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Trainee Guide - Kuwait Institute for Medical Specialization

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I. Date . 2 ..,I,, 2 11111.1111...1.111..,1.1.11.1.. f)33@( O% <strong>Trainee</strong> name* . . . . !%L.. ..~C?.M.~... .., .,. ..,......,,.. <strong>Trainee</strong> 1.D: .1......1.11.111.11~.1.1..11 I.,,,,,<br />

Evaluator’s name’<br />

I ,...,,I.llll.tl11111.1111.1...1..111..1.......1.,11111.11..11,,.1..........,. BQ b&+&&h Kbbt Evaluator’s signature:<br />

I<br />

Designation: Consultant 0 Faculty member � Senior Registrard Registrar0 Other 1111111.1..1.......~...1..1......1.1.1...111,,,<br />

(SPew<br />

Hospital, , m ,,,...11,.1.....*.111.1.111.1.1.11,1., wb w+& Department . 11.1 wi .1......*11***..1 &rK I.., . I. 11*.*..1.*.1..1..**. . . . . Unit. 111..111111,,.1~1111.,..1111...1.1.,1.111,,,,, ‘I<br />

EVALUATION OF PERFORMANCE<br />

II. FOCUS OF INTERACTION (Give a rating from 1 to 5, using the scale given below <strong>for</strong> overall rating, Also check in the relevant box,):<br />

YES NO<br />

[A] .q,, Clinical skills: History - Directly observed? a 0 (D) . . . . . . Diagnosis (clinical judgment)<br />

I..... Clinical skills: Case sheet - Directly observed? 0 0 (E) . . . . . . Therapy (interpretation of!nywstigations)<br />

1.2 Clinical skills: Physical exam - Directly observed?<br />

(B) II.,,, Professional behavior: Directly observed?<br />

(0 III,., Case presentation: written 0 verbal 0<br />

OVERALL RATING OF ENCOUNTER - PERFORMANCE RATED AS:<br />

� ��<br />

UNSATISFACTORY BELOW expected standard<br />

��� ��� ��� ��� ���<br />

COMMENTS ON TRAINEE PERFORMANCE<br />

&ypyQw<br />

. . . . . . . . . . . . . ..I............ 33. ML. . ...*. tm.<br />

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PATIENT NOTES<br />

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. . . . . . ..I...................<br />

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 &$G.! tta .a. TX*0 ..I n ..I...........................I................................I.........................................,,..,..,..~.,,.,,,,,,,,,,.,.,<br />

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