UNIVERSITY OF SANTO TOMAS

COLLEGE OF REHABILITATION SCIENCES

PT10112: Musculoskeletal Examination Laboratory

Name: ______________________________ Case: _________________________

Section: _____ Group no. _____

Legend: / Observed
X Not Observed
NA Not Applicable

CRITERIA GRADING
Using clear Using non-
TOTAL
Obtained the following information: Completely and direct leading
questions questions
General Data
Complaints
History of Present Illness
Past Medical History
Physical Environment (Home and Work)
Social Environment (Home and Work)
Lifestyle
Caregiver’s / Patient’s goal

Performed the following

With proper With
procedures:
Completely Accurately patient adequate TOTAL
(Please indicate the
positioning cuing
procedures)
1.
2.
3.
4.
5.
Before care
Prepared all necessary materials prior to evaluation
Correctly and appropriately checked for vital signs at least prior to evaluation
Subjective
Logical sequencing of questions
Uses language appropriate to patient’s level of understanding, does not utilize jargon or medical
terms in history taking
Demonstrates appropriate listening skills during interview
Asks relevant questions
Asks follow-up questionsq
Objective
All chosen procedures may be considered most important for the case
Explained the purpose of each procedure prior to performance
Performs gross assessment (ROM, MMT)
Performed objective evaluation procedures in appropriate sequence
Uses language appropriate to patient’s level of understanding, does not utilize jargon or medical
terms during objective evaluation
Performed after care procedures
Efficient
Observed proper body mechanics
Patient Interaction
Established rapport with patient and caregiver
Demonstrated proper attitude towards patient and caregiver
Demonstrated precautions / patient safety during evaluation

(/) TOTAL SCORE OUT OF POSSIBLE 62

(NA)
SCORE AS PATIENT (2)
TOTAL
Comments:
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Assessor: _____________________________