Sample marksheets 1. Respiratory 2. Abdominal 3. History Taking 4. Cardiovascular 5. Neurological 6. Communication and Ethics 7. BCC1 8. BCC2
AXXC 20/7/09 13:41 Page 1
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Please record your judgement for this candidate's performance on each of the clinical skills notedbelow. Any award of an unsatisfactory or borderline mark MUST be accompanied by comments.
Centre number
© DRS Data Services Limited/U87860709/AXXC
ROYAL COLLEGES OF PHYSICIANS OF THE UNITED KINGDOMMRCP(UK) PACES EXAMINATION - CLINICAL MARKSHEET
Examiner number
Counsellingrecommended
Clinical skill Satisfactory Borderline Unsatisfactory COMMENTS
CANDIDATE NAME (PLEASE PRINT)
Please use 2B pencil only.
Brief description of the case:
STATION ONE - Respiratory System Examination
Examinationnumber
Examiner name:
Examiner signature:
Did you lead at this case? NoYes
PhysicalExamination(A) Correct
Thorough
Fluent
Systematic
Professional technique of palpation,percussion and auscultation of the chest
Incorrect techniques
Omits significant or important tests
Unsystematic
Hesitant and lacking in confidence
Unprofessional
Selects a sensible and appropriatemanagement plan
Unfamiliar with correct management plan
Selects inappropriate management
ClinicalJudgement(E)
Identifies correct physical signs
Does not find signs that are not present
Misses important physical signs
Finds signs that are not present
IdentifyingPhysicalSigns(B)
DifferentialDiagnosis(D) Poor differential diagnosis
Fails to consider the correct diagnosis
Constructs a sensible differential diagnosis,including the correct diagnosis
Treats patient respectfully and sensitivelyand ensures comfort, safety and dignity
Causes patient physical or emotionaldiscomfort
Jeopardises patient safety
MaintainingPatientWelfare (G)
RESP
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OHIK 20/7/09 13:49 Page 1
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IFMU 20/7/09 13:58 Page 1
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Please record your judgement for this candidate's performance on each of the clinical skills notedbelow. Any award of an unsatisfactory or borderline mark MUST be accompanied by comments.
Centre number
© DRS Data Services Limited/U87880709/IFMU
ROYAL COLLEGES OF PHYSICIANS OF THE UNITED KINGDOMMRCP(UK) PACES EXAMINATION - CLINICAL MARKSHEET
Examiner number
Counsellingrecommended
Clinical skill Satisfactory Borderline Unsatisfactory COMMENTS
CANDIDATE NAME (PLEASE PRINT)
Please use 2B pencil only.
Brief description of the case:
STATION ONE - Abdominal System Examination
Examinationnumber
Examiner name:
Examiner signature:
Did you lead at this case? NoYes
PhysicalExamination(A) Correct
Thorough
Fluent
Systematic
Professional technique of palpation andpercussion for masses, organomegaly andascites
Incorrect techniques
Omits significant or important tests
Unsystematic
Hesitant and lacking in confidence
Unprofessional
Selects a sensible and appropriatemanagement plan
Unfamiliar with correct management plan
Selects inappropriate management
ClinicalJudgement(E)
Identifies correct physical signs
Does not find signs that are not present
Misses important physical signs
Finds signs that are not present
IdentifyingPhysicalSigns(B)
DifferentialDiagnosis(D) Poor differential diagnosis
Fails to consider the correct diagnosis
Constructs a sensible differentialdiagnosis, including the correct diagnosis
Treats patient respectfully and sensitivelyand ensures comfort, safety and dignity
Causes patient physical or emotionaldiscomfort
Jeopardises patient safety
MaintainingPatientWelfare(G)
ABDO
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OHIK 20/7/09 13:49 Page 1
Additional comments for feedback (optional)Please indicate which skills the comments apply to.
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NOT FOR USE IN THE EXAM
IIOV 20/7/09 14:16 Page 1
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ABCDEFGHJK
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Please record your judgement for this candidate's performance on each of the clinical skills notedbelow. Any award of an unsatisfactory or borderline mark MUST be accompanied by comments.
