Case Evaluation

Date

: : : a. Out- patient : Age: Sex: b. In- patient c. Emergency New/Followup:

Diagnosis/ Patients problem Setting Dept d. Other Patients information Focus

:a. Data gathering b. Diagnosis c. Therapy d. Conseling

1. How is the patients problems presented by the students? a. By them selves b. By guiding c. Not present at all

2. How is the procedure examination conducted by the students? a. Appropriate b. Need more practice

3. How is the management plan of this patient? a. Appropriate b. Inappropriate

4. How is the learning issues discussed by the students? a. By them selves b. by guiding c. Not discussed at all

5. How is the basic mechanism of patients problems discussed by the students? a. Adequate b. Inadequate

6. How is the time allocated for thus problems? a. Appropriate b. Too long c. Need more time

Comments:

Preceptor,

CLINICAL/ COMMUNITY SCIENCE SESSION Date Case Presenter : : : 1 2 3 4 5 6 Final Result (average 1-6)

N Students NPM o name 1 2 3 4 Item to be evaluated:

1.Ability to write scientific paper systematicly (including the bibliography) 2. Ability to implement EBM in information gathering and citation 3. Self directed learning 4. Ability to identify and discuss the major mechanism (s) involved 5. Ability to verbalize their knowledge during presentation 6. Students performance: systemic, attitude, communication Audience: N Students name NPM o 1 2 3 4 5 6 7 Item to be evaluated: 1. Partisipation during discussion 2. Ability to verbalize their knowledge during the presentation 1 2 3 4 Final result(average 1-4)

3. Students performance: attitude communication 4. Ability to identify and discuss the major mechanism(s) involved Scale LOW 1 56 C 2 60 C+ 3 64 4 68 5 75 B+ 6 78 7 80 8 90 9 100 HIGH

C++ B

B++ A

MINI CLINICAL EVALUATION EXERCISE (MINI-CEX) FORM Students name Date Diagnosis Setting Other Patients information Focus : : :a. Out-patient :Age: Sex: b. In patient c. Emergency Dept d. New/follow up: d. Conseling :

:a. Data gathering b. Diagnosis c. Therapy

1. Medical Interviewing skill: Not observed 1 2 3 4 5 6 7 8 9

UNSATISFACTORY

SATISFACTORY

SUPERIOR

2. Physial Examination Skills: Not Observed 1 2 3 4 5 6 7 8 9

UNSATISFACTORY

SATISFACTORY

SUPERIOR

3. Humanistiik qualities/Professionalism : Not Observed 1 2 3 4 5 6 7 8 9

UNSATISFACTORY

SATISFACTORY

SUPERIOR

4. Clinical Judgement and information gathering: Not Observed 1 2 3 4 5 6 7 8 9

UNSATISFACTORY 5. Counseling: Not Observed 1 2 3

SATISFACTORY

SUPERIOR

UNSATISFACTORY

SATISFACTORY

SUPERIOR

6. Organization/ Efficiency: Not Observed 1 2 3 4 5 6 7 8 9

UNSATISFACTORY

SATISFACTORY

SUPERIOR

7. Overall Clinical Copetence: Not Observed 1 2 3 4 5 6 7 8 9

UNSATISFACTORY Mini CEX tie: Observibg: Evaluator: LOW 1 Student: LOW 1 Comment 2 3 4 2 3 4

SATISFACTORY minutes. Feedback:

SUPERIOR minutes

HIGH

HIGH

SignatureStudent

Evaluator