Advanced musculoskeletal physiotherapist performance appraisal – Physiotherapist’s name: Date: Please Circle: Designs and performs an individualised, culturally appropriate and Yes No 6.1 effective patient interview. Acts to ensure all and flags’ are identified in the ‘red ‘yellow Yes No 6.6 6.7 assessment process and takes appropriate action in a timely manner. Performs complex modifications to routine musculoskeletal assessment in recognition of factors that may impact on the process such as the Yes No 6.3 patient profile/needs. 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 Yes No 6.2 patient with common and/or complex conditions. Identifies when is required from expert colleagues and acts to obtain 6.5 7.6 Yes No their 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 Yes No 4.2 8.4 obtain their involvement. Identifies when input to complement care is required from other health Yes No 11.5 professionals and acts 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 Yes No 11.6 and/or complex conditions. Conducts a thorough handover to ensure patient care is maintained. Yes No 11.7 Works towards the full extent of their role. Yes No 1.2 Takes responsibility for own actions. Yes No 2.1 Comments: Consultant’s name: Consultant’s signature:
Advanced musculoskeletal physiotherapist – performance appraisal Physiotherapist’s name: Date: Please Circle: Designs and performs an individualised, culturally appropriate and effective patient interview. Yes No 6.1 Acts to ensure all ‘red 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 profile/needs. 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 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 input to complement care is required from other health professionals and acts 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 Works towards the full extent of their role. Yes No 1.2 Takes responsibility for own actions. Yes No 2.1 Comments: Consultant’s name: Consultant’s signature:
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