Professional Documents
Culture Documents
Womens Health
Gill Burkinshaw Section of Reproductive and Developmental Medicine Jessop Wing Royal Hallamshire Hospital Tree Root Walk Sheffield Joanne OLeary Academic Unit of Child Health Stephenson Wing Sheffield Childrens Hospital Western Bank Sheffield Sarah Turvey Academic Clinical Psychiatry The Longley Centre Northern General Hospital Norwood Grange Drive Sheffield S5 7JT Diane Allen Institute of General Practice and Primary Care Sam Fox House Northern General Hospital Sheffield Jacquie Harrison/Paula Hutchinson School of Medicine Beech Hill Road Sheffield S10 2RX
Child Health
Psychiatry
Medicine for Older People Neurology Two Week SSC Sexual Medicine 6 Week SSC
Hospital:___________________________________________
To be completed by supervisor/deputy: Please give feedback on their overall clinical performance (both formatively and summatively assessed). Professional Behaviours should be considered separately.
Feedback 1) Overall clinical performance (, history taking, clinical examination, presentation and discussion of patients, including formative assessments)
4) Professional Behaviour [Maintains an ethical approach. Adequate attendance and timekeeping; Understands the rules governing consent. Displays positive professional behaviours].
Yes / No
PLEASE RETURN THIS FORM TO JOANNE OLEARY ACADEMIC UNIT OF CHILD HEALTH STEPHENSON WING, CHILDRENS HOSPITAL, WESTERN BANK, SHEFFIELD
Hospital:_______________________________________________
To be completed by supervisor/deputy: Please give feedback on their overall clinical performance (both formatively and summatively assessed). Professional Behaviours should be considered separately.
Feedback 1) Overall clinical performance (, history taking, clinical examination, presentation and discussion of patients, including formative assessments)
4) Professional Behaviour [Maintains an ethical approach. Adequate attendance and timekeeping; Understands the rules governing consent. Displays positive professional behaviours].
Yes / No
PLEASE RETURN THIS FORM TO GILL BURKINSHAW ACADEMIC UNIT OF REPRODUCTIVE & DEVELOPMENTAL MEDICINE, JESSOP WING, TREE ROOT WALK SHEFFIELD
To be completed by supervisor/deputy: Please give feedback on their overall clinical performance (both formatively and summatively assessed). Professional Behaviours should be considered separately.
Feedback 1) Overall clinical performance (, history taking, clinical examination, presentation and discussion of patients, including formative assessments)
4) Professional Behaviour [Maintains an ethical approach. Adequate attendance and timekeeping; Understands the rules governing consent. Displays positive professional behaviours].
Yes / No
PLEASE RETURN THIS FORM TO DIANE ALLEN ACADEMIC UNIT OF PRIMARY MEDICAL CARE, SAM FOX HOUSE, NORTHERN GENERAL HOSPITAL, HERRIES ROAD SHEFFIELD
Cases discussed (List the cases key discussed during this attachment)
To be completed by supervisor/deputy: Please give feedback on their overall clinical performance (both formatively and summatively assessed). Professional Behaviour(s) deleted should be considered separately.
Feedback 1) Overall (clinical) performance (presentation and discussion of patients, including formative assessments, preparation for ILA topics etc)
4) Professional Behaviour [Maintains an ethical approach. Adequate attendance and timekeeping; Understands the rules governing consent. Displays positive professional behaviours].
Yes / No
DIANE ALLEN ACADEMIC UNIT OF PRIMARY MEDICAL CARE, SAM FOX HOUSE, NORTHERN GENERAL HOSPITAL, HERRIES ROAD SHEFFIELD
Hospital:_________________________________________
To be completed by supervisor/deputy: Please give feedback on their overall clinical performance (both formatively and summatively assessed). Professional Behaviours should be considered separately.
Feedback 1) Overall clinical performance (, history taking, clinical examination, presentation and discussion of patients, including formative assessments)
4) Professional Behaviour [Maintains an ethical approach. Adequate attendance and timekeeping; Understands the rules governing consent. Displays positive professional behaviours].
