LOGBOOK
for
MBBS III STUDENTS
The College of Medicine, Campus Lilongwe
And
The Department of Medicine at Kamuzu Central Hospital
2012/2013
NAME: ______
CONTENT
General informations 3
Case-work-ups 4
Clinics attended 5
On Calls 5
Practical procedures performed 6
Patient Presentation assessment sheets 1-3 7-9
Long Case Assessment Sheet 10
Continuous assessment Sheet 11
OSCE-marking sheet Cardio Examination 12
OSCE-marking sheet Respiratory Examination 13
OSCE-marking sheet Respiratory Examination 14
OSCE-marking sheet Neuro Examination 15
Long Cases assessment sheet 16
Final assessment sheet 17
Documentation in the Logbook
Students will need to carry their logbook with them during all their rotation and bring it to case presentations and final exams. It will be collected after they completed their exams and archived by the CoM administration. In case you lost the logbook, report immediately to the Academic Lead.
Documentation of Procedures, Clinic attendance, calls, case presentations, Case write up’s
You have to get your log book signed right after the respective activity. You can not ask post-hoc for the signatures.
End of rotation Exams
LONG CASES
· Bring your Logbook to the Exam
· Students will have 45 min to clerk patients, additional 15-20 min to find patient, walking time etc.
· non Chichewa speakers can bring a non- medical interpreter, however no extra time is granted
· presentation time is 20 min (10 min presentation, 10 min questions)
· students can use medical instruments (stethoscope, pulsoxymeter etc.)
· students are not allowed to review the patient file, the CAN read the health passport
· no medical textbooks are allowed: If a student is found to read a textbook or the patient file he/she must be disqualified
· if a patient is not available, leaves during the exam or refuses to participate student must report back to his examiner immediately and will be assigned a new patient
· if any possible examiners will personally examine the patient before the exam
· grading focus on patient history and physical exam (70%), problem list, differentials and investigations (30%)
· grades are documented in logbook of student and handed back to the students right after the exam. Written feedback mainly serves the purpose of documentation and justification of the grade.
· Students are not supposed to discuss or negotiate their grade with examiners. If there are concerns they have to address them to the academic lead (Dr.Schlaich).
· If there are concerns during the exams please call me immediately:0996265576C. Schlaich
OBJECTIVE STRUCTURED EXAM’S (OSCE)
the forms in the logbook will give the student guidance as to the rules that are applied when assessing his/her performance. Students should make use of the OSCE forms when they rehearse their physical examination skills. It is recommended that they rehearse a lot
· Bring Logbook to Exam, marking will be document in respective forms in your logbook
· Each student has to do two stations representing to different systems (out of Neuro, Cardio, Resp and Gastro)
· Each station takes 15 mins
· between the students there is a 5 mins mini break to add up results
· In between the groups there is a break of 10 mins time
· The groups are not supposed to communicate until the OSCE is over
CASE WORK-UPs
A minimum of 18 signed cases is required (document additional work up’s for merit).
Case/Problem / Date of Clerking / Print Name of Clinician / Signature of consultant/registrar/intern1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
CLINICS ATTENDED
Three different clinics clinics minimum
(document additional clinical visits up’s for merit).
Clinic / Date / Print name clinician / Signature ClinicianLight House ART
(Tuesday / Wednesday morning)
Diabetic
(Tuesday morning)
Oncology/Hematology
(Tuesday and Thursday morning)
General Medicine
(Wednesday morning)
In hospital HIV clinic
(Thursday afternoon)
Partners in Hope clinic (Tuesday morning)
TB ward Bweila
(Tuesday or Friday morning)
Short Stay Unit –Admissions with your team-
A minimum of two on calls required. (document additional calls for merit).
Date / Print name Clinician / Signature Clinician1.
2.
PRACTICAL PROCEDURES (document additional work up’s for merit).
Practical Procedure(numbers required) / Date / Print name clinician / Signature Clinician
Venesections (3) / 1.
2.
3.
IM Injections (2) / 1.
2.
SC Injections (2) / 1.
2.
IV Lines (3) / 1.
2.
3.
Pleural Taps (3) / 1.
2.
3.
Ascitic Taps (3) / 1.
2.
3.
Lumbar Punctures (3) / 1.
2.
4.
Blood Glucose Stix (2) / 1.
2.
Urine Dipstick (2) / 1.
2.
NG-tubes (1) / 1.
Urinary Catheters (2) / 1.
Malaria Rapid Test (1) / 1.
ECG (1) / 1.
