Station: Examination Candidate name:

KNOWLEDGE – Observations
Eg Accurate identification of signs
Missed signs
Found signs not present

SKILL – How it is done

Eg Organised and systematic approach
Quality of techniques used
Time management

DIAGNOSIS, CLINICAL REASONING and MANAGEMENT

Eg Accuracy in interpreting findings
Fluency of explanation/instruction to patient
or examiner

ATTITUDE – How it is received

Eg Interaction with patient/rapport
Responding to verbal and non-verbal cues

ATTITUDE – Patient feedback

Would you like to see the Yes, OK Would prefer Not really No; Inappropriate
Doctor again definitely someone else comments

OVERALL IMPRESSION – Examiner feedback

Clear Pass Borderline Pass Pass Borderline Fail Clear Fail

Any other additional comments: