This is an observed examination and examination …...This is an observed examination and...
Transcript of This is an observed examination and examination …...This is an observed examination and...
Phase 3a 2017 Placement Based Assessment
This is an observed examination and examination regulations apply.
The assessment should take place during the penultimate week of the attachment.
Please read the following carefully.
Child Health - Observed Long Case - 45 minutes
Instructions for the examiner 1. The patient must be selected by the examiner before the start of the assessment and have had no previous contact with,
or knowledge of, the candidate.
2. The complexity of the case must be taken into account when forming a judgement about the students’ competence.
3. At no point whilst the candidate is taking the history, should the examiner interact with the candidate or patient unless
the examiner has any concerns about the welfare of either the patient or the student. After completion of the history
the candidate should be invited to present the history without interruption or guidance from the examiner. Following
this the candidate should be asked what focussed and appropriate examinations they wish to perform to help in their
assessment of the patient and the formulation of a differential diagnosis.
4. Questions to the student should relate only to the case in question ie diagnosis, investigations, treatment, management
plan, as indicated by the module’s “Guidance for Examiners”. Please do not ask any additional questions of the
student.
5. Although you may have observed the students’ performance during their attachment please avoid using any other
previous interaction with them as evidence of satisfactory performance in this assessment.
6. Please ensure that you follow the instructions relating to the module’s “Guidance for Examiners”. Thank you for your
help with this matter.
Completing the attached form 1. Please adhere to notes on the detail of the domains which is given on the reverse of the placement based assessment
form.
2. All relevant domains must be graded in accordance with the scale and the level of expected attainment of a 3a student.
Phase 3a students are between 2.5 – 3.5 years through a 5 year degree programme.
3. The final judgement is binary – please indicate either “pass” or “fail”.
4. Students’ value feedback on their performance as it facilitates their continued educational development. Those who
perform satisfactorily may require reassurance that their skills and knowledge are adequate whilst praising good
performance is also most helpful. For poor performance the areas of weakness must be constructively discussed and a
method of improving subsequent performance agreed with the student.
5. Please sign the form and supply your details as indicated.
6. The form must be returned promptly to the appropriate member of the administrative staff.
The Medical School.
Registration Number
Phase 3a Summative Clinical Assessment Form Observed LONG Case
Is this a second attempt? YES □ NO □ (tick as appropriate)
NB use black ink only
CHILD HEALTH 2017
Student Name
Date
Brief case summary Focus of encounter
History □
Examination □
ASSESSMENT Grade the following against the standard expected for a 3a student
NA
Well below the standard
expected of a 3a student
Below the standard
expected of a 3a student
Standard expected of a
3a student
Above the standard
expected of a 3a student
Well above the standard expected of a
3a student
History
□ □ □ □ □ □
Examination
□ □ □ □ □ □
Clinical Reasoning Skills
□ □ □ □ □ □
Professional Behaviour
□ □ □ □ □ □
Global Rating
Fail □ Pass □
FEEDBACK Good or excellent performance Areas requiring attention
Assessors details
Name (please print)
Grade
Signature
Date
Return form to Joanne O’Leary Academic Unit of Child Health, Stephenson Wing, Sheffield Children’s Hospital, Western Bank
The Medical School
Notes
History Medical Interviewing and Communication Skills. Facilitates patient’s telling of history & volunteering of information; effectively uses open and closed questions to obtain accurate, adequate information; responds appropriately to affect and non-verbal cues. Examination Follows efficient, logical sequence with appropriate questioning to elicit phenomenology; balances screening/diagnostic questions for the problem; conducts the examination sensitively Clinical Reasoning Skills Demonstrates good judgeement, synthesis and sifting of information in a focused way; is efficient and safe; knows limitations of personal competence and knows when to request help; is able to formulate a differential diagnosis, discuss appropriate investigations, and plans for immediate management, including risks and benefits. Professional Behaviour Introduces self appropriately, washes hands, shows respect, compassion, empathy, establishes trust; attends to patient’s needs and respects patient confidentiality, chooses an appropriate environment for the interview, is aware of and sensitive to the patient's cultural background.
