Competency Based Logbook and Clinical Manual in General Surgery (10) [First Edition] 9789354660801

Table of contents :
Cover
Half Title Page
Title Page
Copyright
Preface
Contents
1. Competencies
2. Short Cases
3. Long Cases
4. Instruments
5. Simulation Based Teaching
A. Certifiable Skills and Assessment of Skills
6. Attitude, Ethics and Communication (AETCOM)
7. Integration
Back Cover

Citation preview

Competency Based

Logbook and Clinical Manual in

10

General Surgery for Second and Third Professional (Part I and Part II) MBBS As per the latest CBME Guidelines | Competency Based Undergraduate Curriculum for the Indian Medical Graduate

Name: Roll No.:

University Registration No.:

Date of Admission: Permanent Address: E-mail ID: Mobile No.:

Batch:

10

Competency Based

Logbook and Clinical Manual in

General Surgery for Second and Third Professional (Part I and Part II) MBBS As per the latest CBME Guidelines | Competency Based Undergraduate Curriculum for the Indian Medical Graduate

Niket Verma MBBS, MD

Poonam Agrawal MBBS, MD (Biochemistry)

Assistant Professor Department of General Medicine Army College of Medical Sciences Delhi Cantt, New Delhi

Professor and Head Department of Biochemistry Dr Baba Saheb Ambedkar Medical College and Hospital, Rohini New Delhi

Musharraf Husain MS, DNB, MRCS (Edin), MNAMS

Professor and Head General Surgery and Coordinator Medical Education Unit at Hamdard Institute of Medical Sciences and Research, Jamia Hamdard New Delhi

CBS Publishers & Distributors

Pvt Ltd

New Delhi • Bengaluru • Chennai • Kochi • Kolkata • Mumbai Hyderabad • Jharkhand • Nagpur • Patna • Pune • Uttarakhand

Disclaimer Science and technology are constantly changing fields. New research and experience broaden the scope of information and knowledge. The authors have tried their best in giving information available to them while preparing the material for this book. Although, all efforts have been made to ensure optimum accuracy of the material, yet it is quite possible some errors might have been left uncorrected. The publisher, the printer and the authors will not be held responsible for any inadvertent errors, omissions or inaccuracies. eISBN: xxxx Copyright © Authors and Publisher First eBook Edition: 2021 All rights reserved. No part of this eBook may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system without permission, in writing, from the authors and the publisher. Published by Satish Kumar Jain and produced by Varun Jain for CBS Publishers & Distributors Pvt. Ltd. Corporate Office: 204 FIE, Industrial Area, Patparganj, New Delhi-110092 Ph: +91-11-49344934; Fax: +91-11-49344935; Website: www.cbspd.com; www.eduport-global.com; E-mail: [email protected]; [email protected] Head Office: CBS PLAZA, 4819/XI Prahlad Street, 24 Ansari Road, Daryaganj, New Delhi-110002, India. Ph: +91-11-23289259, 23266861, 23266867; Fax: 011-23243014; Website: www.cbspd.com; E-mail: [email protected]; [email protected].

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Representatives Hyderabad Pune Nagpur Manipal Vijayawada Patna

Preface

T

his Logbook and Clinical Manual has been designed keeping in mind the requirements of the new Competency Based Medical Education (CBME) curriculum. Individual departments have the flexibility to decide the list of competencies to be included in this logbook and specify the maximum number of attempts allowed for each activity. Adequate space is provided to enter the details of the competencies and activities, the details of remedial training (if any), the rating for each attempt at the activity and the final decision of the faculty. Separate sections have been designed for recording short cases, long cases and instruments. An assessment scale has also been included after every long case for regular, formative assessment. Separate sections have also been designed for Skills and SBT (Simulation Based Teaching), AETCOM (Attitude, Ethics and Communication) and Integration. Many sections are followed by Reflective Portfolios with ample space for reflection writing by the student learners.

Introduction The Competency Based Medical Education (CBME) curriculum for undergraduate medical education was introduced in the academic year 2019-2020. The new curriculum has brought about a fundamental change in the system of medical education in our country. There is greater emphasis on alignment and integration of the various subjects, on the acquisition of specific competencies and essential skills and on the assessment ‘for’ learning. Maintaining a record of the activities conducted and the competencies and skills acquired is now a mandatory requirement. This Logbook and Clinical Manual aims to provide a ready format to record the activities, competencies, short cases, long cases, instruments and skills in General Surgery. Combined with reflection writing, the records can be used for formative and continuous assessment of the learners. We hope that this logbook will serve as a stimulus to encourage self-directed learning among undergraduate students.

