Please enter candidate number in the grid tothe left and print name below
EXAMINER NAME
Please enter examiner number in the gridto the right and print name below
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Cardiovascular Compliant
Neurology/Neurodisability
Musculoskeletal Hesitant
Respiratory
Abdominal Unwilling
Gastroenterology
Ophthalmology
DermatologyHepatology/Haematology,growth and nutritionNephrology
Clinical Domain Meets Standard Borderline Below Standard
BPhysical Examination
If you ticked YES for box F (above), please provide details of your concerns here. If you need more room, please continue on a comment box on the back.
FUnprofessional Conduct
(Counselling recommended)
E1Rapport & Communication Style
D1Clinical Reasoning
CIdentification of Clinical Signs
YES NOCONCERNSCauses physical or emotional discomfort topatient or parent/carer. Jeopardises patient safety.
DO NOT WRITE INSIDE THIS BOX
1 Royal College of Paediatrics and Child HealthLeading the way in Children’s Health
RCPCH
DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX
DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX
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Lacks insight into implications of findings.Poor understanding/lack of knowledge withsignificant implications. Wrong & confident.
Unable to form coherent and sensiblesuggestions if exam inconclusive.
E1CommunicationSkills:Rapport &CommunicationStyle
Appropriate level of confidence; greeting andintroduction; professional; sensitive; appropriatebody language; responds to verbal & non-verbalcues.
Develops appropriate rapport withpatient/parent/carer or colleague. Puts at ease.
Clarifies role & shared agenda. Appropriate tone &pace.
1
2
3
Minor issues with level of confidence, bodylanguage & non-verbal skills.
Develops reasonable level of rapport; coulddo more to engage patient/parent/carer orcolleague.
Approach to clarifying role & agenda, (tone &pace) needs improvement.
Poor body language & non-verbal skills,unprofessional manner, insensitive oroverconfident.
Poor rapport or detached. Fails to putpatient/parent/carer or colleague at ease.
No clarification of role. Inappropriate tone &pace.
Additional Domain Feedback Comments. Add comments here relevant to performance in Domains
Additional Comments/Special Circumstances (optional) Factors that may impact on candidate performance i.e. procedural issues (station disruption, candidate/patient/role player/parent or carer unwilling, sick, difficult, upset etc.) add comments here. Not for examiners to add comments to support grades.
DO NOT WRITE IN THIS SHADED AREAMRCPCH Clinical Examination - Station 2CLINICAL 2
Please enter candidate number in the grid tothe left and print name below
EXAMINER NAME
Please enter examiner number in the gridto the right and print name below
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Clinical Domain Meets Standard Borderline Below Standard
BPhysical Examination
If you ticked YES for box F (above), please provide details of your concerns here. If you need more room, please continue on a comment box on the back.
FUnprofessional Conduct
(Counselling recommended)
E1Rapport & Communication Style
D1Clinical Reasoning
CIdentification of Clinical Signs
YES NOCONCERNSCauses physical or emotional discomfort topatient or parent/carer. Jeopardises patient safety.
DO NOT WRITE INSIDE THIS BOX
2 Royal College of Paediatrics and Child HealthLeading the way in Children’s Health
RCPCH
DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX
DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX
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Case Description:
Date: Time: Age of child:
Co-operation of Child
Cardiovascular Compliant
Neurology/Neurodisability
Musculoskeletal Hesitant
Respiratory
Abdominal Unwilling
Gastroenterology
Ophthalmology
DermatologyHepatology/Haematology,growth and nutritionNephrology
Lacks insight into implications of findings.Poor understanding/lack of knowledge withsignificant implications. Wrong & confident.
Unable to form coherent and sensiblesuggestions if exam inconclusive.
E1CommunicationSkills:Rapport &CommunicationStyle
Appropriate level of confidence; greeting andintroduction; professional; sensitive; appropriatebody language; responds to verbal & non-verbalcues.
Develops appropriate rapport withpatient/parent/carer or colleague. Puts at ease.
Clarifies role & shared agenda. Appropriate tone &pace.
1
2
3
Minor issues with level of confidence, bodylanguage & non-verbal skills.
Develops reasonable level of rapport; coulddo more to engage patient/parent/carer orcolleague.
Approach to clarifying role & agenda, (tone &pace) needs improvement.
Poor body language & non-verbal skills,unprofessional manner, insensitive oroverconfident.
Poor rapport or detached. Fails to putpatient/parent/carer or colleague at ease.
No clarification of role. Inappropriate tone &pace.
