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7 views

dopps-output

Uploaded by

shaguftalailamemon
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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COLLEGE OF

OF PHYSICIANS AND
SURGEONS PAKISTAN MINI CLINICAL EVALUATION EXERCISE (CEX)
Specialty: ______FCPS Obstetrics & Gynaecology___________

Time Duration = 20 mins (15 mins assessment and 5 mins feedback)

PLEASE COMPLETE THE QUESTIONNAIRE BY FILLING/CHECKING APPROPRIATE BOXES

Assessor: ____________________________________________________ Assessment Date: ________________________

Resident's Name: _____________________________________________________________________________________

Hospital Name: ________________________________________________ R&RC Number: __________________________

Year of Residency: □ R1 □ R2 □ R3 □ R4

Quarter: □ 1st □ 2nd □ 3rd □ 4th

Setting: □ Ward □ Outdoor (Hospital/Community) Others: _________________________________________

Diagnosis of Patient: ___________________________________________ Patient Age: _________ Sex: _______________

Clinical Area: _________________________________________________________________________________________

Complexity of Case/ Procedure: □ Low/Easy □ Moderate/Average □ High/Difficult □ N/A

Focus of Clinical Encounter:: □ History taking □ Physical Examination □Management

□ Communication Skills □ Other

Please grade the following areas on the Not Observed / Below Expectations Satisfactory Above Expectation Excellent
Applicable
given scale: 1 2 3 4 5
Informed Consent of patient
Interviewing Skills
Systematic Progression
Presentation of positive & significant
negative findings
Justification of actions
Professionalism
Organization/Efficiency
Overall clinical competence

Assessor's Satisfaction with Mini-CEX:


(Low) 1 2 3 4 5 (High)

Resident's Satisfaction with Mini-CEX:


(Low) 1 2 3 4 5 (High)

Strengths Suggestions for Improvements

Encounter to be repeated □ YES □ NO

Signature
COLLEGE OF DIRECT OBSERVATION OF PROCEDURAL SKILLS (DOPS)
OF PHYSICIANS AND
SURGEONS PAKISTAN
Specialty: FCPS Obstetrics & Gynaecology

Time Duration = 20 mins (15 mins assessment and 5 mins feedback)


PLEASE COMPLETE THE QUESTIONNAIRE BY FILLING/CHECKING APPROPRIATE BOXES

Assessor: ____________________________________________________ Assessment Date: ________________________

Resident's Name: _____________________________________________________________________________________

Hospital Name: ________________________________________________ R&RC Number: __________________________

Year of Residency: □ R1 □ R2 □ R3 □ R4

Quarter: □ 1st □ 2nd □ 3rd □ 4th

Setting: □ O.T. □ Procedure Room Other:

Diagnosis of Patient: ___________________________________________ Patient Age: _________ Sex: _______________

Name of Procedure: ___________________________________________________________________________________


Complexity of Case/ Procedure: □ Low/Easy □ Moderate/Average □ High/Difficult □ N/A

Number of times procedure performed by Resident: __________________________________________________________

Not Observed / Below Expectation Satisfactory Above Expectation Excellent


Please grade the following areas on the given scale: Applicable
1 2 3 4 5
Indications, anatomy & steps of procedure
Informed consent, with explanation of procedure and complications
Preparation for procedure
Clinical Knowledge
Use of Anesthesia, Analgesia or sedation
Observance of asepsis (Measures for infection control)
Safe use of instruments
Documentation and Post-procedure instructions to patient and staff
Team interaction
Use of accepted techniques (Technical skills)
Management of unexpected event (or seeks help)
Professionalism
Overall ability to perform whole procedure
Assessor's Satisfaction with DOPS:
(Low) 1 2 3 4 5 (High)
Resident's Satisfaction with DOPS:
(Low) 1 2 3 4 5 (High)

Strengths Suggestions for Improvements

Encounter to be repeated □ YES □ NO

Signature

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