Phase 3a 2017
Placement Based Assessment
This is an observed examination and examination regulations apply.
The assessment should take place during the penultimate week of the attachment.
Please read the following carefully.
Child Health - Observed Short Case 1 & 2 - 15 minutes only
Instructions for the examiner
1. The patient must be selected by the examiner before the start of the assessment and have had no previous contact
with, or knowledge of, the candidate.
2. The complexity of the case must be taken into account when forming a judgement about the students’ competence.
3. At no point should the examiner interact with the candidate or patient during the assessment unless the examiner has
any concerns about the welfare of either the patient or the student.
4. Questions to the student should relate only to the case in question ie diagnosis, investigations, treatment,
management plan, as indicated by the module’s “Guidance for Examiners”. Please do not ask any additional
questions of the student.
5. Although you may have observed the students’ performance during their attachment please avoid using any other
previous interaction with them as evidence of satisfactory performance in this assessment.
6. Please ensure that you follow the instructions relating to the conduct of examiners. Thank you for your help with
this matter.
Completing the attached form
1. Please adhere to guidance on the detail of the domains which is given on the reverse of the placement based
assessment form.
2. All relevant domains must be graded in accordance with the scale and the level of expected attainment of a 3a
student. . Phase 3a students are between 2.5 – 3.5 years through a 5 year degree programme.
Please see https://www.minervashef.ac.uk/medfac/minerva/phase3a/child_health_videos/intro
Standard of Examination required for a Phase 3a student.
3. The final judgement is binary – please indicate either “pass” or “fail”.
4. Students’ value feedback on their performance as it facilitates their continued educational development. Students
who perform satisfactorily may not have the same perception of their performance as you do and may require
reassurance that their skills and knowledge are adequate. Praising good performance is also most helpful to
students. Poor performance should not be criticised in a destructive or humiliating manner; rather the areas of
weakness must be discussed and a method of improving subsequent performance agreed with the student.
5. Please sign the form and supply your details as indicated.
6. The form must be returned promptly to the appropriate member of the administrative staff.
The Medical School.
Registration Number
Phase 3a Summative Clinical Assessment Form Observed SHORT Case 1
Is this a second attempt? YES □ NO □ (tick as appropriate)
NB use black ink only
CHILD HEALTH 2017
Student Name
Date
Brief case summary Focus of encounter
History □
Examination □
ASSESSMENT Grade the following against the standard expected for a 3a student
NA
Well below the standard
expected of a 3a student
Below the standard
expected of a 3a student
Standard expected of a
3a student
Above the standard
expected of a 3a student
Well above the standard expected of a
3a student
History
□ □ □ □ □ □
Examination
□ □ □ □ □ □
Clinical Reasoning Skills
□ □ □ □ □ □
Professional Behaviour
□ □ □ □ □ □
Global Rating
Fail □ Pass □
FEEDBACK Good or excellent performance Areas requiring attention
Assessor’s details
Name (please print)
Grade
Signature
Date
Return form to Joanne O’Leary Academic Unit of Child Health, Stephenson Wing, Sheffield Children’s Hospital, Western Bank
The Medical School
Notes
History Medical Interviewing and Communication Skills. Facilitates patient’s telling of history & volunteering of information; effectively uses open and closed questions to obtain accurate, adequate information; responds appropriately to affect and non-verbal cues. Examination Follows efficient, logical sequence with appropriate questioning to elicit phenomenology; balances screening/diagnostic questions for the problem; conducts the examination sensitively Decision Making Skills Demonstrates good judgement, synthesis and sifting of information in a focused way; is efficient and safe; knows limitations of personal competence and knows when to request help; is able to formulate a differential diagnosis, discuss appropriate investigations, and plans for immediate management, including risks and benefits. Professional Behaviour Introduces self appropriately, washes hands, shows respect, compassion, empathy, establishes trust; attends to patient’s needs and respects patient confidentiality, chooses an appropriate environment for the interview, is aware of and sensitive to the patient's cultural background.
