Examination and Procedural skills descriptors Changes to ES questions asked at end of skills log Changes to COT (criterion6) and MSF wording Learning log and trainee guidance to completing log Clinical Examination and Procedural skills evidence form for assessors Appendix A Word pictures and IPUs for clinical examination and procedural skills Clinical Examination and Procedural Skills This competence is about clinical examination and procedural skills and by the end of training, the trainee must have demonstrated competence in Breast examination and in the full range of male and female genital examination Insufficient Evidence Needs Further Development Competent Excellent From the available evidence, the doctor’s performance cannot be placed on a higher point of this developmental scale Chooses examinations broadly in line with the patient’s problem(s) Chooses examinations appropriately targeted to the patient’s problem(s) Proficiently identifies and performs the scope of examination necessary to investigate the patient’s problem(s) Identifies abnormal but fails to recognise their significance Has a systematic approach to clinical examination and able to interpret physical signs accurately Uses an incremental approach to examination, basing further examinations on what is known already and is later discovered Suggests appropriate procedures related to the patient’s problem(s) Varies options of procedures according to circumstances and the preferences of the patient Demonstrates a wide range of procedural skills to a high standard Demonstrates limited fine motor skills when Refers on appropriately when a procedure is outside their level of skill Actively promotes safe practice with regard to
carrying out simple procedures examination and procedural skills Observes the professional of practice including the use of chaperones Identifies and discusses ethical issues with regard to examination and procedural skills Engages with audit quality improvement initiatives with regard to examination and procedural skills Performs procedures and examinations with the patient’s consent and with a clinically justifiable reason to do so Shows awareness of the medico-legal background to informed consent, mental capacity and the best interests of the patient Helps to develop systems that reduce risk in clinical examination and procedural skills The intimate examination is conducted in a way that does not allow a full assessment by inspection or palpation. The doctor proceeds without due attention to the patient’s perspective and feelings Ensures that the patient understands the purpose of an intimate examination, describes what will happen and explains the role of the chaperone. Arranges the place of examination to give the patient privacy and to respect their dignity. Inspection and palpation is appropriate and clinically effective. Recognises the verbal and that the patient is not comfortable with an intrusion into their personal space especially the prospect or conduct of intimate examinations. Is able to help the patient to accept and feel safe during the examination. Indicators of potential underperformance (IPU): Fails to examine when the history suggests conditions that might be confirmed or excluded by examination Patient appears unnecessarily by the examination Inappropriate over - examination Fails to obtain informed consent for the procedure Patient shows no understanding as to the purpose of examination. Appendix B