Salient Features 1. Simple tabular format of the templates for recording the activities, competencies, short cases, long cases, instruments and skills. 2. Flexibility to record the competencies decided by individual departments. 3. An assessment scale included after every long case for regular, formative assessment. 4. Reflective Portfolios for important topics with encouragement of reflection writing and recording the details of assignments and assessments 5. Separate sections for Skills and SBT (Simulation Based Teaching), AETCOM (Attitude, Ethics and Communication) and Integration.

Niket Verma Poonam Agrawal Musharraf Husain

Certificate 1 It is hereby certified that Ms./Mr. ………...………………....………………………….…, Roll No./University Registration No. …………………………………...……..., who is a student of IIIrd Professional MBBS (Part II) at……………………………………...……. (name of Medical College), has satisfactorily achieved all competencies (including certifiable competencies) and completed all assignments from General Surgery mentioned in this logbook. She/He is eligible to appear for the IIIrd Professional MBBS (Part II) University examinations in General Surgery which will be conducted by ………………………………………...… (name of the affiliating university), from ……………… to………………. . Signature of Faculty-incharge Signature of Head of the Department Signature of Principal/Dean of the College

Certificate 2 It is hereby certified that Ms./Mr. ………...………………....………………………….…, Roll No./University Registration No. …………………………………...……..., who is a student of IIIrd Professional MBBS (Part II) at………………………………………..……. (name of Medical College), has NOT achieved all competencies (including certifiable competencies) and/or completed all assignments from General Surgery mentioned in this logbook. She/He is NOT eligible to appear for the IIIrd Professional MBBS (Part II) University examinations in General Surgery which will be conducted by ………………………...… (name of the affiliating university), from ……………… to………………. . Signature of Faculty-incharge Signature of Head of the Department Signature of Principal/Dean of the College

Contents Preface

v

1. Competencies

1

2. Short Cases

13

3. Long Cases

28

4. Instruments

128

5. Simulation Based Teaching

143

A. Certifiable Skills and Assessment of Skills

147

6. Attitude, Ethics and Communication (AETCOM)

174

7. Integration

182

Competencies

1

Section 1: Competencies General Surgery Sr. No.

Competency number and description of the activity

Maximum number of attempts allowed for the activity

No. of attempts taken by the learner (with date of each attempt)

Any remedial training needed? (Yes/No) If yes then state the reason(s)

Rating 1. Scope for further improvement 2. Satisfactory (All attempts at the activity must be rated separately)

General Surgery

1.

2.

3.

4.

5.

Final decision of faculty C–Completed N–Not completed

Feedback conveyed by faculty (Yes/No) Signature of faculty (with date)

Feedback received by learner (Yes/No) Signature of learner (with date)

Competency Based Logbook and Clinical Manual in General Surgery

2

General Surgery Sr. No.

Competency number and description of the activity

Maximum number of attempts allowed for the activity

No. of attempts taken by the learner (with date of each attempt)

Any remedial training needed? (Yes/No) If yes then state the reason(s)

Rating 1. Scope for further improvement 2. Satisfactory (All attempts at the activity must be rated separately)

General Surgery

6.

7.

8.

9.

10.

Final decision of faculty C–Completed N–Not completed

Feedback conveyed by faculty (Yes/No) Signature of faculty (with date)

Feedback received by learner (Yes/No) Signature of learner (with date)

Competencies

3

General Surgery Sr. No.

Competency number and description of the activity

Maximum number of attempts allowed for the activity

No. of attempts taken by the learner (with date of each attempt)

Any remedial training needed? (Yes/No) If yes then state the reason(s)

Rating 1. Scope for further improvement 2. Satisfactory (All attempts at the activity must be rated separately)

General Surgery

11.

12.

13.

14.

15.

Final decision of faculty C–Completed N–Not completed

Feedback conveyed by faculty (Yes/No) Signature of faculty (with date)

Feedback received by learner (Yes/No) Signature of learner (with date)

4

Competency Based Logbook and Clinical Manual in General Surgery General Surgery

Sr. No.

Competency number and description of the activity

Maximum number of attempts allowed for the activity

No. of attempts taken by the learner (with date of each attempt)

Any remedial training needed? (Yes/No) If yes then state the reason(s)

Rating 1. Scope for further improvement 2. Satisfactory (All attempts at the activity must be rated separately)

General Surgery

16.

17.

18.

19.

20.

Final decision of faculty C–Completed N–Not completed

Feedback conveyed by faculty (Yes/No) Signature of faculty (with date)

Feedback received by learner (Yes/No) Signature of learner (with date)

Competencies

5

General Surgery Sr. No.