Registration Number
Phase 3a Summative Clinical Assessment Form Observed SHORT Case 2
Is this a second attempt? YES □ NO □ (tick as appropriate)
NB use black ink only
CHILD HEALTH 2017
Student Name
Date
Brief case summary Focus of encounter
History □
Examination □
ASSESSMENT Grade the following against the standard expected for a 3a student
NA
Well below the standard
expected of a 3a student
Below the standard
expected of a 3a student
Standard expected of a
3a student
Above the standard
expected of a 3a student
Well above the standard expected of a
3a student
History
□ □ □ □ □ □
Examination
□ □ □ □ □ □
Clinical Reasoning Skills
□ □ □ □ □ □
Professional Behaviour
□ □ □ □ □ □
Global Rating
Fail □ Pass □
FEEDBACK Good or excellent performance Areas requiring attention
Assessor’s details
Name (please print)
Grade
Signature
Date
Return form to Joanne O’Leary Academic Unit of Child Health, Stephenson Wing, Sheffield Children’s Hospital, Western Bank
The Medical School
Notes
History Medical Interviewing and Communication Skills. Facilitates patient’s telling of history & volunteering of information; effectively uses open and closed questions to obtain accurate, adequate information; responds appropriately to affect and non-verbal cues. Examination Follows efficient, logical sequence with appropriate questioning to elicit phenomenology; balances screening/diagnostic questions for the problem; conducts the examination sensitively Decision Making Skills Demonstrates good judgement, synthesis and sifting of information in a focused way; is efficient and safe; knows limitations of personal competence and knows when to request help; is able to formulate a differential diagnosis, discuss appropriate investigations, and plans for immediate management, including risks and benefits. Professional Behaviour Introduces self appropriately, washes hands, shows respect, compassion, empathy, establishes trust; attends to patient’s needs and respects patient confidentiality, chooses an appropriate environment for the interview, is aware of and sensitive to the patient's cultural background.
Phase 3a 2017
Placement Based Assessment
This is an observed examination and examination regulations apply.
The assessment should take place during the penultimate week of the attachment.
Please read the following carefully.
Psychiatry - Observed Long Case - one hour only
Guidance for the examiner
1. The patient must be selected by the examiner before the start of the assessment and have had no previous contact with,
or knowledge of, the candidate.
2. The complexity of the case must be taken into account when forming a judgement about the students’ competence.
3. At no point should the examiner interact with the candidate or patient during the assessment unless the examiner has
any concerns about the welfare of either the patient or the student.
4. Questions to the student should relate only to the case in question ie diagnosis, investigations, treatment, management
plan, as indicated by the module’s “Guidance for Examiners”. Please do not ask any additional questions of the
student.
5. Although you may have observed the students’ performance during their attachment please avoid using any other
previous interaction with them as evidence of satisfactory performance in this assessment.
6. Please ensure that you follow the instructions relating to the module’s “Guidance for Examiners”. Thank you for your
help with this matter.
Completing the attached form
1. Please adhere to guidance on the detail of the domains which is given on the reverse of the placement based
assessment form.
2. All relevant domains must be graded in accordance with the scale and the level of expected attainment of a 3a student.
3. The final judgement is binary – please indicate either “pass” or “fail”.
4. Students’ value feedback on their performance as it facilitates their continued educational development. Those who
perform satisfactorily may require reassurance that their skills and knowledge are adequate whilst praising good
performance is also most helpful. For poor performance the areas of weakness must be constructively discussed and a
method of improving subsequent performance agreed with the student.
5. Please sign the form and supply your details as indicated.
6. The form must be returned promptly to the appropriate member of the administrative staff.
The Medical School.
