Candidate assessment criteria Candidate and assessor information Unsatisfactory Satisfactory Patient information Superior Clinical record keeping Not observed Clinical assessment Management plan investigations – Not observed Management plan treatments – Management plan follow up – Clinical reasoning Overall competence Please describe what were effective, what could be improved and your overall impression of the strengths, weaknesses Comments and areas for improvement. If required, please specify suggested actions for improvement and timeline. (Must be completed if candidate did not meet expectations) Minutes spent observing: Minutes spent providing feedback: Test rating To what degree was this a test of the doctor’s abilities? Inadequate Adequate Superior Overall performance rating Signature of assessor: (relative to PGY1) Date: Did not meet expectations Signature of candidate: Met expectations Date:
Candidate and assessor information Patient information Candidate assessment criteria Unsatisfactory Satisfactory Superior Clinical record keeping Not observed Clinical assessment Management plan – investigations Not observed Management plan – treatments Management plan – follow up Clinical reasoning Overall competence Comments Please describe what were effective, what could be improved and your overall impression of the strengths, weaknesses and areas for improvement. If required, please specify suggested actions for improvement and timeline. (Must be completed if candidate did not meet expectations) Minutes spent observing: Minutes spent providing feedback: Test rating To what degree was this a test of the doctor’s abilities? Inadequate Adequate Superior Overall performance rating (relative to PGY1) Signature of assessor: Date: Did not meet expectations Met expectations Signature of candidate: Date:
CBD%20assessment%20form%20and%20information%202016.docx