Centre number
© DRS Data Services Limited/U87890709/IIOV
ROYAL COLLEGES OF PHYSICIANS OF THE UNITED KINGDOMMRCP(UK) PACES EXAMINATION - CLINICAL MARKSHEET
Examiner number
Counsellingrecommended
Clinical skill Satisfactory Borderline Unsatisfactory COMMENTS
Elicits presenting complaint, systems review,past, family and medication history, in athorough, systematic, fluent andprofessional manner
Omits important areas of the history
Unsystematic
Appears unpractised
Unprofessional
ClinicalCommunicationSkills(C)
CANDIDATE NAME (PLEASE PRINT)
Please use 2B pencil only.
Brief description of the case:
STATION TWO - History Taking Skills
Examinationnumber
Scenarionumber
Examiner name:
Examiner signature:
Did you lead at this case? NoYes
Selects a comprehensive, sensible andappropriate management plan
Unfamiliar with correct management plan
Selects inappropriate management
ClinicalJudgement(E)
ManagingPatients’Concerns(F)
Seeks, detects, acknowledges andattempts to address patient's concerns
Confirms patient’s knowledge andunderstanding
Listens
Empathic
Overlooks patients concerns
Does not check knowledge and understanding
Poor listening
Not empathic
DifferentialDiagnosis(D)
Poor differential diagnosis
Fails to consider the correct diagnosis
Constructs a sensible differential diagnosis,including the correct diagnosis
Treats patient respectfully and sensitivelyand ensures comfort, safety and dignity
Causes patient physical or emotionaldiscomfort
Jeopardises patient safety
MaintainingPatientWelfare (G)
Explains relevant clinical information in an
Accurate
Clear
Structured
Comprehensive
Fluent and
Professional manner
Omits important information
Gives inaccurate information
Uses jargon
Poorly structured
Appears unpractised
Unprofessional
Assesses impact of symptoms on patient’soccupation, lifestyle and activities of dailyliving
HISTORY
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OHIK 20/7/09 13:49 Page 1
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© DRS Data Services Limited/U87870709/OHIK
NOT TO BE USED IN THE EXAM
AXGO 20/7/09 16:02 Page 1
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Please record your judgement for this candidate's performance on each of the clinical skills notedbelow. Any award of an unsatisfactory or borderline mark MUST be accompanied by comments.
Centre number
© DRS Data Services Limited/U87900709/AXGO
ROYAL COLLEGES OF PHYSICIANS OF THE UNITED KINGDOMMRCP(UK) PACES EXAMINATION - CLINICAL MARKSHEET
Examiner number
Counsellingrecommended
Clinical skill Satisfactory Borderline Unsatisfactory COMMENTS
Correct
Thorough
Fluent
Systematic and professional technique ofassessment of arterial and venous pulsesand palpation and auscultation of theprecordium
Incorrect techniques
Omits significant or important tests
Unsystematic
Hesitant and lacking in confidence
Unprofessional
PhysicalExamination(A)
CANDIDATE NAME (PLEASE PRINT)
Please use 2B pencil only.
Brief description of the case:
STATION THREE - Cardiovascular System Examination
Examinationnumber
Examiner name:
Examiner signature:
Did you lead at this case? NoYes
IdentifyingPhysicalSigns (B) Identifies correct physical signs
Does not find signs that are not present
Misses important physical signs
Finds signs that are not present
Constructs a sensible differential diagnosis,including the correct diagnosis
Poor differential diagnosis
Fails to consider the correct diagnosis
DifferentialDiagnosis(D)
ClinicalJudgement(E) Unfamiliar with correct management plan
Selects inappropriate management
Selects a sensible and appropriatemanagement plan
Treats patient respectfully and sensitivelyand ensures comfort, safety and dignity
Causes patient physical or emotionaldiscomfort
Jeopardises patient safety
MaintainingPatientWelfare(G)
CVS
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OHIK 20/7/09 13:49 Page 1
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FIMM 21/7/09 9:34 Page 1
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ABCDEFGHJK
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Please record your judgement for this candidate's performance on each of the clinical skills notedbelow. Any award of an unsatisfactory or borderline mark MUST be accompanied by comments.