Registration Number
Phase 3a Summative Clinical Assessment Form Observed LONG Case
Is this a second attempt? YES □ NO □ (tick as appropriate)
NB use black ink only
PSYCHIATRY 2017
Student Name
Date
Brief case summary
Grade the following where appropriate at the standard expected of a 3a student
Well below the standard expected of a
3a student
Below the standard
expected of a 3a student
Standard expected of a
3a student
Above the standard
expected of a 3a student
Well above the standard expected of a
3a student
History Introduction and establishment of rapport Systematic approach All relevant elements of history elicited
□ □ □ □ □ Mental State Examination Systematic approach Comprehensive psychopathology elicited
□ □ □ □ □ Physical Examination Comments on relevant physical examinations □ □ □ □ □ Formulation Differential diagnoses Justification of differential diagnoses Aetiology and Prognosis
□ □ □ □ □ Risk Assessment □ □ □ □ □ Management Investigations Management plans
□ □ □ □ □ Professional Behaviours □ □ □ □ □ Global Rating Fail □ Pass □
Feedback Good / Excellent Performance Areas requiring attention
Assessor’s Name (please print) Assessor’s email
Return form to Ms S Turvey, Academic Psychiatry, The Medical School, Beech Hill Road, Sheffield, S10 2RX
The Medical School.
Phase 3a 2017 Placement Based Assessment
This is an observed examination and examination regulations apply.
The assessment should take place during the penultimate week of the attachment.
Please read the following carefully.
Women’s Health - Observed Long Case - one hour only
Guidance for the examiner
1. The patient must be selected by the examiner before the start of the assessment and have had no previous contact with,
or knowledge of, the candidate.
2. The complexity of the case must be taken into account when forming a judgement about the students’ competence.
3. At no point should the examiner interact with the candidate or patient during the assessment unless the examiner has
any concerns about the welfare of either the patient or the student.
4. Questions to the student should relate only to the case in question ie diagnosis, investigations, treatment, management
plan, as indicated by the module’s “Guidance for Examiners”. Please do not ask any additional questions of the
student.
5. Although you may have observed the students’ performance during their attachment please avoid using any other
previous interaction with them as evidence of satisfactory performance in this assessment.
6. Please ensure that you follow the instructions relating to the module’s “Guidance for Examiners”. Thank you for your
help with this matter.
Completing the attached form
1. Please adhere to guidance on the detail of the domains which is given on the reverse of the placement based
assessment form.
2. All relevant domains must be graded in accordance with the scale and the level of expected attainment of a 3a student.
3. The final judgement is binary – please indicate either “pass” or “fail”.
4. Students’ value feedback on their performance as it facilitates their continued educational development. Those who
perform satisfactorily may require reassurance that their skills and knowledge are adequate whilst praising good
performance is also most helpful. For poor performance the areas of weakness must be constructively discussed and a
method of improving subsequent performance agreed with the student.
5. Please sign the form and supply your details as indicated.
6. The form must be returned promptly to the appropriate member of the administrative staff.
The Medical School.
Registration Number
Phase 3a Summative Clinical Assessment Form Observed LONG Case
Is this a second attempt? YES □ NO □ (tick as appropriate)
NB use black ink only
WOMEN’S HEALTH 2017
Student Name
Date
Brief case summary Focus of encounter
History □
Examination □
ASSESSMENT Grade the following against the standard expected for a 3a student
NA
Well below the standard
expected of a 3a student
Below the standard
expected of a 3a student
Standard expected of a
3a student
Above the standard
expected of a 3a student
Well above the standard expected of a
3a student
History
□ □ □ □ □ □
Examination
□ □ □ □ □ □
Clinical Reasoning Skills
□ □ □ □ □ □
Professional Behaviour
□ □ □ □ □ □
Global Rating
Fail □ Pass □
FEEDBACK Good or excellent performance Areas requiring attention
Assessors details
Name (please print)
Grade
Signature
Date
Return form to Mrs G Burkinshaw, Reproduction and Developmental Medicine, Jessop Wing, Tree Root Walk, Sheffield
The Medical School
Notes
History Medical Interviewing and Communication Skills. Facilitates patient’s telling of history & volunteering of information; effectively uses open and closed questions to obtain accurate, adequate information; responds appropriately to affect and non-verbal cues. Examination Follows efficient, logical sequence with appropriate questioning to elicit phenomenology; balances screening/diagnostic questions for the problem; conducts the examination sensitively Decision Making Skills Demonstrates good judgement, synthesis and sifting of information in a focused way; is efficient and safe; knows limitations of personal competence and knows when to request help; is able to formulate a differential diagnosis, discuss appropriate investigations, and plans for immediate management, including risks and benefits. Professional Behaviour Introduces self appropriately, washes hands, shows respect, compassion, empathy, establishes trust; attends to patient’s needs and respects patient confidentiality, chooses an appropriate environment for the interview, is aware of and sensitive to the patient's cultural background.
