Please assess and mark the following domains ‘Not Yet Competent a Borderline 2) ‘Competent 2) Professional 4) ‘Pre-procedure ‘preparation ‘(Room and equipment ext up find ergantaton Including patient comfort) Professional approach “Including communication, ‘Sonsent and consleration towards the patient) nae. ‘equipment and technique) Technicalasnects of us EE Srmance Pi yiold a Gaeta return) Max (Max possible /36): hind ol] heart -‘Suggestions for development (assessor comments): hee - ho corps Jf own chad ~ fl Ow “ bok shores pu Pw An a bry pt Car Came pices. Self-refiection (to be completed by the Intern) — what did you learn from this experience, ‘what would you do differently next time. What steps can you Implement to ensure the next time you perform this procedure you will do it more professionally: Be observa? OD Poteet own bely. key Shocdder- slightly chser fe Ae becly 1 preteen pass/ble ry F ‘Agreed Action (Intern and Assessor initial): Page 2 of 2