Additional Domain Feedback Comments. Add comments here relevant to performance in Domains
Additional Comments/Special Circumstances (optional) Factors that may impact on candidate performance i.e. procedural issues (station disruption, candidate/patient/role player/parent or carer unwilling, sick, difficult, upset etc.) add comments here. Not for examiners to add comments to support grades.
DO NOT WRITE IN THIS SHADED AREAMRCPCH Clinical Examination - Station 3CLINICAL 3
Please enter candidate number in the grid tothe left and print name below
EXAMINER NAME
Please enter examiner number in the gridto the right and print name below
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3 Royal College of Paediatrics and Child HealthLeading the way in Children’s Health
RCPCHCase Description:
Date: Time: Age of child:
Co-operation of Child
Cardiovascular Compliant
Neurology/Neurodisability
Musculoskeletal Hesitant
Respiratory
Abdominal Unwilling
Gastroenterology
Ophthalmology
DermatologyHepatology/Haematology,growth and nutritionNephrology
DO NOT WRITE BELOW THIS LINE
Clinical Domain Meets Standard Borderline Below Standard
BPhysical Examination
If you ticked YES for box F (above), please provide details of your concerns here. If you need more room, please continue on a comment box on the back.
FUnprofessional Conduct
(Counselling recommended)
E1Rapport & Communication Style
D1Clinical Reasoning
CIdentification of Clinical Signs
YES NOCONCERNSCauses physical or emotional discomfort topatient or parent/carer. Jeopardises patient safety.
DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX
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DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX
DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX
DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX
Additional Domain Feedback Comments. Add comments here relevant to performance in Domains
Additional Comments/Special Circumstances (optional) Factors that may impact on candidate performance i.e. procedural issues (station disruption, candidate/patient/role player/parent or carer unwilling, sick, difficult, upset etc.) add comments here. Not for examiners to add comments to support grades.
Clinical Domain Borderline Below Standard
Examiner should mark criteria boxes for any Borderline or Below Standard domain score
Meets Standard
BPhysicalExamination
Well-structured, systematic exam technique.
Appropriate care taken to adapt to needs ofpatient. Permission to examine sought.
Appropriate use of equipment/development toys.
1
2
3
Exam technique lacking some structure.
Limited adaptation to meet needs of patient.
Unfocused use of equipment.
Very slow, uncertain, unstructured,unsystematic exam technique.
Poor adaptation to patient needs. Lack ofcare. No attempt to seek permission.
Incorrect or no use ofequipment/development toys.
CIdentification ofClinical Signs
Identifies clinical signs that are present.
Correctly interprets clinical signs that are present.
Please enter candidate number in the grid tothe left and print name below
EXAMINER NAME
Please enter examiner number in the gridto the right and print name below
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4 Royal College of Paediatrics and Child HealthLeading the way in Children’s Health
RCPCHCase Description:
Date: Time: Age of child:
Co-operation of Child
Cardiovascular Compliant
Neurology/Neurodisability
Musculoskeletal Hesitant
Respiratory
Abdominal Unwilling
Gastroenterology
Ophthalmology
DermatologyHepatology/Haematology,growth and nutritionNephrology
DO NOT WRITE BELOW THIS LINE
Clinical Domain Meets Standard Borderline Below Standard
BPhysical Examination
If you ticked YES for box F (above), please provide details of your concerns here. If you need more room, please continue on a comment box on the back.
FUnprofessional Conduct
(Counselling recommended)
E1Rapport & Communication Style
D1Clinical Reasoning
CIdentification of Clinical Signs
YES NOCONCERNSCauses physical or emotional discomfort topatient or parent/carer. Jeopardises patient safety.
DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX
DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX
DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX
DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX
DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX
Additional Domain Feedback Comments. Add comments here relevant to performance in Domains
Additional Comments/Special Circumstances (optional) Factors that may impact on candidate performance i.e. procedural issues (station disruption, candidate/patient/role player/parent or carer unwilling, sick, difficult, upset etc.) add comments here. Not for examiners to add comments to support grades.
Clinical Domain Borderline Below Standard
Examiner should mark criteria boxes for any Borderline or Below Standard domain score
Meets Standard
BPhysicalExamination
Well-structured, systematic exam technique.
Appropriate care taken to adapt to needs ofpatient. Permission to examine sought.
Appropriate use of equipment/development toys.
1
2
3
Exam technique lacking some structure.
Limited adaptation to meet needs of patient.
Unfocused use of equipment.
Very slow, uncertain, unstructured,unsystematic exam technique.
Poor adaptation to patient needs. Lack ofcare. No attempt to seek permission.