Competency number and description of the activity

Maximum number of attempts allowed for the activity

No. of attempts taken by the learner (with date of each attempt)

Any remedial training needed? (Yes/No) If yes then state the reason(s)

Rating 1. Scope for further improvement 2. Satisfactory (All attempts at the activity must be rated separately)

General Surgery

21.

22.

23.

24.

25.

Final decision of faculty C–Completed N–Not completed

Feedback conveyed by faculty (Yes/No) Signature of faculty (with date)

Feedback received by learner (Yes/No) Signature of learner (with date)

6

Competency Based Logbook and Clinical Manual in General Surgery General Surgery

Sr. No.

Competency number and description of the activity

Maximum number of attempts allowed for the activity

No. of attempts taken by the learner (with date of each attempt)

Any remedial training needed? (Yes/No) If yes then state the reason(s)

Rating 1. Scope for further improvement 2. Satisfactory (All attempts at the activity must be rated separately)

General Surgery

26.

27.

28.

29.

30.

Final decision of faculty C–Completed N–Not completed

Feedback conveyed by faculty (Yes/No) Signature of faculty (with date)

Feedback received by learner (Yes/No) Signature of learner (with date)

Competencies

7

General Surgery Sr. No.

Competency number and description of the activity

Maximum number of attempts allowed for the activity

No. of attempts taken by the learner (with date of each attempt)

Any remedial training needed? (Yes/No) If yes then state the reason(s)

Rating 1. Scope for further improvement 2. Satisfactory (All attempts at the activity must be rated separately)

General Surgery

31.

32.

33.

34.

35.

Final decision of faculty C–Completed N–Not completed

Feedback conveyed by faculty (Yes/No) Signature of faculty (with date)

Feedback received by learner (Yes/No) Signature of learner (with date)

8

Competency Based Logbook and Clinical Manual in General Surgery General Surgery

Sr. No.

Competency number and description of the activity

Maximum number of attempts allowed for the activity

No. of attempts taken by the learner (with date of each attempt)

Any remedial training needed? (Yes/No) If yes then state the reason(s)

Rating 1. Scope for further improvement 2. Satisfactory (All attempts at the activity must be rated separately)

General Surgery

36.

37.

38.

39.

40.

Final decision of faculty C–Completed N–Not completed

Feedback conveyed by faculty (Yes/No) Signature of faculty (with date)

Feedback received by learner (Yes/No) Signature of learner (with date)

Competencies

9

General Surgery Sr. No.

Competency number and description of the activity

Maximum number of attempts allowed for the activity

No. of attempts taken by the learner (with date of each attempt)

Any remedial training needed? (Yes/No) If yes then state the reason(s)

Rating 1. Scope for further improvement 2. Satisfactory (All attempts at the activity must be rated separately)

General Surgery

41.

42.

43.

44.

45.

Final decision of faculty C–Completed N–Not completed

Feedback conveyed by faculty (Yes/No) Signature of faculty (with date)

Feedback received by learner (Yes/No) Signature of learner (with date)

10

Competency Based Logbook and Clinical Manual in General Surgery General Surgery

Sr. No.

Competency number and description of the activity

Maximum number of attempts allowed for the activity

No. of attempts taken by the learner (with date of each attempt)

Any remedial training needed? (Yes/No) If yes then state the reason(s)

Rating 1. Scope for further improvement 2. Satisfactory (All attempts at the activity must be rated separately)

General Surgery

46.

47.

48.

49.

50.

Final decision of faculty C–Completed N–Not completed

Feedback conveyed by faculty (Yes/No) Signature of faculty (with date)

Feedback received by learner (Yes/No) Signature of learner (with date)

Competencies

11

General Surgery (This page may be used to record the salient points of the discussion as well as any activities, assignments or assessments on the topic) Sub-topic:

Date:

1. Please describe briefly what was discussed OR details of activity/assignment/assessment:

2. What did you learn from the discussion OR the activity/assignment/assessment:

3. Do you feel that the knowledge you have acquired will help you become a better doctor? Please explain in your own words.

Feedback Received (Yes/No):

12

Competency Based Logbook and Clinical Manual in General Surgery General Surgery

(This page may be used to record the salient points of the discussion as well as any activities, assignments or assessments on the topic) Sub-topic:

Date:

1. Please describe briefly what was discussed OR details of activity/assignment/assessment:

2. What did you learn from the discussion OR the activity/assignment/assessment:

3. Do you feel that the knowledge you have acquired will help you become a better doctor? Please explain in your own words.