Yes / No
PLEASE RETURN THIS FORM TO SARAH TURVEY ACADEMIC CLINICAL PSYCHIATRY, THE LONGLEY CENTRE, NORTHERN GENERAL HOSPITAL, HERRIES ROAD SHEFFIELD
To be completed by supervisor/deputy: Please give feedback on their overall clinical performance (both formatively and summatively assessed). Professional Behaviours should be considered separately.
Cases Seen (Please tick or add the cases seen during this attachment) Gait / coordination problems (14) Problems with higher cognitive function (15, 31, 33) Coma / brain death (16) Dizziness / vertigo (17) Headaches (18, 20) Blackouts / loss of consciousness (19, 23) Movement disorder / tremor (21) Altered sensation (22) Visual field / cranial nerve disorders (24) Weakness (25) Other (please add details below)
Feedback 1) Presentation of patient on ward round (history taking, clinical examination, presentation and discussion of patients, including formative assessments)
4) Concerns about professional behaviour [Professional behaviour: Maintains an ethical approach; adequate attendance and timekeeping; understands the rules governing consent; displays positive professional behaviours].
Yes / No
PLEASE RETURN THIS FORM TO JACQUIE HARRISON SCHOOL OF MEDICINE, MEDICAL SCHOOL, BEECH HILL ROAD SHEFFIELD
Registration No_______________________________
Supervisors name: ___________________________ Hospital/GROUP:_______________________________________________ To be completed by the student To be completed by supervisor/deputy: Please give feedback on their overall clinical performance (both formatively and summatively assessed). Professional Behaviours should be considered separately.
Feedback 1) Overall clinical performance (, history taking, clinical examination, presentation and discussion of patients, including formative assessments)
4) Professional Behaviour [Maintains an ethical approach. Adequate attendance and timekeeping; Understands the rules governing consent. Displays positive professional behaviours].
Yes / No
PLEASE RETURN THIS FORM TO JACQUIE HARRISON SCHOOL OF MEDICINE, MEDICAL SCHOOL, BEECH HILL ROAD SHEFFIELD
IT Skills
i [Word processed report, poster & abstract; presentation & abstract or other agreed assessment]. Feedback for all grades please
Overall Competence
Feedback for all grades please
Excellent
Good
Satisfactory
Borderline
Unsatisfactory
Professional Behaviours
[Includes ensuring an ethical approach, avoiding plagiarism, & completion on time and as requested]. Feedback for all grades please
PLEASE RETURN THIS FORM TO JACQUIE HARRISON SCHOOL OF MEDICINE, MEDICAL SCHOOL, BEECH HILL ROAD SHEFFIELD
Interpersonal Skills
IS3
Clinical Skills
IS4 Deals sensitively with patients, their family/friends/carers IS5 Identifies potential danger for self and others and takes appropriate action to limit impact CS1 Contributes to cure of illness, recovery from sickness and the easing of suffering and discomfort in encounters with patients CS2 Participates in health promotion and in prevention of disease and disability in encounters with patients CS3 Gathers relevant patient history information systematically either from patient or third party Conducts complete mental state examination or selects appropriate components in a systematic and directed fashion CS5 Conducts complete physical examination or selects appropriate components in a systematic and directed fashion CS6 Makes accurate assessment of patient's problems & formulates differential diagnosis CS7 Selects & initiates appropriate investigations CS8 Interprets and evaluates data from history, physical examination and other findings to formulate diagnosis CS9 Formulates and implements management plan and monitors its effectiveness PS1 Ensures optimum patient comfort and privacy PS2 Prepares patient for, explains & conducts technical and practical procedures effectively PS3 Ensures patient consent is obtained in all aspects of investigation, treatment and management PS4 Can access relevant information and record information accurately PS5 Makes thorough and accurate observations, measurements and calculations PS6 Recognises, identifies and can describe abnormalities and symptoms PS7 Demonstrates effective decision making PS8 Manages life-threatening conditions PB1 Adopts a questioning approach to own work and that of others PB2 Works within limits of own knowledge and experience PB3 Maintains patient confidentiality PB4 Is responsive to changes in health care, policy and current science PB5 Maintains an ethical approach PB6 Complies with legal responsibilities and requirements and guidelines of regulatory bodies and the NHS PB7 Demonstrates respect for the role and function of all those involved in patient care PB8 Demonstrates a patient centred approach CS4
