a job application? *
4. Have you ever told your boss what he or she wanted to hear rather than the truth? Explain. *
Substance Abuse
1. Have you ever used illegal drugs? *
2. How much contact do you have with people who use illegal drugs? *
3. Who should be responsible for controlling the use of illegal drugs at work? *
4. What is your opinion about illegal drug use? Are there circumstances when you think it's OK? *
5. Has there ever been an instance when you drank and drove? What were the circumstances? *
Sexual Harassment
1. How often have you made a sexual remark at work? What kinds of remarks have you made at work? *
2. Have you ever told a dirty joke at work or to a client? *
Organization
1. Describe a time when you lost track of some details of a patient and it caused a problem. *
2. Explain how you keep track of the details of care plan. *
2a. Have you ever not completed a care plan for a patient? Please provide details. *
3. Tell me about a time when you reacted quickly, before others, to a patient situation? *
Conventional (Rules)
1. Have you ever had to bypass an important procedure because you were in a hurry? Details? *
2. Tell me of a time a good patient wanted something that was not consistent with policy. Details? *
3. How have you handled a situation where there was no procedure in place? *
Extroversion
1. How do you deal with chatty patients when need to move on to the next task? *
2.Describe a time when you were having a bad day but needed to remain optimistic for a client. *
Stability
1. Tell me of an instance when a patient was very upset about something and was being unreasonable. *
2. Tell me about a time when your job was so demanding that you weren't able to complete your work. *
3. Provide an example of how you've dealt with stress in your job. How do you relieve stress? *
Team
1. Do you prefer team sports or individual sports? Why? *
2. Give me an example of when a coworker needed your help with something. Describe the situation. *
Computer Use
Have you ever used a computer at work or at a client's home for: *Have you ever used a computer at work or at a client's home for:
Please explain all that you have checked. *
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