Feedback Received (Yes/No):

Short Cases

13

Section 2: Short Cases Short Case 1

Patient Name: Resident of:

Age:

Gender: Occupation:

Chief Complaints: 1. 2. 3. 4. Relevant Present and Past History:

Relevant Examination:

Provisional Diagnosis:

Proposed Investigations/Management:

Advice:

Feedback given by Faculty

Feedback received by Learner

14

Competency Based Logbook and Clinical Manual in General Surgery Short Case 2

Patient Name: Resident of:

Age:

Gender: Occupation:

Chief Complaints: 1. 2. 3. 4.

Relevant Present and Past History:

Relevant Examination:

Provisional Diagnosis:

Proposed Investigations/Management:

Advice:

Feedback given by Faculty

Feedback received by Learner

Short Cases

15

Short Case 3

Patient Name: Resident of:

Age:

Gender: Occupation:

Chief Complaints: 1. 2. 3. 4.

Relevant Present and Past History:

Relevant Examination:

Provisional Diagnosis:

Proposed Investigations/Management:

Advice:

Feedback given by Faculty

Feedback received by Learner

16

Competency Based Logbook and Clinical Manual in General Surgery Short Case 4

Patient Name: Resident of:

Age:

Gender: Occupation:

Chief Complaints: 1. 2. 3. 4.

Relevant Present and Past History:

Relevant Examination:

Provisional Diagnosis:

Proposed Investigations/Management:

Advice:

Feedback given by Faculty

Feedback received by Learner

Short Cases

17

Short Case 5

Patient Name: Resident of:

Age:

Gender: Occupation:

Chief Complaints: 1. 2. 3. 4.

Relevant Present and Past History:

Relevant Examination:

Provisional Diagnosis:

Proposed Investigations/Management:

Advice:

Feedback given by Faculty

Feedback received by Learner

18

Competency Based Logbook and Clinical Manual in General Surgery Short Case 6

Patient Name: Resident of:

Age:

Gender: Occupation:

Chief Complaints: 1. 2. 3. 4.

Relevant Present and Past History:

Relevant Examination:

Provisional Diagnosis:

Proposed Investigations/Management:

Advice:

Feedback given by Faculty

Feedback received by Learner

Short Cases

19

Short Case 7

Patient Name: Resident of:

Age:

Gender: Occupation:

Chief Complaints: 1. 2. 3. 4.

Relevant Present and Past History:

Relevant Examination:

Provisional Diagnosis:

Proposed Investigations/Management:

Advice:

Feedback given by Faculty

Feedback received by Learner

20

Competency Based Logbook and Clinical Manual in General Surgery Short Case 8

Patient Name: Resident of:

Age:

Gender: Occupation:

Chief Complaints: 1. 2. 3. 4.

Relevant Present and Past History:

Relevant Examination:

Provisional Diagnosis:

Proposed Investigations/Management:

Advice:

Feedback given by Faculty

Feedback received by Learner

Short Cases

21

Short Case 9

Patient Name: Resident of:

Age:

Gender: Occupation:

Chief Complaints: 1. 2. 3. 4.

Relevant Present and Past History:

Relevant Examination:

Provisional Diagnosis:

Proposed Investigations/Management:

Advice:

Feedback given by Faculty

Feedback received by Learner

22

Competency Based Logbook and Clinical Manual in General Surgery Short Case 10

Patient Name: Resident of:

Age:

Gender: Occupation:

Chief Complaints: 1. 2. 3. 4.

Relevant Present and Past History:

Relevant Examination:

Provisional Diagnosis:

Proposed Investigations/Management:

Advice:

Feedback given by Faculty

Feedback received by Learner

Short Cases

23

Short Case 11

Patient Name: Resident of:

Age:

Gender: Occupation:

Chief Complaints: 1. 2. 3. 4.

Relevant Present and Past History:

Relevant Examination:

Provisional Diagnosis:

Proposed Investigations/Management:

Advice:

Feedback given by Faculty

Feedback received by Learner

24

Competency Based Logbook and Clinical Manual in General Surgery Short Case 12

Patient Name: Resident of:

Age:

Gender: Occupation:

Chief Complaints: 1. 2. 3. 4.

Relevant Present and Past History:

Relevant Examination:

Provisional Diagnosis:

Proposed Investigations/Management:

Advice:

Feedback given by Faculty

Feedback received by Learner

Short Cases

25

Short Case 13

Patient Name: Resident of:

Age:

Gender: Occupation:

Chief Complaints: 1. 2. 3. 4.

