PRACTICAL EXAM ASSESSMENT TOOL

Transcription

1 PRACTICAL EXAM ASSESSMENT TOOL UNIT INFORMATION UNIT OF STUDY: SEMESTER: DEPARTMENT: BIOE221_CLINICAL EXAMINATION SS17 BIOSCIENCE EXAM TYPE: PRACTICAL EXAM 1, 2 & 3 STUDENTS MUST COMPLETE THIS SECTION Student s Name: (BLOCK LETTERS) Student No: Class Day: Time: Lecturer: Endeavour College of Natural Health considers cheating in examinations to be a serious offence. Penalties for cheating include suspension from Endeavour College and/or failure in the subject of study. I have read and understood the penalties involved if I do not abide by the rules pertaining to examinations (Endeavour College of Natural Health Assessment Policy-HE, Examinations Policy and Student Integrity Policy.) Student s Signature: EXAMINER S INSTRUCTIONS PLEASE READ CAREFULLY Paper No: 1 Duration: 30 MINS PER ASSESSMENT Open/Closed Book: PRACTICAL Marks: 288 Weighting: TOTAL 70% (PE1=20% PE2 & 3 25% each) Number of Pages: Examination Parts # of Parts: Instructions: Part A Part B Part C Part D PE1: Vital Signs, Peripheries, Head & Neck Examinations, (79 marks) PE2: Thoracic Examinations, Abdominal Examination (102 marks) PE3: Neurological Examinations, Musculoskeletal Examinations (107 marks) N/A Instructor Authorised / Allowed Materials: Approved clinical examination equipment as per the subject outline Calculator (Basic non-programmable calculator only no mobile phones permitted) Special Instructions to Students: A 5 minute post assessment reading time applies to PE1 & PE2 to be used for biometric calculations Materials Supplied by Endeavour College: The following consumable items will be supplied Hand wash, alcohol wipes, tongue depressors, scales, stadiometer, towels. LECTURER USE ONLY Parts A B C D Total Marks N/A This examination paper must not be released to the student at the conclusion of the exam. Last Updated on 11-Nov-16 Page 1 of 11

2 MARKING RUBRIC Equiv. 0% Equiv. 1-15% Equiv % Equiv % Student unable to perform the Student is unable to perform Student is able to demonstrate examination. the examination practically. some parts of the examination Examination was not Student is able to provide a process, but mostly incorrect mostly incorrect. performed due to insufficient basic theoretical explanation and incomplete. time. of the purpose of performing the examination. Student is able to provide a basic theoretical explanation of the process involved in performing the examination. Student is able to demonstrate the complete process, but it is Student is able to provide a basic theoretical explanation of the process involved in performing the examination and the purpose for performing the examination. OR (Equiv. <70%) OR (Equiv %) OR (Equiv. 80%+) Simple procedure either not Simple procedure performed Simple procedure performed performed, or performed correctly. correctly. incorrectly. Student able to provide a Student able to provide an indepth Or: calculation incorrect basic theoretical explanation explanation of the of the process involved in process and purpose for performing the examination. performing the examination. Or: calculation correct Equiv % Equiv % Equiv % Equiv. 91%+ Student is able to demonstrate Student was able to Student was able to the complete process, however demonstrate the complete demonstrate the complete there are significant errors process efficiently and with only process efficiently and with few which would affect the reliability minor errors which would not minor errors which would not of the clinical findings. affect the reliability of the clinical affect the reliability of the clinical Student is able to provide a basic, but comprehensive explanation of the process, including identification of relevant landmarks, and is able to identify the purpose for performing the examination. Student was able to perform the examination with minor errors in safety and infection control practices. findings. Student is able to provide a basic, but comprehensive explanation of the process, including relevant landmarks, and is able to identify the purpose for performing the examination. Student adhered to relevant safety and infection control practices. findings. Student is able to provide an indepth explanation of the process, including relevant landmarks, as well as being able to identify the purpose for performing the examination, and provide a basic interpretation of key clinical findings. Student adhered to relevant safety and infection control practices. Student was able to perform the examination, however the safety of either the practitioner or the patient was compromised in the process. Student was able to demonstrate the complete process efficiently without error. Student is able to provide an indepth explanation of the process, including relevant landmarks, as well as being able to identify the purpose for performing the examination, and provide an in-depth interpretation of key clinical findings. Student adhered to relevant safety and infection control practices. Last Updated on 11-Nov-16 Page 2 of 11

