CONSULTATION DETAILS ROLE OF PRECEPTEE CLIENT ID COMMENTS (e.g. STI screen, cervical screen, (i.e. whether you observed or NUMBER ONLY Issues discussed (e.g. menopause, breast awareness, contraception consultation, test results were supervised for the (no other client contraception, continence etc.) etc.) consultation and or examination) details) Areas of difficulty (e.g. location of cervix, client anxiety, vaginismus etc.) Please note: Preceptors are asked to provide constructive feedback to assist the preceptee with their learning. Preceptor signature:
CONSULTATION DETAILS (e.g. STI screen, cervical screen, contraception consultation, test results etc.) ROLE OF PRECEPTEE (i.e. whether you observed or were supervised for the consultation and or examination) CLIENT ID NUMBER ONLY (no other client details) COMMENTS Issues discussed (e.g. menopause, breast awareness, contraception, continence etc.) Areas of difficulty (e.g. location of cervix, client anxiety, vaginismus etc.) Please note: Preceptors are asked to provide constructive feedback to assist the preceptee with their learning. Preceptor signature:
vic-clinical-assessment-doc.docx