Phase 3a 2017
Placement Based Assessment
This is an observed examination and examination regulations apply.
The assessment should take place during the penultimate week of the attachment.
Please read the following carefully.
Women’s Health - Observed Short Case - 20 minutes only Guidance for the examiner
1. The patient must be selected by the examiner before the start of the assessment and have had no previous contact
with, or knowledge of, the candidate.
2. The complexity of the case must be taken into account when forming a judgement about the students’ competence.
3. At no point should the examiner interact with the candidate or patient during the assessment unless the examiner has
any concerns about the welfare of either the patient or the student.
4. Questions to the student should relate only to the case in question ie diagnosis, investigations, treatment,
management plan, as indicated by the module’s “Guidance for Examiners”. Please do not ask any additional
questions of the student.
5. Although you may have observed the students’ performance during their attachment please avoid using any other
previous interaction with them as evidence of satisfactory performance in this assessment.
6. Please ensure that you follow the instructions relating to the conduct of examiners. Thank you for your help with
this matter.
Completing the attached form
1. Please adhere to guidance on the detail of the domains which is given on the reverse of the placement based
assessment form.
2. All relevant domains must be graded in accordance with the scale and the level of expected attainment of a 3a
student.
3. The final judgement is binary – please indicate either “pass” or “fail”.
4. Students’ value feedback on their performance as it facilitates their continued educational development. Students
who perform satisfactorily may not have the same perception of their performance as you do and may require
reassurance that their skills and knowledge are adequate. Praising good performance is also most helpful to
students. Poor performance should not be criticised in a destructive or humiliating manner; rather the areas of
weakness must be discussed and a method of improving subsequent performance agreed with the student.
5. Please sign the form and supply your details as indicated.
6. The form must be returned promptly to the appropriate member of the administrative staff.
The Medical School.
Registration Number
Phase 3a Summative Clinical Assessment Form Observed SHORT Case 1
Is this a second attempt? YES □ NO □ (tick as appropriate)
NB use black ink only
WOMEN’S HEALTH 2017
Student Name
Date
Brief case summary Focus of encounter
History □
Examination □
ASSESSMENT Grade the following against the standard expected for a 3a student
NA
Well below the standard
expected of a 3a student
Below the standard
expected of a 3a student
Standard expected of a
3a student
Above the standard
expected of a 3a student
Well above the standard expected of a
3a student
History
□ □ □ □ □ □
Examination
□ □ □ □ □ □
Clinical Reasoning Skills
□ □ □ □ □ □
Professional Behaviour
□ □ □ □ □ □
Global Rating
Fail □ Pass □
FEEDBACK Good or excellent performance Areas requiring attention
Assessors details
Name (please print)
Grade
Signature
Date
Return form to Mrs G Burkinshaw, Reproduction and Developmental Medicine, Jessop Wing, Tree Root Walk, Sheffield
The Medical School
Notes
History Medical Interviewing and Communication Skills. Facilitates patient’s telling of history & volunteering of information; effectively uses open and closed questions to obtain accurate, adequate information; responds appropriately to affect and non-verbal cues. Examination Follows efficient, logical sequence with appropriate questioning to elicit phenomenology; balances screening/diagnostic questions for the problem; conducts the examination sensitively Decision Making Skills Demonstrates good judgement, synthesis and sifting of information in a focused way; is efficient and safe; knows limitations of personal competence and knows when to request help; is able to formulate a differential diagnosis, discuss appropriate investigations, and plans for immediate management, including risks and benefits. Professional Behaviour Introduces self appropriately, washes hands, shows respect, compassion, empathy, establishes trust; attends to patient’s needs and respects patient confidentiality, chooses an appropriate environment for the interview, is aware of and sensitive to the patient's cultural background.