Relevant Present and Past History:

Relevant Examination:

Provisional Diagnosis:

Proposed Investigations/Management:

Advice:

Feedback given by Faculty

Feedback received by Learner

26

Competency Based Logbook and Clinical Manual in General Surgery Short Case 14

Patient Name: Resident of:

Age:

Gender: Occupation:

Chief Complaints: 1. 2. 3. 4.

Relevant Present and Past History:

Relevant Examination:

Provisional Diagnosis:

Proposed Investigations/Management:

Advice:

Feedback given by Faculty

Feedback received by Learner

Short Cases

27

Short Case 15

Patient Name: Resident of:

Age:

Gender: Occupation:

Chief Complaints: 1. 2. 3. 4.

Relevant Present and Past History:

Relevant Examination:

Provisional Diagnosis:

Proposed Investigations/Management:

Advice:

Feedback given by Faculty

Feedback received by Learner

28

Competency Based Logbook and Clinical Manual in General Surgery Section 3: Long Cases 1. Clinical Case (Ulcer/Wound)

1. UHID No.: 3. Patient’s Name: 5. Occupation:

2. Ward/Bed No.: 4. Age/Gender: 6. Address: Clinical History

Chief Complaints (with Duration in Chronological Order)

(1) (2) (3) (4)

History of Present Illness:

Past History (relevant to the diagnosis):

Medical History:

Personal History: Habit: Sedentary/Active/Hard Labour Sleep: Diet:

Addiction: Tobacco/Alcohol/other Appetite: Bowel/Bladder Habits:

Family History: Obstetric and Menstrual History (Females): Treatment History: GENERAL PHYSICAL EXAMINATION Appearance (including built, nutrition, hydration, anaemia, icterus, dyspnoea and cyanosis):

Pulse:

BP:

Resp. Rate:

JVP:

Pedal Oedema:

Lymph Nodes:

Temp.:

Long Cases

29

SYSTEMIC EXAMINATION Abdomen: Inspection: Palpation: Percussion: Auscultation: Rectal/Vaginal Examination: Respiratory System: Cardiovascular System: Nervous System: Local Examination (illustrate by diagram wherever possible):

Clinical Impression: DIFFERENTIAL DIAGNOSIS S. No.

Diagnosis

Points in favour

INVESTIGATIONS Blood/Serum CBC: LFT: Blood Sugar: ECG: Radiological X-rays Chest/Abdomen:

RFT/KFT: Urine Examination: Others:

Points against

Competency Based Logbook and Clinical Manual in General Surgery

30

Ultrasound:

CT Scan/MRI:

Any other investigation: Final Diagnosis: Treatment Plan:

OPERATIVE NOTES Date:

Special Preoperative Preparation:

Premedication(s): Anaesthesia Used: Procedure Planned:

Procedure Executed:

Indication: Operative Steps: Position of the Patient: Incision and Exposure: Findings: Steps:

Postoperative Advice: PROGRESS REPORT Date

Progress Notes

Long Cases

31

CASE SUMMARY (Write the brief summary about the diagnosis, management and outcome of the case at the time of discharge or when you leave the case.)

Signature (Consultant-in-Charge) ASSESSMENT Evaluator Name:

Diagnosis of the Patient: Does not Meet Expectation 1 2 3

Meets Expectation 4

5

6

Exceeds Expectation 7 8 9

History taking: Clinical examination: Investigations: Treatment plan: Counselling/Communication: Professionalism: Evaluator grading (out of 10)

Feedback given by Evaluator

Feedback received by Learner

(signature)

(signature)

32

Competency Based Logbook and Clinical Manual in General Surgery 2. Clinical Case (Ulcer/Wound)

1. UHID No: 3. Patient’s Name: 5. Occupation:

2. Ward/Bed No.: 4. Age/Gender: 6. Address: Clinical History

Chief Complaints (with Duration in Chronological Order)

(1) (2) (3) (4)

History of Present Illness:

Past History (relevant to the diagnosis):

Medical History:

Personal History: Habit: Sedentary/Active/Hard Labour Sleep: Diet:

Addiction: Tobacco/Alcohol/other Appetite: Bowel/Bladder Habits:

Family History: Obstetric and Menstrual History (Females): Treatment History: GENERAL PHYSICAL EXAMINATION Appearance (including built, nutrition, hydration, anaemia, icterus, dyspnoea and cyanosis):

Pulse:

BP:

Resp. Rate:

JVP:

Pedal Oedema:

Lymph Nodes:

Temp.:

Long Cases

33

SYSTEMIC EXAMINATION Abdomen: Inspection: Palpation: Percussion: Auscultation: Rectal/Vaginal Examination: Respiratory System: Cardiovascular System: Nervous System: Local Examination (illustrate by diagram wherever possible):

Clinical Impression: DIFFERENTIAL DIAGNOSIS S. No.