3 Definition of Rubric Terminology Term Definition Example Significant error A significant error is defined as one that compromises the integrity of the examination, or contravenes patient safety, practitioner safety, or infection control principles. Not bending knees prior to commencing abdominal palpation. Inability to produce a reliable, audible sound during percussion. Minor error Basic theoretical explanation In-Depth theoretical explanation A minor error is defined as a deviation from the prescribed process, but which does not compromise the integrity of the examination, or the safety of either the patient or the practitioner. The student is able to identify the examination being referred to, and provide a general explanation of the process and the purpose for performing the examination. The student is able to identify the examination being referred to, and provide a detailed explanation of the process, using correct anatomical and clinical terminology. The student is also able to provide a detailed explanation of the purpose of the examination, and give an interpretation of key clinical findings. Re-use of single use only disposable equipment. Failure to palpate the brachial pulse point before otherwise correctly placing the stethoscope whilst taking the blood pressure. Not adhering to the correct pattern or direction of auscultation during respiratory or abdominal examination. E.g. anticlockwise direction during abdominal examination. Failure to clean thermometer with alcowipe before placing it back into the cover. To take a patient s blood pressure we place the cuff around the upper arm and listen to the pulse at the elbow. We do this to see if the patient has high or low blood pressure To take a patient s blood pressure we place the cuff around the upper arm at least 2cm above the transverse crease of the antecubital fossa. We palpate the brachial pulse which is located medial to the bicep tendon. We obtain 2 readings which are the systolic pressure which is the maximum pressure in the blood vessels during ventricular contraction, and the diastolic pressure which is the lowest pressure in the blood vessels when the ventricles are relaxed. A systolic pressure above 140mmhg and a diastolic pressure above 90mmhg would indicate hypertension Last Updated on 11-Nov-16 Page 3 of 11

4 Practical Examination 1 (Sessions 1 3) Handwash /Handrub Students can perform either depending on the facilities available Height cm Patient must be bare footed. Examiner to write result in comments above. Weight kg Excess clothing must be removed. Examiner to write result in comments above. BMI kg/m 2 BMI to be calculated during post-assessment reading time. Student to enter result in comments above. Waist:Hip Ratio WHR Obtain waist and hip circumference during assessment. Ratio to be calculated during post-assessment reading time. Student to enter result in comments above Temperature Must wipe thermometer before and after use. Radial Pulse (Vital Sign) [3] [4] [5] [6] [7] Exam. Stu. Examiner to simultaneously take pulse on opposite arm with student result correlating to the examiners result within 4bpm, or maximum score of 4. Pulse must be stated to examiner as at least rate, rhythm and strength or maximum score of 5. Must state landmarks for radial pulse or maximum score of 5. Respiration (Vital Sign) [3] [4] [5] [6] [7] Exam. Stu. Examiner to simultaneously take the patients respiratory rate. The student result should correlate to the examiners result within 4br/min, or maximum score of 4. Last Updated on 11-Nov-16 Page 4 of 11

5 Blood Pressure [3] [4] [5] [6] [7] mmhg Brachial Systolic Perform as lying and sitting BP. Student must locate and palpate the brachial pulse point before placement of stethoscope of maximum score of 5. Examiner to enter the result in comments above. Must state landmarks for brachial pulse or maximum score of 5. Examiner to enter palpatory brachial systolic in comments above. Peripheral Pulses: Carotid Ulnar Popliteal Posterior tibial Dorsalis pedis Student must state the landmarks for each pulse. Skin Turgor Clubbing Capillary refill Oedema [3] [4] [5] [6] [7] Oedema must be performed on the ankles bilaterally. Student must demonstrate the procedure commencing at the malleolus and progressing up the pre-tibial region or maximum score of 5. Ear Examination [3] [4] [5] [6] [7] A thorough inspection and palpation must be done before insertion of the otoscope into the ear or maximum score of 3. Lymphatic palpation [3] [4] [5] [6] [7] Student must be able to name each of the lymphatic groups of the head and neck region that is palpated or maximum score of 5. Last Updated on 11-Nov-16 Page 5 of 11

6 Thyroid examination [3] [4] [5] [6] [7] The examination must commence with a visual inspection of the thyroid from the front and side of the patient or maximum score of 4. The examination may be performed without water by having the patient swallow when requested. Eye mucous membrane It is essential that the student wear gloves whilst performing this examination, and the student must wash hands before and after the examination. Post-Assessment Reading Time During the post-assessment reading time the student is required to: 1. Use the height and weight measurements to calculate the BMI. 2. Use the waist and hip circumference measurements to calculate the Waist:Hip Ratio (WHR). 3. Use the brachial systolic from the BP and the ankle systolic from the Ankle-Brachial Pressure Index to calculate the ABPI. 4. Enter the results of these calculations into the comments section of the relevant shaded tables above. Use of a standard non-programmable calculator is permitted. to Student: Examiner Use Only Total Mark: / 79 Last Updated on 11-Nov-16 Page 6 of 11

