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7/29/2019 tugass mataaa

1/4

Case Evaluation

Date :

Diagnosis/ Patients problem :

Setting : a. Out- patient b. In- patient c. Emergency

Dept d. Other

Patients information : Age: Sex: New/Followup:

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,


2/4

CLINICAL/ COMMUNITY SCIENCE SESSION

Date :

Case :

Presenter :

No

Studentsname

NPM 1 2 3 4 5 6Final Result (average 1-6)

1234Item 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:

No

Students name NPM 1 2 3 4 Final result(average1-4)

1234567Item to be evaluated:

1. Partisipation during discussion

2. Ability to verbalize their knowledge during the presentation


3/4

3. Students performance: attitude communication

4. Ability to identify and discuss the major mechanism(s) involved

Scale LOW 1 2 3 4 5 6 7 8 9 HIGH

56 60 64 68 75 78 80 90 100

C C+ C++ B B+ B++ A

MINI CLINICAL EVALUATION EXERCISE (MINI-CEX) FORM

Students name :

Date :

Diagnosis :

Setting :a. Out-patient b. In patient c. Emergency Dept d.

Other

Patients information :Age: Sex: New/follow up:

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

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


3. Humanistiik qualities/Professionalism : Not Observed

1 2 3 4 5 6 7 8 9


4. Clinical Judgement and information gathering: Not Observed

1 2 3 4 5 6 7 8 9


5. Counseling: Not Observed

1 2 3 4 5 6 7 8 9



4/4

6. Organization/ Efficiency: Not Observed

1 2 3 4 5 6 7 8 9


7. Overall Clinical Copetence: Not Observed1 2 3 4 5 6 7 8 9


Mini CEX tie: Observibg: minutes. Feedback: minutes

Evaluator:

LOW 1 2 3 4 5 6 7 8 9 HIGH

Student:

LOW 1 2 3 4 5 6 7 8 9 HIGH

Comment

SignatureStudent Evaluator

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