Catholic Health Interview Questions: Cracking the Code to Landing Your Dream Job

Hiring for “Organizational Fit” November-December 2006

BY: BRIAN OTOOLE, Ph. D. Dr. OToole is vice president, mission and ethics, Sisters of Mercy Health System, St. Louis.

Too many health care leaders who hire people have had to learn the hard way that the old saying “Hire for skills and fire for behaviors” is true. “.

People tend to interview and rate job candidates based on their skills and hire them based on their ability to do the job when the job market is tight. But most performance problems—which can take up too much of a leader’s time and energy in the form of counseling, efforts to improve performance, and sometimes even firing—are caused by bad behavior rather than a lack of job skills. Because of this, many leaders will try to judge a candidate’s personality, social skills, and character during an interview in order to figure out how well they will fit in with the department or organization. When hiring people, these kinds of leaders usually have to go with their feelings or intuition, or “gut instinct.”

The implications of this problem are compounded when it comes to hiring leaders. A leaders management style can have a profound impact on the culture of a department or organization. Relevant here is another common saying: “Most people dont leave an organization — they leave their boss. A lot of Catholic health care groups are working hard to offer leadership development and leadership formation programs because of this. It is the main goal of these programs to help leaders manage people better by improving their skills, attitudes, and actions.

But there is still a problem, which can be summed up in another old proverb: “Most zebras don’t change their stripes.” Programs for leadership development can teach new skills, but programs for leadership formation try to build on the values, character, and honesty of the leader. Many of our values are formed early in life. Unless someone has a life-changing experience like Paul did when he was knocked off his horse and became a different person, formation programs rarely change values, character, or give someone more integrity than they had before. If you hired Attila the Hun because he could turn things around or had special skills, he probably won’t change how he runs things much, no matter how much you train him.

As health care gets more complicated, and religious women and men become less involved in Catholic health care, it’s getting harder and harder for Catholic organizations to keep their culture alive. People who understand and are committed to acting and making decisions in a way similar to what the religious sisters and brothers did will play a big role in how well the plan works.

Because of this, it is very important that when Catholic health care hires new people, especially those in leadership positions, they are evaluated not only on their skills and “job fit,” but also on their personal values and integrity, how they make decisions, and their general character (as shown by their behavior). All of these things must be taken into account when evaluating “organizational fit.” “.

As noted, most leaders try to assess candidates for organizational fit. There aren’t many tools, though, that make this process official and allow assessments to be done in a consistent and professional way. The few “off-the-shelf” interview tools that are made to measure organizational fit are general; they don’t measure how well candidates will fit into the culture of Catholic health care. Because each leader has to make their own decisions, they may have different views on that culture. As a result, they may interpret and judge a candidate’s answers in different ways. Further, the leader’s decision may even be wrong because the candidate is likely to be at their best during an interview. Subjective judgment is inescapably problematic.

Three Methodologies The Sisters of Mercy Health System, St. Louis has been working on three tools for leaders for the past few years that make it easier and more consistent to see if a candidate is a good fit for the company. These tools work with more traditional interview methods that check for “job fit,” or the candidate’s skills and ability to do the technical part of the job. When you hire someone based on organizational fit, you look at how well they fit with the Mercy culture. This means that you look at how well their skills, interests, and actions match up with the Mercy charism, religious heritage, and values.

The development and implementation of these interview and assessment tools involved three important steps:

• First, we had to be very clear about what we were looking for in candidates as we judged their fit with the company. We had to agree on what that was. Focus groups from all over the health system found groups of behaviors and attitudes that people had in common. Not only did these categories help us come up with interview questions, but they also helped us make the screens that interviewers could use to judge how well candidates answered those questions.
• Second, we had to carefully write pilot versions of the interview process to make sure we had the right questions that would get good answers and, most importantly, that the assessment screens were correct, easy to understand, and simple to use.
• Third, we had to teach people how to use these tools thoroughly and make sure they were used in all interviews.

Tool 1: Behavioral-Based Interviewing: To start, we made a behavioral interviewing tool that will be used for all new hires. As most leaders know, future behaviors often can be predicted on the basis of past behaviors. Behavioral-based interviews don’t ask general questions like “What are your greatest strengths?” Instead, they ask candidates to talk about specific behaviors they’ve shown in the past. Say, “Tell me about a time when you had to work closely with people you didn’t get along with.”