Diagnosis

Points in favour

INVESTIGATIONS Blood/Serum CBC: LFT: Blood Sugar: ECG: Radiological X-rays Chest/Abdomen:

RFT/KFT: Urine Examination: Others:

Points against

Competency Based Logbook and Clinical Manual in General Surgery

34

Ultrasound:

CT Scan/MRI:

Any other investigation: Final Diagnosis: Treatment Plan:

OPERATIVE NOTES Date:

Special Preoperative Preparation:

Premedication(s): Anaesthesia Used: Procedure Planned:

Procedure Executed:

Indication: Operative Steps: Position of the Patient: Incision and Exposure: Findings: Steps:

Postoperative Advice: PROGRESS REPORT Date

Progress Notes

Long Cases

35

CASE SUMMARY (Write the brief summary about the diagnosis, management and outcome of the case at the time of discharge or when you leave the case.)

Signature (Consultant-in-Charge) ASSESSMENT Evaluator Name:

Diagnosis of the Patient: Does not Meet Expectation 1 2 3

Meets Expectation 4

5

6

Exceeds Expectation 7 8 9

History taking: Clinical examination: Investigations: Treatment plan: Counselling/Communication: Professionalism: Evaluator grading (out of 10)

Feedback given by Evaluator

Feedback received by Learner

(signature)

(signature)

36

Competency Based Logbook and Clinical Manual in General Surgery 3. Clinical Case (Swelling/Lump)

1. UHID No.: 3. Patient’s Name: 5. Occupation:

2. Ward/Bed No.: 4. Age/Gender: 6. Address: Clinical History

Chief Complaints (with Duration in Chronological Order)

(1) (2) (3) (4)

History of Present Illness:

Past History (relevant to the diagnosis):

Medical History:

Personal History: Habit: Sedentary/Active/Hard Labour Sleep: Diet:

Addiction: Tobacco/Alcohol/other Appetite: Bowel/Bladder Habits:

Family History: Obstetric and Menstrual History (Females): Treatment History: GENERAL PHYSICAL EXAMINATION Appearance (including built, nutrition, hydration, anaemia, icterus, dyspnoea and cyanosis):

Pulse:

BP:

Resp. Rate:

JVP:

Pedal Oedema:

Lymph Nodes:

Temp.:

Long Cases

37

SYSTEMIC EXAMINATION Abdomen: Inspection: Palpation: Percussion: Auscultation: Rectal/Vaginal Examination: Respiratory System: Cardiovascular System: Nervous System: Local Examination (illustrate by diagram wherever possible):

Clinical Impression: DIFFERENTIAL DIAGNOSIS S. No.

Diagnosis

Points in favour

INVESTIGATIONS Blood/Serum CBC: LFT: Blood Sugar: ECG: Radiological X-rays Chest/Abdomen:

RFT/KFT: Urine Examination: Others:

Points against

Competency Based Logbook and Clinical Manual in General Surgery

38

Ultrasound:

CT Scan/MRI:

Any other investigation: Final Diagnosis: Treatment Plan:

OPERATIVE NOTES Date:

Special Preoperative Preparation:

Premedication(s): Anaesthesia Used: Procedure Planned:

Procedure Executed:

Indication: Operative Steps: Position of the Patient: Incision and Exposure: Findings: Steps:

Postoperative Advice: PROGRESS REPORT Date

Progress Notes

Long Cases

39

CASE SUMMARY (Write the brief summary about the diagnosis, management and outcome of the case at the time of discharge or when you leave the case.)

Signature (Consultant-in-Charge) ASSESSMENT Evaluator Name:

Diagnosis of the Patient: Does not Meet Expectation 1 2 3

Meets Expectation 4

5

6

Exceeds Expectation 7 8 9

History taking: Clinical examination: Investigations: Treatment plan: Counselling/Communication: Professionalism: Evaluator grading (out of 10)

Feedback given by Evaluator

Feedback received by Learner

(signature)

(signature)

40

Competency Based Logbook and Clinical Manual in General Surgery 4. Clinical Case (Swelling/Lump)

1. UHID No.: 3. Patient’s Name: 5. Occupation:

2. Ward/Bed No.: 4. Age/Gender: 6. Address: Clinical History

Chief Complaints (with Duration in Chronological Order)

(1) (2) (3) (4)

History of Present Illness:

Past History (relevant to the diagnosis):

Medical History:

Personal History: Habit: Sedentary/Active/Hard Labour Sleep: Diet:

Addiction: Tobacco/Alcohol/other Appetite: Bowel/Bladder Habits:

Family History: Obstetric and Menstrual History (Females): Treatment History: GENERAL PHYSICAL EXAMINATION Appearance (including built, nutrition, hydration, anaemia, icterus, dyspnoea and cyanosis):

Pulse:

BP:

Resp. Rate:

JVP:

Pedal Oedema:

Lymph Nodes:

Temp.:

Long Cases

41

SYSTEMIC EXAMINATION Abdomen: Inspection: Palpation: Percussion: Auscultation: Rectal/Vaginal Examination: Respiratory System: Cardiovascular System: Nervous System: Local Examination (illustrate by diagram wherever possible):

Clinical Impression: DIFFERENTIAL DIAGNOSIS S. No.

Diagnosis

Points in favour

INVESTIGATIONS Blood/Serum CBC: LFT: Blood Sugar: ECG: Radiological X-rays Chest/Abdomen:

RFT/KFT: Urine Examination: Others:

Points against

Competency Based Logbook and Clinical Manual in General Surgery

42

Ultrasound:

CT Scan/MRI:

Any other investigation: Final Diagnosis: Treatment Plan:

OPERATIVE NOTES Date:

Special Preoperative Preparation:

Premedication(s): Anaesthesia Used: Procedure Planned:

Procedure Executed:

Indication: Operative Steps: Position of the Patient: Incision and Exposure: Findings: Steps:

Postoperative Advice: PROGRESS REPORT Date

Progress Notes

Long Cases

43

CASE SUMMARY (Write the brief summary about the diagnosis, management and outcome of the case at the time of discharge or when you leave the case.)

Signature (Consultant-in-Charge) ASSESSMENT Evaluator Name:

Diagnosis of the Patient: Does not Meet Expectation 1 2 3

Meets Expectation 4

5

6

Exceeds Expectation 7 8 9

History taking: Clinical examination: Investigations: Treatment plan: Counselling/Communication: Professionalism: Evaluator grading (out of 10)

Feedback given by Evaluator

Feedback received by Learner

(signature)

(signature)

44

Competency Based Logbook and Clinical Manual in General Surgery 5. Clinical Case (Vascular Disease)

1. UHID No.: 3. Patient’s Name: 5. Occupation:

2. Ward/Bed No.: 4. Age/Gender: 6. Address: Clinical History

Chief Complaints (with Duration in Chronological Order)

(1) (2) (3) (4)

History of Present Illness:

Past History (relevant to the diagnosis):

Medical History:

Personal History: Habit: Sedentary/Active/Hard Labour Sleep: Diet:

Addiction: Tobacco/Alcohol/other Appetite: Bowel/Bladder Habits:

Family History: Obstetric and Menstrual History (Females): Treatment History: GENERAL PHYSICAL EXAMINATION Appearance (including built, nutrition, hydration, anaemia, icterus, dyspnoea and cyanosis):

Pulse:

BP:

Resp. Rate:

JVP:

Pedal Oedema:

Lymph Nodes:

Temp.:

Long Cases

45

SYSTEMIC EXAMINATION Abdomen: Inspection: Palpation: Percussion: Auscultation: Rectal/Vaginal Examination: Respiratory System: Cardiovascular System: Nervous System: Local Examination (illustrate by diagram wherever possible):

Clinical Impression: DIFFERENTIAL DIAGNOSIS S. No.

Diagnosis

Points in favour

INVESTIGATIONS Blood/Serum CBC: LFT: Blood Sugar: ECG: Radiological X-rays Chest/Abdomen:

RFT/KFT: Urine Examination: Others:

Points against

Competency Based Logbook and Clinical Manual in General Surgery

46

Ultrasound:

CT Scan/MRI:

Any other investigation: Final Diagnosis: Treatment Plan:

OPERATIVE NOTES Date:

Special Preoperative Preparation:

Premedication(s): Anaesthesia Used: Procedure Planned:

Procedure Executed:

Indication: Operative Steps: Position of the Patient: Incision and Exposure: Findings: Steps:

Postoperative Advice: PROGRESS REPORT Date

Progress Notes

Long Cases

47

CASE SUMMARY (Write the brief summary about the diagnosis, management and outcome of the case at the time of discharge or when you leave the case.)