Not required ( merit)
Additional procedures
(from the list above or
Extra activities like ultrasound, bleeding time, fine needle biopsy) / 1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11
12.
13.
14.
Patient Presentation Assessment Sheet - MBBS III (N°1)
______
Student name:
Date:
Name of faculty grading: Signature:
Topic:
______
History of Presenting Complaint and Past Medical History (40%)
Examination (30%)
Problem List and Differential Diagnosis (15%)
Presentation Skills (15 %)
Summary Feedback (please circle)
FAIL PASS DISTINCTION
Patient Presentation Assessment Sheet - MBBS III (N°2)
______
Student name:
Date:
Name of faculty grading: Signature:
Topic:
______
History of Presenting Complaint and Past Medical History (40%)
Examination (30%)
Problem List and Differential Diagnosis (15%)
Presentation Skills (15 %)
Summary Feedback (please circle)
FAIL PASS DISTINCTION
Patient Presentation Assessment Sheet - MBBS III (repeat)
______
Student name:
Date:
Name of faculty grading: Signature:
Topic:
______
History of Presenting Complaint and Past Medical History (40%)
Examination (30%)
Problem List and Differential Diagnosis (15%)
Presentation Skills (15 %)
Summary Feedback (please circle)
FAIL PASS DISTINCTION
Long Case Assessment Sheet - MBBS III
______
Student name:
Date:
Name of faculty grading (1):
Name of faculty grading (2):
Topic:
______
Presentation of patient history
Presentation of physical examination
Problem list and summary
Differential diagnosis
Grading scheme75—100 / = distinction
65—74 / = credit
50— 64 / = pass
45 - 49 / = marginal failure
0 - 44 / = undoubted failure
Other comments:
Total mark: /100
Signatures of Markers
______
Continuous Assessment - MBBS III
Student name:
Date:
Faculty name:
______
1. History Taking and Examination Skills
2. Knowledge
(includes contribution to seminars, PBLs…)
3. Professionalism
(includes reliability, punctuality, interaction with colleagues)
4. Interaction with patients
5. Logbook
· Procedures
· Case write up’s
· Clinic Attendance
Summary Impression and Recommendation:
PASS FAIL (circle)
Signed by Academic Lead Lilongwe CAMPUS
______
Dept. of Medicine MBBS III OSCE – Cardiovascular Station
Technique / Good / Incomplete / Not Done/inadequate
Introduction to patient, politeness, positioning / 2 / 1 / 0
General Inspection / 2 / 1 / 0
Inspection of the hands / 2 / 1 / 0
Pulse (rate, rhythm, volume, character, max 2 credits) and blood pressure or mention wish to take (1 credit) / 3 / 1 / 0
Neck: JVP / 3 / 1 / 0
Eyes: conjunctival pallor; mouth: central cyanosis / 2 / 1 / 0
Chest Inspection / 2 / 1 / 0
Palpation of precordium / 2 / 1 / 0
Palpation of apex beat / 2 / 1 / 0
Positioning of patient for auscultation / 2 / 1 / 0
Auscultation of precordium (4 areas) / 4 / 2 / 0
Description of heart sounds and possible murmurs / 4 / 2 / 0
Bilateral auscultation of carotids / 2 / 1 / 0
Auscultation of the lung bases / 2 / 1 / 0
Assessment of liver for hepatomegaly / 2 / 1 / 0
Peripheral edema / 2 / 1 / 0
Peripheral pulses / 2 / 1 / 0
Presentation and interpretation of findings / 5 4 3 2 1 0
Thanks patient and leaves pt. in a comfortable position / 2 / 1 / 0
SUM (max 47)
MBBS III OSCE – Respiratory Station
Technique / Good / Incomplete / Not Done/inadequate
Introduction to patient, politeness, positioning / 2 / 1 / 0
General Inspection / 2 / 1 / 0
Respiratory Rate / 2 / 1 / 0
Inspection of the hands (clubbing, pallor, cyanosis, nails) / 2 / 1 / 0
Eyes: conjunctival pallor,
Mouth – KS, oral thrush, OHL, central cyanosis / 3 / 1 / 0
Cervical and supraclavicular lymphadenopathy / 2 / 1 / 0
Trachea / 2 / 1 / 0
Chest Inspection / 2 / 1 / 0
Chest palpation: expansion, tactile vocal fremitus / 2 / 1 / 0
Percussion and description of percussion note / 4 / 2 / 0
Auscultation of the anterior and lateral aspects of the lungs with correct description of findings / 4 / 2 / 0