Centre number
© DRS Data Services Limited/U87910709/FIMM
ROYAL COLLEGES OF PHYSICIANS OF THE UNITED KINGDOMMRCP(UK) PACES EXAMINATION - CLINICAL MARKSHEET
Examiner number
Counsellingrecommended
Clinical skill Satisfactory Borderline Unsatisfactory COMMENTS
Correct
Thorough
Fluent
Systematic and professional technique ofassessment of tone, power, reflexes,sensation, coordination and cranial nervefunction as appropriate
Incorrect techniques
Omits significant or important tests
Unsystematic
Hesitant and lacking in confidence
Unprofessional
PhysicalExamination(A)
CANDIDATE NAME (PLEASE PRINT)
Please use 2B pencil only.
Brief description of the case:
STATION THREE - Nervous System Examination
Examinationnumber
Examiner name:
Examiner signature:
Did you lead at this case? NoYes
Constructs a sensible differential diagnosis,including the correct diagnosis
Poor differential diagnosis
Fails to consider the correct diagnosis
DifferentialDiagnosis(D)
ClinicalJudgement(E) Unfamiliar with correct management plan
Selects inappropriate management
Selects a sensible and appropriatemanagement plan
Treats patient respectfully and sensitivelyand ensures comfort, safety and dignity
Causes patient physical or emotionaldiscomfort
Jeopardises patient safety
MaintainingPatientWelfare(G)
Identifies correct physical signs
Does not find signs that are not present
Misses important physical signs
Finds signs that are not present
IdentifyingPhysicalSigns(B)
NEURO
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OHIK 20/7/09 13:49 Page 1
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QSXP 20/7/09 15:51 Page 1
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ABCDEFGHJK
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Please record your judgement for this candidate's performance on each of the clinical skills notedbelow. Any award of an unsatisfactory or borderline mark MUST be accompanied by comments.
Centre number
© DRS Data Services Limited/U87920709/QSXP
ROYAL COLLEGES OF PHYSICIANS OF THE UNITED KINGDOMMRCP(UK) PACES EXAMINATION - CLINICAL MARKSHEET
Examiner number
Counsellingrecommended
Clinical skill Satisfactory Borderline Unsatisfactory COMMENTS
Explains relevant clinical information in an
Accurate
Clear
Structured
Comprehensive
Fluent and
Professional manner
Omits important information
Gives inaccurate or unclear information
Poorly structured
Uses jargon
Appears unpractised
Unprofessional
ClinicalCommunicationSkills(C)
CANDIDATE NAME (PLEASE PRINT)
Please use 2B pencil only.
Brief description of the case:
STATION FOUR - Communication Skills
Examinationnumber
Scenarionumber
Examiner name:
Examiner signature:
Did you lead at this case? NoYes
ManagingPatients’Concerns(F)
Seeks, detects, acknowledges and attemptsto address patient’s or relative’s concerns
Listens
Confirms patient’s or relative’s knowledgeand understanding
Empathic
Overlooks patient’s or relative’s concerns
Poor listening
Not empathic
Does not check knowledge and understanding
Selects or negotiates a sensible andappropriate management plan for thispatient, relative or clinical situation
Can apply clinical knowledge, includingknowledge of law and ethics, to this case
Selects or negotiates an inappropriate,incomplete or incorrect management plan
Cannot apply clinical knowledge, includingknowledge of law and ethics, to this case
ClinicalJudgement(E)
MaintainingPatientWelfare(G)
Treats patient respectfully and sensitivelyand ensures comfort, safety and dignity
Causes patient physical or emotionaldiscomfort
Jeopardises patient safety
C+E
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OHIK 20/7/09 13:49 Page 1
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NOT TO BE USED IN THE EXAM
YQYG 21/7/09 10:26 Page 1
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ABCDEFGHJK
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Please record your judgement for this candidate's performance on each of the clinical skills notedbelow. Any award of an unsatisfactory or borderline mark MUST be accompanied by comments.
