CONSULTATION DETAILS ROLE OF PRECEPTEE CLIENT ID COMMENTS Room for notes that can be used as a reflective tool on (the reason for the client’s visit (e.g. (i.e. specify if supervised by a NUMBER ONLY what you have learned (e.g. health aspects discussed, cervical screening, STI check, preceptor (S) or observing (no other client skills learned in using equipment, infection control tips, contraceptive choice, test results, another’s practice (O). If details) comments regarding client history, areas of difficulty etc.). pregnancy test etc.).) consultation included taking a reproductive and sexual history include this (H)) Please note: Preceptors are asked to provide constructive feedback to assist the preceptee with their learning. Preceptor signature:
CONSULTATION DETAILS (the reason for the client’s visit (e.g. cervical screening, STI check, contraceptive choice, test results, pregnancy test etc.).) ROLE OF PRECEPTEE (i.e. specify if supervised by a preceptor (S) or observing another’s practice (O). If consultation included taking a reproductive and sexual history include this (H)) CLIENT ID NUMBER ONLY (no other client details) COMMENTS Room for notes that can be used as a reflective tool on what you have learned (e.g. health aspects discussed, skills learned in using equipment, infection control tips, comments regarding client history, areas of difficulty etc.). Please note: Preceptors are asked to provide constructive feedback to assist the preceptee with their learning. Preceptor signature:
vic-clinical-assessment-doc.docx