Assessment of Skill Acquisition -Chest Drain Removal
CS MEN Assessment of Skill Acquisition - Chest Drain Removal
Assessor: |
Status: |
Practitioner: |
Status: |
Clinical Skill:
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Date: |
Number of Supervised Evaluations: |
Practitioners should be assessed until competence is achieved in all domains or if competence is achieved on first attempt they must undergo a minimum of 3 observations. Competence is achievement when all criteria are met in all domains. Assessors should indicate if competence has been achieved in each domain by circling 'YES' or 'NOT YET.' Feedback should be entered in each remarks box, identifying criteria to be achieved or demonstrated.
1. Professionalism Criteria
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Competence Achieved YES/NOT YET Remarks: |
2. Patient Assessment Criteria
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Competence Achieved YES/NOT YET Remarks: |
3. Knowledge and Application Criteria
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Competence Achieved YES/NOT YET Remarks: |
4. Communication Criteria
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Competence Achieved YES/NOT YET Remarks: |
5. Organisational Criteria
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Competence Achieved YES/NOT YET Remarks: |
6. Technical Ability Criteria
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Competence Achieved YES/NOT YET Remarks: |
7. Overall Competence Criteria
identifies areas for further learning |
Competence Achieved YES/NOT YET Remarks: |
Assessor's Feedback (indicating areas for improvement as necessary): |
Agreed Action Plan (Between assessor and practitioner): |
Time to achieve action plan: | 1 week | 2 weeks | Other (please specify) |
Practitioner Signature: | Assessor Signature: |