Centre number
© DRS Data Services Limited/U87930709/YQYG
ROYAL COLLEGES OF PHYSICIANS OF THE UNITED KINGDOMMRCP(UK) PACES EXAMINATION - CLINICAL MARKSHEET
Examiner number
Counsellingrecommended
Clinical skill Satisfactory Borderline Unsatisfactory COMMENTS
Elicits history relevant to the complaint andexplains information to the patient in a
Focused
Fluent
Professional manner
Omits important areas of the history
Unpractised
Unprofessional
Poor explanation to the patient
ClinicalCommunicationSkills(C)
CANDIDATE NAME (PLEASE PRINT)
Please use 2B pencil only.
Brief description of the case:
STATION FIVE - Brief Clinical Consultation One
Examinationnumber
Scenarionumber
Examiner name:
Examiner signature:
Did you lead at this case? NoYes
PhysicalExamination(A)
Correct
Appropriate
Practised
Professional
Incorrect techniques
Omits significant or important tests
Inappropriate focus to examination
Hesitant and lacking in confidence
Unprofessional
Selects sensible and appropriateinvestigations and treatment
Selects inappropriate investigations ortreatment
ClinicalJudgement(E)
ManagingPatients’Concerns(F)
Detects, acknowledges and attempts toaddress patient's concerns
Listens
Empathic
Overlooks patients concerns
Poor listening
Not empathic
Identifies correct physical signs
Does not find signs that are not present
Misses important physical signs
Finds signs that are not present
IdentifyingPhysicalSigns (B)
DifferentialDiagnosis(D)
Poor differential diagnosis
Fails to consider the correct diagnosis
Constructs a sensible differential diagnosis,including the correct diagnosis
Treats patient respectfully and sensitivelyand ensures comfort, safety and dignity
Causes patient physical or emotionaldiscomfort
Jeopardises patient safety
MaintainingPatientWelfare(G)
BCC1
NOT TO BE USED IN THE EXAM
OHIK 20/7/09 13:49 Page 1
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© DRS Data Services Limited/U87870709/OHIK
NOT TO BE USED IN THE EXAM
AIGA 21/7/09 11:05 Page 1
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ABCDEFGHJK
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Please record your judgement for this candidate's performance on each of the clinical skills notedbelow. Any award of an unsatisfactory or borderline mark MUST be accompanied by comments.
Centre number
© DRS Data Services Limited/U87940709/AIGA
ROYAL COLLEGES OF PHYSICIANS OF THE UNITED KINGDOMMRCP(UK) PACES EXAMINATION - CLINICAL MARKSHEET
Examiner number
Counsellingrecommended
Clinical skill Satisfactory Borderline Unsatisfactory COMMENTS
Elicits history relevant to the complaint andexplains information to the patient in a
Focused
Fluent
Professional manner
Omits important areas of the history.
Unpractised
Unprofessional
Poor explanation to the patient
ClinicalCommunicationSkills(C)
CANDIDATE NAME (PLEASE PRINT)
Please use 2B pencil only.
Brief description of the case:
STATION FIVE - Brief Clinical Consultation Two
Examinationnumber
Scenarionumber
Examiner name:
Examiner signature:
Did you lead at this case? NoYes
PhysicalExamination(A)
Correct
Appropriate
Practised
Professional
Incorrect techniques
Omits significant or important tests
Inappropriate focus to examination
Hesitant and lacking in confidence
Unprofessional
Selects sensible and appropriateinvestigations and treatment
Selects inappropriate investigations ortreatment
ClinicalJudgement(E)
ManagingPatients’Concerns(F)
Detects, acknowledges and attempts toaddress patient's concerns
Listens
Empathic
Overlooks patients concerns
Poor listening
Not empathic
Identifies correct physical signs
Does not find signs that are not present
Misses important physical signs
Finds signs that are not present
IdentifyingPhysicalSigns (B)
DifferentialDiagnosis(D)
Poor differential diagnosis
Fails to consider the correct diagnosis
Constructs a sensible differential diagnosis,including the correct diagnosis
Treats patient respectfully and sensitivelyand ensures comfort, safety and dignity
Causes patient physical or emotionaldiscomfort
Jeopardises patient safety
MaintainingPatientWelfare(G)
BCC2
NOT TO BE USED IN THE EXAM
OHIK 20/7/09 13:49 Page 1
Additional comments for feedback (optional)Please indicate which skills the comments apply to.
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NOT TO BE USED IN THE EXAM
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