7 Practical Examination 2 (Sessions 5 7) Mouth & throat examination [3] [4] [5] [6] [7] Examination must include inspection of the outer structures of the mouth, inner mucous membranes, teeth, gums and oropharynx or maximum score of 4. Student must state the appropriate grading for the tonsil size or maximum score of 5. Respiratory Inspection [3] [4] [5] [6] [7] Student must perform inspection including anterior, lateral and posterior perspectives and describe a minimum of six respiratory inspection signs or maximum score of 4. The client should be draped and positioned prior to the commencement of the inspection. Respiratory Palpation General Palpation Symmetric Expansion Tactile Fremitus [3] [4] [5] [6] [7] Respiratory Percussion [3] [4] [5] [6] [7] The sound quality of the percussion technique must be sufficiently audible to be clinically reliable or maximum score of 4. Respiratory Auscultation [3] [4] [5] [6] [7] Heart Auscultation Aortic valve Pulmonary valve Tricuspid valve Mitral valve For each valve location the student must describe the relevant landmarks and state whether the valve is part of the S1 or S2 heart sounds in an unaffected adult. Ankle-Brachial Pressure Index (ABPI) [3] [4] [5] [6] [7] Ankle Systolic ABPI ABPI to be calculated during post-assessment reading time. Examiner to write the ankle and brachial systolic pressure in comments above. Student to write the ABPI in comments above. Last Updated on 11-Nov-16 Page 7 of 11

8 Abdominal Inspection [3] [4] [5] [6] [7] Student must describe a minimum of 6 relevant abdominal inspection signs or maximum of score of 4. The client should be draped and positioned prior to the commencement of the inspection. Abdominal Auscultation [3] [4] [5] [6] [7] Abdominal auscultation must be performed second in the order of the examination or maximum score of 4. Abdominal Percussion 4 quadrants Liver span Spleen [3] [4] [5] [6] [7] [3] [4] [5] [6] [7] The sound quality of the percussion technique must be sufficiently audible to be clinically reliable or maximum score of 4. Either palpation or percussion may be performed first in the order of the examination. Abdominal Palpation Light palpation Deep palpation Liver palpation Spleen palpation [3] [4] [5] [6] [7] [3] [4] [5] [6] [7] to Student: Examiner Use Only Total Mark: / 102 Last Updated on 11-Nov-16 Page 8 of 11

9 Practical Examination 3 (Sessions 9 11) Mental State [3] [4] [5] [6] [7] Student must describe ABCT and TPP aspects of mental state exam or maximum score of 4. Cranial Nerves I II V VII IX, X XI XII Student need only demonstrate 1 technique for the assessment of each cranial nerve or group. Note: III, IV & VI are tested separately below. Motor System Assessment [3] [4] [5] [6] [7] Examiner to advise student to perform the examination either on the upper limbs or the lower limbs. Muscle power must be reported by student according to the muscle power scale or maximum score of 5. Cerebellar Function Rapid alternating movement Finger-to-finger test Finger-to-nose test Heel-to-toe walking Rombergs test Gait Cover test Student must describe what they would expect to see as both a normal and abnormal cover test result. Corneal Light Reflex Student must describe what they expect to see as both a normal and abnormal corneal light reflex test result. Last Updated on 11-Nov-16 Page 9 of 11

10 Diagnostic Positions Test Student must be able to identify which cranial nerves are being tested in the diagnostic positions test, but is not required to identify the cranial nerve relative to each cardinal point. Pupil Reactions [3] [4] [5] [6] [7] The examination must include general inspection as well as both direct and indirect testing of the pupil reactions. Sensory System Examination Light touch Sharp/Dull Test Stereognosis Light touch and sharp/dull tests can be performed on either the arms or the legs as instructed by the examiner. Deep Tendon Reflexes Bicep Tricep Patellar Achilles Plantar The student must state the spinal nerve level for each of the reflexes and state the rating for each reflex. Joint ROM Temporomandibular Cervical Spine Lumbar Spine Shoulder Elbow Wrist and Hand Hip Knee Ankle and Foot Inspection and Palpation Muscle Strength [3] [4] [5] [6] [7] Student must describe each ROM using correct directional terminology. The examiner will nominate one joint for which the student will need to perform a full examination including inspection, palpation, ROM and muscle strength. Muscle strength must be described using the Muscle strength scale. Last Updated on 11-Nov-16 Page 10 of 11

11 Phalens Test Phalens test may be performed as part of joint ROM of wrist and hand above. Straight Leg Raise Straight leg raise may be performed as part of joint ROM of hip above. Pain Assessment [3] [4] [5] [6] [7] Student to speak directly to patient to ascertain presence of pain, perform general assessment of pain and rate pain. to Student: Examiner Use Only Total Mark: / 107 Last Updated on 11-Nov-16 Page 11 of 11