Advanced musculoskeletal physiotherapist performance appraisal – Physiotherapist’s name: Date: Please circle: Performance criteria: 1.2, 2.1, 3.3–4, 4.1–2, 6.1–7, 7.6, 8.4, 9.5–7, 10.3, 11.5–7, 19.7, 20.9 Designs and performs an individualised, culturally appropriate and effective Yes No 6.1 patient interview Acts to ensure all flags’ and flags’ are identified in the assessment ‘red ‘yellow 6.6 Yes No process and takes appropriate action in a timely manner 6.7 Performs complex modifications to routine musculoskeletal assessment in recognition of factors that may impact on the process such as the patient Yes No 6.3 Designs and conducts an individualised, culturally appropriate and effective clinical assessment that: is systems-based Yes No 6.4 includes relevant clinical tests selects and measures relevant health indicators substantiates the provisional diagnosis Formulates a preliminary hypothesis and differential diagnoses for a patient with Yes No 6.2 common and/or complex conditions Identifies when input is required from expert colleagues and acts to obtain their 6.5 Yes No 7.6 involvement 9.5 Uses concise, systematic communication at the appropriate level when Yes No 4.1 conversing with colleagues Presents all relevant information to expert colleagues, when acting to obtain their 4.2 Yes No involvement 8.4 Identifies when to complement care is required from other health Yes No 11.5 professionals and act to obtain their involvement Uses finite healthcare resources wisely to achieve best outcomes Yes No 10.3 Provides appropriate education and advice to patients with common and/or Yes No 11.6 complex conditions Conducts a thorough handover, to ensure patient care is maintained Yes No 11.7 towards the full extent of their role Yes No 1.2 2.1, Takes responsibility for own actions and functions accordance with legislation, Yes No 19.7, health standards and organisational policies and procedures 20.9 Comments: Consultant’s name: Consultant’s signature:
Advanced musculoskeletal physiotherapist – performance appraisal Physiotherapist’s name: Date: Performance criteria: 1.2, 2.1, 3.3–4, 4.1–2, 6.1–7, 7.6, 8.4, 9.5–7, 10.3, 11.5–7, 19.7, 20.9 Please circle: Designs and performs an individualised, culturally appropriate and effective patient interview Yes No 6.1 Acts to ensure all ‘red flags’ and ‘yellow flags’ are identified in the assessment process and takes appropriate action in a timely manner Yes No 6.6 6.7 Performs complex modifications to routine musculoskeletal assessment in recognition of factors that may impact on the process such as the patient Yes No 6.3 Designs and conducts an individualised, culturally appropriate and effective clinical assessment that: is systems-based includes relevant clinical tests selects and measures relevant health indicators substantiates the provisional diagnosis Yes No 6.4 Formulates a preliminary hypothesis and differential diagnoses for a patient with common and/or complex conditions Yes No 6.2 Identifies when input is required from expert colleagues and acts to obtain their involvement Yes No 6.5 7.6 9.5 Uses concise, systematic communication at the appropriate level when conversing with colleagues Yes No 4.1 Presents all relevant information to expert colleagues, when acting to obtain their involvement Yes No 4.2 8.4 Identifies when to complement care is required from other health professionals and act to obtain their involvement Yes No 11.5 Uses finite healthcare resources wisely to achieve best outcomes Yes No 10.3 Provides appropriate education and advice to patients with common and/or complex conditions Yes No 11.6 Conducts a thorough handover, to ensure patient care is maintained Yes No 11.7 towards the full extent of their role Yes No 1.2 Takes responsibility for own actions and functions accordance with legislation, health standards and organisational policies and procedures Yes No 2.1, 19.7, 20.9 Comments: Consultant’s name: Consultant’s signature:
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