Incorrect or no use ofequipment/development toys.
CIdentification ofClinical Signs
Identifies clinical signs that are present.
Correctly interprets clinical signs that are present.
Please enter candidate number in the grid tothe left and print name below
EXAMINER NAME
Please enter examiner number in the gridto the right and print name below
0
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Fine motor
Gross motor
Speech & Language
Social
Compliant
Hesitant
Unwilling
Clinical Domain
A1 Information Gathering /History Taking
Meets Standard Borderline Below Standard
BPhysical Examination
If you ticked YES for box F (above), please provide details of your concerns here. If you need more room, please continue on a comment box on the back.
FUnprofessional Conduct
(Counselling recommended)
E1Rapport & Communication Style
D2Management Planning
D1Clinical Reasoning
CIdentification of Clinical Signs
YES NOCONCERNSCauses physical or emotional discomfort topatient or parent/carer. Jeopardises patient safety.
DO NOT WRITE INSIDE THIS BOX
5 Royal College of Paediatrics and Child HealthLeading the way in Children’s Health
RCPCH
DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX
DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX
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Does not fully relate management plan topatient/parent/carer concerns. Somereference made to referral &/or escalation.
Unable to suggest appropriate investigations.
Inappropriate, unsafe or unethicalmanagement plan suggested. Inappropriatereferral / escalation. No clear relation topatient/parent/carer concerns.
E1CommunicationSkills:Rapport &CommunicationStyle
Appropriate level of confidence; greeting andintroduction; professional; sensitive; appropriatebody language; responds to verbal & non-verbalcues.
Develops appropriate rapport withpatient/parent/carer or colleague. Puts at ease.
Clarifies role & shared agenda. Appropriate tone &pace.
1
2
3
Minor issues with level of confidence, bodylanguage & non-verbal skills.
Develops reasonable level of rapport; coulddo more to engage patient/parent/carer orcolleague.
Approach to clarifying role & agenda, (tone &pace) needs improvement.
Poor body language & non-verbal skills,unprofessional manner, insensitive oroverconfident.
Poor rapport or detached. Fails to putpatient/parent/carer or colleague at ease.
No clarification of role. Inappropriate tone &pace.
Additional Domain Feedback Comments. Add comments here relevant to performance in Domains
Additional Comments/Special Circumstances (optional) Factors that may impact on candidate performance i.e. procedural issues (station disruption, candidate/patient/role player/parent or carer unwilling, sick, difficult, upset etc.) add comments here. Not for examiners to add comments to support grades.
DO NOT WRITE IN THIS SHADED AREAMRCPCH Clinical Examination - Station 6HISTORY
Please enter candidate number in the grid tothe left and print name below
EXAMINER NAME
Please enter examiner number in the gridto the right and print name below
0
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Clinical Domain
A1Information Gathering/
History Taking
Meets Standard Borderline Below Standard
If you ticked YES for box F (above), please provide details of your concerns here. If you need more room, please continue on a comment box on the back.
FUnprofessional Conduct
(Counselling recommended)
E1Rapport & Communication Style
E2Verbal & Listening
Communication Skills
D2Management Planning
D1Clinical Reasoning
YES NOCONCERNSCauses physical or emotional discomfort topatient or parent/carer. Jeopardises patient safety.
6 Royal College of Paediatrics and Child HealthLeading the way in Children’s Health
RCPCHSCENARIO
DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX
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Does not fully relate management plan topatient/parent/carer concerns. Somereference made to referral &/or escalation.
Unable to suggest appropriate investigations.
Inappropriate, unsafe or unethicalmanagement plan suggested. Inappropriatereferral/escalation. No clear relation topatient/parent/carer concerns.
Appropriate level of confidence, greeting andintroduction; professional; sensitive, appropriatebody language; responds to verbal & non-verbalcues.
Develops appropriate rapport withpatient/parent/carer or colleague. Puts at ease.
Clarifies role & shared agenda. Appropriate tone &pace.
1
2
3
Minor issues with level of confidence, bodylanguage & non-verbal skills.
Develops reasonable level of rapport; coulddo more to engage patient/parent/carer orcolleague.
Approach to clarifying role & agenda, (tone &pace) needs improvement.
Poor body language & non-verbal skills,unprofessional manner, insensitive oroverconfident.
Poor rapport or detached. Fails to putpatient/parent/carer or colleague at ease.
No clarification of role. Inappropriate tone &pace.
Applies active listening & displays interest withpatient/parent/carer/colleagues.
Appropriate language used in challengingcircumstances with any jargon explained.
Allows others opportunity to speak.
