Y4 logbook Case Presentation Form

Case Presentation Form

Student’s name: ......................................................... Date of assessment: _ /__/____

Hospital/Location: ............................................................................................................

Setting: In-patient/ Out-patient/ Emergency File No.: ……………………………………

Patient problem/ Diagnosis: .............................................................................................

Process Score & comments

1 2 3 4 5
Presentation Skills
Student introduces himself/herself
Reporter Skills - Case Details (History - Content)
Mentioned Patient Personal details and significant medical conditions (if any)
Identified the patient chief complaints/ problems
Elicited details of symptoms and Sequence of events
Identified effect on the patient’s life
Explored patient’s ideas, concerns and expectations
Obtained relevant background information including: Past Medical, Drug,
Family and Social History;
Systems review; Factors influencing health
Reporter Skills - Case Details (Examination finding- Content)
Assessed the general condition of the patient
Identified abnormal findings in the case
Mentioned other relevant findings related to the case (Pertinent Positives and
Pertinent Negatives
Reporter Skills - Case details (Investigations and Hospital course)
Mentioned significant investigations and their results
Mentioned medication or other measures given
Mentioned patient progress
Interpreter skills (Clinical Reasoning Skills)
Interprets clinical findings
Put (and reason) a diagnosis or differential diagnosis
Recommend other investigations
Manager Skills
Discusses a plan of management

Overall Performance
1: Inappropriate 2: Not competent 3: Competent 4: Clearly competent 5: Excellent
 Y4 logbook Case Presentation Form

Feedback

Feedback Action plan

(To be completed by the assessor) (To be completed by the student)

 What went well

.......................................................................... ..........................................................................

.......................................................................... ..........................................................................

.......................................................................... ..........................................................................

.......................................................................... ..........................................................................

...................................................................... ......................................................................

 What can be done in a different way Action Plan development

.......................................................................... (To be filled by any of your PPD, CD, or Clinical tutors

randomly at any occasion of logbook revision)
..........................................................................

.......................................................................... ..........................................................................

.......................................................................... ..........................................................................

.......................................................................... ..........................................................................

.......................................................................... ..........................................................................

.......................................................................... ..........................................................................

.......................................................................... ..........................................................................

.......................................................................... ..........................................................................

Hospital Staff Name and Stamp Student signature