Phase 3a 2017
Placement Based Assessment
This is an observed examination and examination regulations apply.
The assessment should take place during the penultimate week of the attachment.
Please read the following carefully.
Women’s Health - Observed Short Case - 20 minutes only Guidance for the examiner
1. The patient must be selected by the examiner before the start of the assessment and have had no previous contact
with, or knowledge of, the candidate.
2. The complexity of the case must be taken into account when forming a judgement about the students’ competence.
3. At no point should the examiner interact with the candidate or patient during the assessment unless the examiner has
any concerns about the welfare of either the patient or the student.
4. Questions to the student should relate only to the case in question ie diagnosis, investigations, treatment,
management plan, as indicated by the module’s “Guidance for Examiners”. Please do not ask any additional
questions of the student.
5. Although you may have observed the students’ performance during their attachment please avoid using any other
previous interaction with them as evidence of satisfactory performance in this assessment.
6. Please ensure that you follow the instructions relating to the conduct of examiners. Thank you for your help with
this matter.
Completing the attached form
1. Please adhere to guidance on the detail of the domains which is given on the reverse of the placement based
assessment form.
2. All relevant domains must be graded in accordance with the scale and the level of expected attainment of a 3a
student.
3. The final judgement is binary – please indicate either “pass” or “fail”.
4. Students’ value feedback on their performance as it facilitates their continued educational development. Students
who perform satisfactorily may not have the same perception of their performance as you do and may require
reassurance that their skills and knowledge are adequate. Praising good performance is also most helpful to
students. Poor performance should not be criticised in a destructive or humiliating manner; rather the areas of
weakness must be discussed and a method of improving subsequent performance agreed with the student.
5. Please sign the form and supply your details as indicated.
6. The form must be returned promptly to the appropriate member of the administrative staff.
The Medical School.
Registration Number
Phase 3a Summative Clinical Assessment Form Observed SHORT Case 2
Is this a second attempt? YES □ NO □ (tick as appropriate)
NB use black ink only
WOMEN’S HEALTH 2017
Student Name
Date
Brief case summary Focus of encounter
History □
Examination □
ASSESSMENT Grade the following against the standard expected for a 3a student
NA
Well below the standard
expected of a 3a student
Below the standard
expected of a 3a student
Standard expected of a
3a student
Above the standard
expected of a 3a student
Well above the standard expected of a
3a student
History
□ □ □ □ □ □
Examination
□ □ □ □ □ □
Clinical Reasoning Skills
□ □ □ □ □ □
Professional Behaviour
□ □ □ □ □ □
Global Rating
Fail □ Pass □
FEEDBACK Good or excellent performance Areas requiring attention
Assessors details
Name (please print)
Grade
Signature
Date
Return form to Mrs G Burkinshaw, Reproduction and Developmental Medicine, Jessop Wing, Tree Root Walk, Sheffield
The Medical School
Notes
History Medical Interviewing and Communication Skills. Facilitates patient’s telling of history & volunteering of information; effectively uses open and closed questions to obtain accurate, adequate information; responds appropriately to affect and non-verbal cues. Examination Follows efficient, logical sequence with appropriate questioning to elicit phenomenology; balances screening/diagnostic questions for the problem; conducts the examination sensitively Decision Making Skills Demonstrates good judgement, synthesis and sifting of information in a focused way; is efficient and safe; knows limitations of personal competence and knows when to request help; is able to formulate a differential diagnosis, discuss appropriate investigations, and plans for immediate management, including risks and benefits. Professional Behaviour Introduces self appropriately, washes hands, shows respect, compassion, empathy, establishes trust; attends to patient’s needs and respects patient confidentiality, chooses an appropriate environment for the interview, is aware of and sensitive to the patient's cultural background.