1
2
3
Not actively listening throughout the station;misses some subtle cues.
Language not fully tailored to subject withsome jargon used.
Interrupts occasionally.
Does not listen/display interest in views ofpatient/parent/carer or colleagues. Missescues; obstructive; inappropriate language.
Language not tailored to subject with anoverreliance on jargon.
Interrupts repeatedly; dismisses concerns.
Additional Domain Feedback Comments. Add comments here relevant to performance in Domains
Additional Comments/Special Circumstances (optional) Factors that may impact on candidate performance i.e. procedural issues (station disruption, candidate/patient/role player/parent or carer unwilling, sick, difficult, upset etc.) add comments here. Not for examiners to add comments to support grades.
DO NOT WRITE IN THIS SHADED AREAMRCPCH Clinical Examination - Station 7COMMUNICATION A
Please enter candidate number in the grid tothe left and print name below
EXAMINER NAME
Please enter examiner number in the gridto the right and print name below
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9
Clinical Domain
A2Information Sharing / Accuracy
of Information
Meets Standard Borderline Below Standard
If you ticked YES for box F (above), please provide details of your concerns here. If you need more room, please continue on a comment box on the back.
FUnprofessional Conduct
(Counselling recommended)
E1Rapport & Communication Style
E2Verbal & Listening
Communication Skills
E3Managing Concerns &Agreeing Next Steps
YES NOCONCERNSCauses physical or emotional discomfort topatient or parent/carer. Jeopardises patient safety.
7 Royal College of Paediatrics and Child HealthLeading the way in Children’s Health
RCPCHSCENARIO
DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX
DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX
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DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX
DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX
Additional Domain Feedback Comments. Add comments here relevant to performance in Domains
Additional Comments/Special Circumstances (optional) Factors that may impact on candidate performance i.e. procedural issues (station disruption, candidate/patient/role player/parent or carer unwilling, sick, difficult, upset etc.) add comments here. Not for examiners to add comments to support grades.
Clinical Domain Borderline Below Standard
Examiner should mark criteria boxes for any Borderline or Below Standard domain score
A2InformationSharing /Accurancy ofInformation
Explains relevant, clinically accurate information.
Information provided in a well structured manner.
Verifies understanding & summarises.
1
2
3
Meets Standard
Some inaccuracy/irrelevance in informationgiven.
Information provided lacking in somestructure.
Limited verification of understanding.
Inaccurate, irrelevant information given.
Information provided lacks structure.
No verification of understanding.
E1CommunicationSkills: Rapport&CommunicationStyle
E2Verbal &Listening CommunicationSkills
Appropriate level of confidence, greeting andintroduction; professional; sensitive, appropriatebody language; responds to verbal & non-verbalcues.
Develops appropriate rapport withpatient/parent/carer or colleague. Puts at ease.
Clarifies role & shared agenda. Appropriate tone &pace.
1
2
3
Minor issues with level of confidence, bodylanguage & non-verbal skills.
Develops reasonable level of rapport; coulddo more to engage patient/parent/carer orcolleague.
Approach to clarifying role & agenda, (tone &pace) needs improvement.
Poor body language & non-verbal skills,unprofessional manner, insensitive oroverconfident.
Poor rapport or detached. Fails to putpatient/parent/carer or colleague at ease.
No clarification of role. Inappropriate tone &pace.
Applies active listening & displays interest withpatient/parent/carer/colleagues.
Appropriate language used in challengingcircumstances with any jargon explained.
Allows others opportunity to speak.
1
2
3
Not actively listening throughout the station;misses some subtle cues.
Language not fully tailored to subject withsome jargon used.
Interrupts occasionally.
Does not listen/display interest in views ofpatient/parent/carer or colleagues. Missescues; obstructive; inappropriate language.
Language not tailored to subject with anoverreliance on jargon.
Please enter candidate number in the grid tothe left and print name below
EXAMINER NAME
Please enter examiner number in the gridto the right and print name below
0
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9
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9
Clinical Domain
A2Information Sharing / Accuracy
of Information
Meets Standard Borderline Below Standard
If you ticked YES for box F (above), please provide details of your concerns here. If you need more room, please continue on a comment box on the back.
FUnprofessional Conduct
(Counselling recommended)
E1Rapport & Communication Style
E2Verbal & Listening
Communication Skills
E3Managing Concerns &Agreeing Next Steps
YES NOCONCERNSCauses physical or emotional discomfort topatient or parent/carer. Jeopardises patient safety.