Auscultation of the posterior aspects of the lungs with correct description of findings / 4 / 2 / 0
Vocal resonance / 2 / 1 / 0
Presentation and interpretation of findings (maximum 5) / 5 4 3 2 1 0
Thanks patient and leaves pt. in a comfortable position / 2 / 1 / 0
SUM (max. 40)
MBBS III OSCE – Abdominal Station
Technique / Good / Incomplete / Not Done/inadequate
Introduction to patient, politeness, positioning / 2 / 1 / 0
General Inspection / 2 / 1 / 0
Inspection of the hands / 2 / 1 / 0
Inspection of the Face / 2 / 1 / 0
Abdominal inspection / 2 / 1 / 0
Auscultation of all quadrants / 2 / 1 / 0
Percussion in general / 2 / 1 / 0
Paercussion to determine liver span / 2 / 1 / 0
Palpation (superficial) / 2 / 1 / 0
Palpation (deep) / 2 / 1 / 0
Palpation of spleen (assesss technique) / 2 / 1 / 0
Palpation of liver (assesss technique) / 2 / 1 / 0
Ballotment of kidneys / 2 / 1 / 0
Bilateral palpation of femoral pulses / 2 / 1 / 0
Bilateral auscultation for femoral bruits bilaterally / 2 / 1 / 0
Palpation of inguinal lymph nodes / 2 / 1 / 0
Presentation and interpretation of findings (maximum 5) / 5 4 3 2 1 0
Thanks patient and leaves pt. in a comfortable position / 2 / 1 / 0
SUM (max. 39 credits)
MBBS III OSCE – Neurology Station – Upper or lower limb examination
Technique / Good / Incomplete / Not Done/Inadequate
Introduction to patient, politeness, positioning / 2 / 1 / 0
General Inspection (eg. muscle wasting, tremor, involuntary movements, skin lesions, fasciculation) / 2 / 1 / 0
Tone / 2 / 1 / 0
Power
(Isolates each muscle group during active movement, tests appropriate myotome and understands MRC grading of power) / 4 / 2 / 0
Reflexes
(reinforces the reflex or shows awareness of this when indicated) / 4 / 2 / 0
Sensation (light touch, pin prick, joint position) / 3 / 1 / 0
Able to assess sensation in a systematic and relevant way i.e. dermatome, glove/stocking or sensory level with light touch and pinprick. If abnormality noted with joint position sense ascends up the body until normal or unable to. / 2 / 1 / 0
Coordination (able to demonstrate one of the following; finger nose, heal to shin, dysdiadokokinesia where appropriate) / 2 / 1 / 0
Gait (candidate also able to show awareness of bringing out gait abnormality e.g. tandem walking, Romberg test) / 2 / 1 / 0
Presentation and Interpretation of findings (maximum 5) / 5 4 3 2 1 0
Thanks patient and leaves pt. in a comfortable position / 2 / 1 / 0
SUM (max 30)
MBBS III OSCE – Neurology Station – Cranial nerve examination
Technique / Good / Incomplete / Not Done/inadequate
Introduction to patient, politeness, positioning / 2 / 1 / 0
General Inspection (eg. muscular wasting, tremor, ptosis, facial asymmetry, gaze deviation) / 2 / 1 / 0
I
(asks appropriate questions and aware of objective methods of assessing this nerve) / 2 / 1 / 0
II
( able to demonstrate or aware of modalities of this cranial nerve e.g. acuity, visual fields, light reflex, accommodation and fundoscopy) / 3 / 1 / 0
III IV VI
( able to demonstrate full range of eye movement; looking for evidence of gaze palsies, nystagmus or diplopia) / 2 / 1 / 0
V
(assesses the sensory component i.e. sensation of the face/aware of corneal reflex and motor component i.e. muscles of mastication and jaw jerk) / 3 / 1 / 0
VII
(assess the facial muscles & aware of its sensory component) / 3 / 1 / 0
VIII
(able to perform a general screen + aware of the principles of the Rinne’s and Weber’s test) / 2 / 1 / 0
XI, V, XII
(able to demonstrate palatal and tongue movement, aware of the principles of the gag reflex / 2 / 1 / 0
XI
( able to demonstrate the movements of the shoulder and neck, isolating the muscle group during active movement) / 2 / 1 / 0
Presentation and Interpretation of findings (maximum 5 / 5 4 3 2 1 0
Thanks patient and leaves pt. in a comfortable position / 2 / 1 / 0
SUM (max 30)