Phase 3a 2017
Placement Based Assessment
This is an observed examination and examination regulations apply.
The assessment should take place during the penultimate week of the attachment.
Please read the following carefully.
Community and Public Health - Observed Short Case - 20 minutes only Guidance for the examiner
1. The patient must be selected by the examiner before the start of the assessment and have had no previous contact
with, or knowledge of, the candidate.
2. The complexity of the case must be taken into account when forming a judgement about the students’ competence.
3. At no point should the examiner interact with the candidate or patient during the assessment unless the examiner has
any concerns about the welfare of either the patient or the student.
4. Questions to the student should relate only to the case in question ie diagnosis, investigations, treatment,
management plan, as indicated by the module’s “Guidance for Examiners”. Please do not ask any additional
questions of the student.
5. Although you may have observed the students’ performance during their attachment please avoid using any other
previous interaction with them as evidence of satisfactory performance in this assessment.
6. Please ensure that you follow the instructions relating to the conduct of examiners. Thank you for your help with
this matter.
Completing the attached form
1. Please adhere to guidance on the detail of the domains which is given on the reverse of the placement based
assessment form.
2. All relevant domains must be graded in accordance with the scale and the level of expected attainment of a 3a
student.
3. The final judgement is binary – please indicate either “pass” or “fail”.
4. Students’ value feedback on their performance as it facilitates their continued educational development. Students
who perform satisfactorily may not have the same perception of their performance as you do and may require
reassurance that their skills and knowledge are adequate. Praising good performance is also most helpful to
students. Poor performance should not be criticised in a destructive or humiliating manner; rather the areas of
weakness must be discussed and a method of improving subsequent performance agreed with the student.
5. Please sign the form and supply your details as indicated.
6. The form must be returned promptly to the appropriate member of the administrative staff.
The Medical School.
Registration Number
Phase 3a Summative Clinical Assessment Form Observed SHORT Case 1
Is this a second attempt? YES □ NO □ (tick as appropriate)
NB use black ink only
COMMUNITY & PUBLIC HEALTH 2017
Student Name
Date
Brief case summary Focus of encounter
History □
Examination □
ASSESSMENT Grade the following against the standard expected for a 3a student
NA
Well below the standard
expected of a 3a student
Below the standard
expected of a 3a student
Standard expected of a
3a student
Above the standard
expected of a 3a student
Well above the standard expected of a
3a student
History
□ □ □ □ □ □
Examination
□ □ □ □ □ □
Clinical Reasoning Skills
□ □ □ □ □ □
Professional Behaviour
□ □ □ □ □ □
Global Rating
Fail □ Pass □
FEEDBACK Good or excellent performance Areas requiring attention
Assessors details
Name (please print)
Grade
Signature
Date
Return form to Peggy Haughton/ Laura Besson Academic Unit of Primary Medical Care, Sam Fox House, NGH
The Medical School
Notes
History Medical Interviewing and Communication Skills. Facilitates patient’s telling of history & volunteering of information; effectively uses open and closed questions to obtain accurate, adequate information; responds appropriately to affect and non-verbal cues. Examination Follows efficient, logical sequence with appropriate questioning to elicit phenomenology; balances screening/diagnostic questions for the problem; conducts the examination sensitively Decision Making Skills Demonstrates good judgement, synthesis and sifting of information in a focused way; is efficient and safe; knows limitations of personal competence and knows when to request help; is able to formulate a differential diagnosis, discuss appropriate investigations, and plans for immediate management, including risks and benefits. Professional Behaviour Introduces self appropriately, washes hands, shows respect, compassion, empathy, establishes trust; attends to patient’s needs and respects patient confidentiality, chooses an appropriate environment for the interview, is aware of and sensitive to the patient's cultural background.
Phase 3a 2017
Placement Based Assessment
This is an observed examination and examination regulations apply.
The assessment should take place during the penultimate week of the attachment.
Please read the following carefully.
Community and Public Health - Observed Short Case - 20 minutes only
Guidance for the examiner
1. The patient must be selected by the examiner before the start of the assessment and have had no previous contact
with, or knowledge of, the candidate.
2. The complexity of the case must be taken into account when forming a judgement about the students’ competence.
3. At no point should the examiner interact with the candidate or patient during the assessment unless the examiner has
any concerns about the welfare of either the patient or the student.
4. Questions to the student should relate only to the case in question ie diagnosis, investigations, treatment,
management plan, as indicated by the module’s “Guidance for Examiners”. Please do not ask any additional
questions of the student.
5. Although you may have observed the students’ performance during their attachment please avoid using any other
previous interaction with them as evidence of satisfactory performance in this assessment.
6. Please ensure that you follow the instructions relating to the conduct of examiners. Thank you for your help with
this matter.
Completing the attached form
1. Please adhere to guidance on the detail of the domains which is given on the reverse of the placement based
assessment form.
2. All relevant domains must be graded in accordance with the scale and the level of expected attainment of a 3a
student.
3. The final judgement is binary – please indicate either “pass” or “fail”.
4. Students’ value feedback on their performance as it facilitates their continued educational development. Students
who perform satisfactorily may not have the same perception of their performance as you do and may require
reassurance that their skills and knowledge are adequate. Praising good performance is also most helpful to
students. Poor performance should not be criticised in a destructive or humiliating manner; rather the areas of
weakness must be discussed and a method of improving subsequent performance agreed with the student.
5. Please sign the form and supply your details as indicated.
6. The form must be returned promptly to the appropriate member of the administrative staff.
The Medical School.
Registration Number
Phase 3a Summative Clinical Assessment Form Observed SHORT Case 2
Is this a second attempt? YES □ NO □ (tick as appropriate)
NB use black ink only
COMMUNITY & PUBLIC HEALTH 2017
Student Name
Date
Brief case summary Focus of encounter
History □
Examination □
ASSESSMENT Grade the following against the standard expected for a 3a student
NA
Well below the standard
expected of a 3a student
Below the standard
expected of a 3a student
Standard expected of a
3a student
Above the standard
expected of a 3a student
Well above the standard expected of a
3a student
History
□ □ □ □ □ □
Examination
□ □ □ □ □ □
Clinical Reasoning Skills
□ □ □ □ □ □
Professional Behaviour
□ □ □ □ □ □
Global Rating
Fail □ Pass □
FEEDBACK Good or excellent performance Areas requiring attention
Assessors details
Name (please print)
Grade
Signature
Date
Return form to: Peggy Haughton/ Laura Besson, Sam Fox House, NGH
The Medical School
Notes
History Medical Interviewing and Communication Skills. Facilitates patient’s telling of history & volunteering of information; effectively uses open and closed questions to obtain accurate, adequate information; responds appropriately to affect and non-verbal cues. Examination Follows efficient, logical sequence with appropriate questioning to elicit phenomenology; balances screening/diagnostic questions for the problem; conducts the examination sensitively Decision Making Skills Demonstrates good judgement, synthesis and sifting of information in a focused way; is efficient and safe; knows limitations of personal competence and knows when to request help; is able to formulate a differential diagnosis, discuss appropriate investigations, and plans for immediate management, including risks and benefits. Professional Behaviour Introduces self appropriately, washes hands, shows respect, compassion, empathy, establishes trust; attends to patient’s needs and respects patient confidentiality, chooses an appropriate environment for the interview, is aware of and sensitive to the patient's cultural background.