A 60-year-old Indigenous patient with type 2 diabetes expresses a preference for managing their condition with traditional healing practices over the insulin you recommend. Their daughter is concerned about their high blood sugar levels. How do you navigate this conversation?

Where answers to this question lose points

Our scorer marks every answer on three parts. For each of the 45 applicants who finished this question on Confetto, we took their first scored answer and counted the part that scored lowest.

• Structure: a clear order and a clear point22 of 45

Confetto data as of November 8, 2026. A part is shown only when 20 or more applicants share it. Answers where two parts tied are not counted toward either. We never show anyone's answers or details.

What this question tests

• Communication
• Cultural humility
• Patient care

How to structure your answer

1. Ask questions (25 seconds). The answer opens by wanting to understand the patient's perspective and cultural background, rather than announcing a treatment verdict. It asks the patient what their traditional healing practices involve, how they have helped before, and why they matter for managing diabetes.
2. Who is affected (20 seconds). The patient comes first, including their health, cultural values, autonomy, and trust in the clinician. The answer then acknowledges the daughter's concern and considers involving trusted traditional healers or community elders, with the patient's agreement.
3. The conflict (20 seconds). The conflict is between respecting the patient's preference for traditional healing and recommending insulin to reduce the risks of uncontrolled diabetes. The answer treats providing clear medical information and protecting the patient's freedom to choose as responsibilities that must be held together.
4. Options (40 seconds). Traditional healing alone respects the patient's preference but leaves concerns about uncontrolled blood sugar, while insisting on insulin risks undermining trust and autonomy. The answer favors exploring insulin alongside traditional practices, although this requires discussion rather than assuming the patient will accept both.
5. Choose (30 seconds). The answer chooses to pursue a collaborative approach, asking whether the patient would consider combining insulin with traditional healing. Its main reason is to address medical risks without dismissing cultural values or imposing treatment, while recognizing that the final decision belongs to the patient.
6. What next (20 seconds). The answer's next step is to offer a family discussion, with the patient's permission, and explore involving trusted traditional healers or elders. It does not specify follow-up, documentation, or senior involvement, so its ongoing plan remains less developed.

Example answer from Confetto

Example answer from Confetto. Not a real applicant's answer.

My immediate thought is that I need to understand this patient's perspective and cultural background before making any assumptions about their treatment preferences. I believe respecting their autonomy while ensuring they have complete information is crucial for building trust and achieving the best health outcome.

I would start by asking the patient to tell me more about their traditional healing practices and what they mean to them. I'm genuinely curious to understand how these practices have helped them in the past and why they feel this approach is important for their diabetes management. I recognize that Indigenous communities have centuries of healing knowledge, and dismissing this would be both disrespectful and counterproductive to our relationship.

At the same time, I feel a responsibility to ensure the patient understands the serious risks of uncontrolled diabetes. I would explain that blood sugar levels above certain ranges can lead to complications like kidney damage, vision loss, and cardiovascular problems. However, I'd frame this as providing information rather than trying to override their choices.

I think the most important step would be exploring whether we can find a collaborative approach. I'd ask if they would be open to combining traditional practices with insulin, explaining that many patients successfully integrate both Western and traditional medicine. I might also inquire if there are traditional healers or community elders they trust who could be part of this conversation.

Regarding their daughter's concerns, I would acknowledge her worry while emphasizing that the decision ultimately belongs to the patient. I'd offer to facilitate a family discussion if the patient agrees, ensuring everyone understands both the medical recommendations and the patient's cultural values.

Throughout this conversation, I believe my role is to be a medical advisor and cultural ally, not someone who imposes treatment decisions.

Use it for its structure. Interviewers can tell a memorized script, so tell your own story.

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