Focus groups composed by Mercy co-workers identified desired behaviors that we would look for in candidates. We categorized these behaviors as “relational,” “compassionate,” “service-oriented,” and “respectful or appreciative of Mercys religious heritage and traditions. Then, we made behavioral-based questions for each category and assessment screens so the interviewer could look at how the candidates answered. The assessment was scored on a 2-1-0 scale. A score of 2 means that the candidate (as we so often say) already “gets it. “That person already acts in ways that make them a great fit for Mercy and seems to have the beliefs, values, and commitment that make them that way.” Someone who gets a score of 1 has given good answers and has shown that they could become a good fit for Mercy, either formally (through formation programs) or informally (through interacting with Mercy coworkers). If a candidate gets a score of 0, it means that their answers might be fine in some other companies, but not for Mercy. They would not be a good fit for the company.

For example, one question in the service category states: “People can be very demanding. There’s a lot to do, but some people believe their needs are the most important in the world. What is an example of a time when you had to deal with someone who felt and acted this way?” The interviewer listens to the example and judges it based on the following criteria:

• Did the candidate do everything they could to help the needy person but then say bad things about them or criticize them? (This is an unacceptable answer and gets a 0) ) .
• Do you think the candidate tried to be fair by treating the needy person the same way they would treat anyone else, even though they didn’t like that person? (This is a good answer and gets a 1!) ) .
• Did the candidate understand how the needy person felt and try to put his or her own feelings aside in order to make the person feel special and cared for? (This is the best answer and gets a score of 2) ).

When the interview is finished, scores from each question are added up. The total offers a good indication of the kind of fit the candidate would be for the organization. By giving all candidates the same questions and test screens, Mercy makes sure that everyone is treated and judged in the same fair way.

Tool 2: Values and charisma test. Behavior-based interviews are very useful, but leaders also use their gut feelings and intuition to decide if a candidate is a good fit for the company. The way a candidate talks about themselves and others, as well as signs of passion or disengagement, are all nonverbal cues that can help you figure out if they are a good fit for the company. However, such cues are inevitably filtered through the interviewers subjectivity. It was to reduce this subjectivity that we created the second tool.

In order to do this, we asked Mercy leaders what they thought were the most common intuitive judgments they made when trying to decide if a candidate would be a good fit for the organization. We asked Mercy leaders who had been in charge for a long time and had done a lot of interviews to explain what made them think that candidates would be a good fit for the Mercy culture. We also asked what it was that made them feel uneasy about candidates with regard to organizational fit.

We made a list of the most common traits and put them on an evaluation sheet that the interviewer was supposed to fill out after the interview. In one column, the traits that fit the Mercy culture the best are listed. In the other column, the traits that fit the culture the least are listed. Again, the scoring is done on a 2-1-0 basis.

Here are some questions based on such characteristics:

• As part of the interview, did the candidate thank others for their gifts and contributions? Or did the candidate say nice things about themselves in comparison to others?
• What kind of caring for others did the candidate show? Did they care about managing time and resources (i.e. e. , good business sense)? Or did the candidate stress one trait more than the other?
• Did the candidate show that they were ready to be responsible for their actions and for others to be responsible for their actions? Or did the candidate blame others?

As before, the scores for each trait are added up to give a number rating of how well each candidate fits with Mercy. When this is done consistently with each candidate, the most common leaders’ judgments provide a more objective evaluation than any one leader could give on their own.

Tool 3: Values-Based Interviewing Our third tool arose out of two important beliefs. As we already said, Mercy thinks that leaders have a big impact on how a department or organization works. We also think that choosing the right leaders is important for keeping the charism, religious heritage, and values of a Catholic faith-based ministry alive, since the number of religious women and men working in Catholic health care is going down.

Because of this, Mercy checks candidates for all jobs to see if they are likely to follow Mercy’s rules. For leadership roles, Mercy also checks candidates’ values, commitments, and personal character. That is, it is not enough for a Mercy leader to act in a good way; he or she must also naturally be good at, interested in, and in line with the Mercy charism, religious heritage, and values.

Because of this, we’ve come up with a different set of interview questions and screening tools for people applying for leadership roles, especially for director and executive level positions. We began by agreeing on the critical elements for assessing leaders. These were mostly the values of our health care system, the normative principles listed in Part One of the Ethical and Religious Directives for Catholic Health Care Services, and parts of the Sisters of Mercy’s charism, such as ministry, hospitality, compassion, and right relationships. Then, for each part, we made interview questions that focused on actions and choices but also always asked candidates to explain why they acted that way. The questions were meant to show not only what the candidate would do or how they would make a choice in a certain situation, but also their personal values, commitment, and character.