8 Royal College of Paediatrics and Child HealthLeading the way in Children’s Health
RCPCHSCENARIO
DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX
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Additional Domain Feedback Comments. Add comments here relevant to performance in Domains
Additional Comments/Special Circumstances (optional) Factors that may impact on candidate performance i.e. procedural issues (station disruption, candidate/patient/role player/parent or carer unwilling, sick, difficult, upset etc.) add comments here. Not for examiners to add comments to support grades.
Clinical Domain Borderline Below Standard
Examiner should mark criteria boxes for any Borderline or Below Standard domain score
A2InformationSharing /Accurancy ofInformation
Explains relevant, clinically accurate information.
Information provided in a well structured manner.
Verifies understanding & summarises.
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Some inaccuracy/irrelevance in informationgiven.
Information provided lacking in somestructure.
Limited verification of understanding.
Inaccurate, irrelevant information given.
Information provided lacks structure.
No verification of understanding.
E1CommunicationSkills: Rapport&CommunicationStyle
E2Verbal &Listening CommunicationSkills
Appropriate level of confidence, greeting andintroduction; professional; sensitive, appropriatebody language; responds to verbal & non-verbalcues.
Develops appropriate rapport withpatient/parent/carer or colleague. Puts at ease.
Clarifies role & shared agenda. Appropriate tone &pace.
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Minor issues with level of confidence, bodylanguage & non-verbal skills.
Develops reasonable level of rapport; coulddo more to engage patient/parent/carer orcolleague.
Approach to clarifying role & agenda, (tone &pace) needs improvement.
Poor body language & non-verbal skills,unprofessional manner, insensitive oroverconfident.
Poor rapport or detached. Fails to putpatient/parent/carer or colleague at ease.
No clarification of role. Inappropriate tone &pace.
Applies active listening & displays interest withpatient/parent/carer/colleagues.
Appropriate language used in challengingcircumstances with any jargon explained.
Allows others opportunity to speak.
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Not actively listening throughout the station;misses some subtle cues.
Language not fully tailored to subject withsome jargon used.
Interrupts occasionally.
Does not listen/display interest in views ofpatient/parent/carer or colleagues. Missescues; obstructive; inappropriate language.
Language not tailored to subject with anoverreliance on jargon.
Please enter candidate number in the grid tothe left and print name below
EXAMINER NAME
Please enter examiner number in the gridto the right and print name below
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Clinical Domain Meets Standard Borderline Below Standard
If you ticked YES for box F (above), please provide details of your concerns here. If you need more room, please continue on a comment box on the back.
FUnprofessional Conduct
(Counselling recommended)
D2Management Planning
D1Clinical Reasoning
CIdentification ofClinical Signs
YES NOCONCERNSCauses physical or emotional discomfort topatient or parent/carer. Jeopardises patient safety.
9 Royal College of Paediatrics and Child HealthLeading the way in Children’s Health
RCPCHSCENARIO
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Additional Comments/Special Circumstances (optional) Factors that may impact on candidate performance i.e. procedural issues (station disruption, candidate/patient/role player/parent or carer unwilling, sick, difficult, upset etc.) add comments here. Not for examiners to add comments to support grades.
Clinical Domain Borderline Below Standard
Examiner should mark criteria boxes for any Borderline or Below Standard domain score
Meets Standard
CIdentification ofClinical Signs
Identifies clinical signs that are present.
Correctly interprets clinical signs that are present.
Please enter candidate number in the grid tothe left and print name below
EXAMINER NAME
Please enter examiner number in the gridto the right and print name below
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Clinical Domain Meets Standard Borderline Below Standard
If you ticked YES for box F (above), please provide details of your concerns here. If you need more room, please continue on a comment box on the back.
FUnprofessional Conduct
(Counselling recommended)
D2Management Planning
D1Clinical Reasoning
CIdentification ofClinical Signs
YES NOCONCERNSCauses physical or emotional discomfort topatient or parent/carer. Jeopardises patient safety.
10 Royal College of Paediatrics and Child HealthLeading the way in Children’s Health
RCPCHSCENARIO
DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX
DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX DO NOT WRITE INSIDE THIS BOX
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Additional Comments/Special Circumstances (optional) Factors that may impact on candidate performance i.e. procedural issues (station disruption, candidate/patient/role player/parent or carer unwilling, sick, difficult, upset etc.) add comments here. Not for examiners to add comments to support grades.
Clinical Domain Borderline Below Standard
Examiner should mark criteria boxes for any Borderline or Below Standard domain score
Meets Standard
CIdentification ofClinical Signs
Identifies clinical signs that are present.
Correctly interprets clinical signs that are present.