Practical Skills
Professional Behaviours
PB9 Recognises and takes advantage of opportunities to teach PB10 Fulfils professional responsibilities in contexts inside & outside work SSC Specific Outcomes Able to identify own learning needs and negotiate those with supervisor Fulfils learning needs Fulfils agreed assessment Produces a word-processed document which is formatted appropriately and uploaded to the e-portfolio
1-week SSC ASSESSMENT PROFORMA: Psychiatry, Neurology, Medicine for Older People Phase 3a
To be completed by student: Student Registration No________________________ Group _____________ Dates of SSC______________________________________
IT Skills
i [Word processed report, formatted appropriately]. Feedback for all grades please
Overall Competence
Feedback for all grades please
Satisfactory
Borderline
Unsatisfactory
Professional Behaviours
[Includes ensuring an ethical approach, avoiding plagiarism, & completion on time and as requested]. Feedback for all grades please
PLEASE RETURN THIS FORM TO JACQUIE HARRISON SCHOOL OF MEDICINE, MEDICAL SCHOOL, BEECH HILL ROAD SHEFFIELD
IS5 Identifies potential danger for self and others and takes appropriate action to limit impact Clinical Skills CS1 and Contributes to cure of illness, recovery from sickness and the easing of suffering discomfort in encounters with patients
CS2 Participates in health promotion and in prevention of disease and disability in encounters with patients CS3 Gathers relevant patient history information systematically either from patient or third party Conducts complete mental state examination or selects appropriate components in a systematic and directed fashion CS5 Conducts complete physical examination or selects appropriate components in a systematic and directed fashion CS6 Makes accurate assessment of patient's problems & formulates differential diagnosis CS7 Selects & initiates appropriate investigations CS8 Interprets and evaluates data from history, physical examination and other findings to formulate diagnosis CS9 Formulates and implements management plan and monitors its effectiveness Practical Skills PS1 Ensures optimum patient comfort and privacy PS2 Prepares patient for, explains & conducts technical and practical procedures effectively PS3 Ensures patient consent is obtained in all aspects of investigation, treatment and management PS4 Can access relevant information and record information accurately PS5 Makes thorough and accurate observations, measurements and calculations PS6 Recognises, identifies and can describe abnormalities and symptoms PS7 Demonstrates effective decision making PS8 Manages life-threatening conditions PB1 Adopts a questioning approach to own work and that of others PB2 Works within limits of own knowledge and experience PB3 Maintains patient confidentiality PB4 Is responsive to changes in health care, policy and current science PB5 Maintains an ethical approach PB6 Complies with legal responsibilities and requirements and guidelines of regulatory bodies and the NHS PB7 Demonstrates respect for the role and function of all those involved in patient care PB8 Demonstrates a patient centred approach PB9 Recognises and takes advantage of opportunities to teach PB10 Fulfils professional responsibilities in contexts inside & outside work CS4
Professional Behaviours
Understands the subject Able to write in the style of a scientific paper Can word-process a report which is formatted appropriately and uploaded to the eportfolio
Attendance
I confirm that the above named student has attended both the Lectures and Seminar for Psychosexual Medicine
Borderline
Unsatisfactory
Signature of Supervisor
Date
PLEASE RETURN THIS FORM TO JACQUIE HARRISON SCHOOL OF MEDICINE, MEDICAL SCHOOL, BEECH HILL ROAD SHEFFIELD