These questions were tested and refined in leadership interviews over a period of three years. The answers were graded on how well they showed a fit with Mercy’s organization. The responses were then turned into screens that let interviewers look at the answers of specific candidates. The scoring was again 2-1-0.

For example, one question states: “Service is one of our Mercy values. “If you think of yourself as a service-oriented leader, what does that look like? And why are you a service-oriented leader?” Some candidates said they helped others because they knew that was what was expected of them and because they thought that this would help them become successful leaders. We thought this was an unacceptable answer for a Mercy leader, so we gave it a 0 because it might be a good answer for some organizations because it could lead to good results.

Some candidates said that they helped others so that their teams or the company as a whole could do well, and that it made them feel good to do so. This is an acceptable answer, so we scored it as a 1.

Other candidates said that being service-oriented at work was in line with their personal values and that they tried to be good examples of service even when it didn’t help them. They said that a good leader shouldn’t be self-centered but should always try to put the needs of others ahead of their own. Some even believed they served God when they served others. Because these were highly desirable answers, these candidates received a 2.

As with the other interviews, we add up the candidates’ scores in each area to get a number that tells us how well they would fit in as a leader in Mercy. Along with a more consistent and objective way to measure organizational fit, this tool has taught us some interesting things about how to conduct interviews.

• First, arguing about which screen had the 2, 1, and 0 scores was very helpful. For example, we learned that everyone believes in “justice,” but leaders who ask interviewees questions about justice and then look at the answers with justice-related screens often have different ideas about what justice means in health care leadership.
• Second, we noticed that some candidates for executive leadership roles come to us having been fully trained by staffing firms on how to answer our value-based questions. We found, though, that while these candidates may be very articulate in their first one or two questions, those who aren’t a good fit for us quickly run out of things they know how to say and end up awkwardly repeating themselves on later questions, making them seem fake and sincere.
• Third, we’ve found that body language can sometimes be a great way to tell if someone is a good fit for the company. There is a lot of interest and life in answering these questions from candidates whose values, personality, and habits are very similar to Mercy’s. If, on the other hand, a candidate isn’t a good fit for us, the questions often make them look awkward, confused, or otherwise not interested. We think it’s a good idea to look for these kinds of clues. If that’s the case, it’s better for both them and Mercy to find out that we’re not meant to be together. The candidate can then look for a company whose values are more in line with their own.

As the saying goes, “were almost there, but never quite.” That’s why we’ve started working on a fourth tool to help us judge leadership candidates. With this tool, people who want to be leaders are asked to pick between two statements that are both possible and true. One statement, however, is more strongly compatible than the other with our Mercy charism, religious heritage, and values. People running for office are asked to work alone in silence and pick one of the statements that best describes their own values and behavior. The best answers to these questions can then be scored and added up to give another view on how well each candidate fits in with Mercy’s organization.

As an example, one sentence about the value of community and the common good starts with “I want my health care organization to stress the importance of ” and then gives two possible endings: “a) doing everything we can to help our community” or “b) being the best place to work and the health care leader in our area.” “Both answers are good and worth considering, but a) is better because it fits better with our value of the common good. Another statement begins: “I will feel I have had a successful health care career if . I either a) left the companies I worked for better off for having worked there or b) I am able to do most of the things I set out to do. Again, both answers are fine, but a) is better because it focuses on the organization, while b) focuses on the person.

The Refining Continues Hiring for organizational fit is critical for sustaining the Catholic health care ministry. At Mercy, we readily admit that none of our interview and assessment tools is perfect. We will continue to refine and further develop each of them. Mercy is also happy to work with other Catholic health care organizations to create better ways to test candidates based on how well they fit with important parts of their own culture.

We’re glad that these interview and evaluation methods have taken our leaders beyond making subjective decisions about how well candidates will fit in with the company. Our resources give everyone a way to understand Mercy culture and a fair way to see if a candidate is able to understand, cares about, and acts in a way that is consistent with Mercy’s charism, religious heritage, and values.

Copyright © 2006 by the Catholic Health Association of the United States. To get permission to print this article again, email Betty Crosby or call (314) 253-3477.

Copyright © 2006 by the Catholic Health Association of the United States

For reprint permission, contact Betty Crosby or call (314) 253-3490.

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