Signature (Consultant-in-Charge) ASSESSMENT Evaluator Name:

Diagnosis of the Patient: Does not Meet Expectation 1 2 3

Meets Expectation 4

5

6

Exceeds Expectation 7 8 9

History taking: Clinical examination: Investigations: Treatment plan: Counselling/Communication: Professionalism: Evaluator grading (out of 10)

Feedback given by Evaluator

Feedback received by Learner

(signature)

(signature)

48

Competency Based Logbook and Clinical Manual in General Surgery 6. Clinical Case (Vascular Disease)

1. UHID No.: 3. Patient’s Name: 5. Occupation:

2. Ward/Bed No.: 4. Age/Gender: 6. Address: Clinical History

Chief Complaints (with Duration in Chronological Order)

(1) (2) (3) (4)

History of Present Illness:

Past History (relevant to the diagnosis):

Medical History:

Personal History: Habit: Sedentary/Active/Hard Labour Sleep: Diet:

Addiction: Tobacco/Alcohol/other Appetite: Bowel/Bladder Habits:

Family History: Obstetric and Menstrual History (Females): Treatment History: GENERAL PHYSICAL EXAMINATION Appearance (including built, nutrition, hydration, anaemia, icterus, dyspnoea and cyanosis):

Pulse:

BP:

Resp. Rate:

JVP:

Pedal Oedema:

Lymph Nodes:

Temp.:

Long Cases

49

SYSTEMIC EXAMINATION Abdomen: Inspection: Palpation: Percussion: Auscultation: Rectal/Vaginal Examination: Respiratory System: Cardiovascular System: Nervous System: Local Examination (illustrate by diagram wherever possible):

Clinical Impression: DIFFERENTIAL DIAGNOSIS S. No.

Diagnosis

Points in favour

INVESTIGATIONS Blood/Serum CBC: LFT: Blood Sugar: ECG: Radiological X-rays Chest/Abdomen:

RFT/KFT: Urine Examination: Others:

Points against

Competency Based Logbook and Clinical Manual in General Surgery

50

Ultrasound:

CT Scan/MRI:

Any other investigation: Final Diagnosis: Treatment Plan:

OPERATIVE NOTES Date:

Special Preoperative Preparation:

Premedication(s): Anaesthesia Used: Procedure Planned:

Procedure Executed:

Indication: Operative Steps: Position of the Patient: Incision and Exposure: Findings: Steps:

Postoperative Advice: PROGRESS REPORT Date

Progress Notes

Long Cases

51

CASE SUMMARY (Write the brief summary about the diagnosis, management and outcome of the case at the time of discharge or when you leave the case.)

Signature (Consultant-in-Charge) ASSESSMENT Evaluator Name:

Diagnosis of the Patient: Does not Meet Expectation 1 2 3

Meets Expectation 4

5

6

Exceeds Expectation 7 8 9

History taking: Clinical examination: Investigations: Treatment plan: Counselling/Communication: Professionalism: Evaluator grading (out of 10)

Feedback given by Evaluator

Feedback received by Learner

(signature)

(signature)

52

Competency Based Logbook and Clinical Manual in General Surgery 7. Clinical Case (Hernia)

1. UHID No.: 3. Patient’s Name: 5. Occupation:

2. Ward/Bed No.: 4. Age/Gender: 6. Address: Clinical History

Chief Complaints (with Duration in Chronological Order)

(1) (2) (3) (4)

History of Present Illness:

Past History (relevant to the diagnosis):

Medical History:

Personal History: Habit: Sedentary/Active/Hard Labour Sleep: Diet:

Addiction: Tobacco/Alcohol/other Appetite: Bowel/Bladder Habits:

Family History: Obstetric and Menstrual History (Females): Treatment History: GENERAL PHYSICAL EXAMINATION Appearance (including built, nutrition, hydration, anaemia, icterus, dyspnoea and cyanosis):

Pulse:

BP:

Resp. Rate:

JVP:

Pedal Oedema:

Lymph Nodes:

Temp.:

Long Cases

53

SYSTEMIC EXAMINATION Abdomen: Inspection: Palpation: Percussion: Auscultation: Rectal/Vaginal Examination: Respiratory System: Cardiovascular System: Nervous System: Local Examination (illustrate by diagram wherever possible):

Clinical Impression: DIFFERENTIAL DIAGNOSIS S. No.

Diagnosis

Points in favour

INVESTIGATIONS Blood/Serum CBC: LFT: Blood Sugar: ECG: Radiological X-rays Chest/Abdomen:

RFT/KFT: Urine Examination: Others:

Points against

Competency Based Logbook and Clinical Manual in General Surgery

54

Ultrasound:

CT Scan/MRI:

Any other investigation: Final Diagnosis: Treatment Plan:

OPERATIVE NOTES Date:

Special Preoperative Preparation:

Premedication(s): Anaesthesia Used: Procedure Planned:

Procedure Executed:

Indication: Operative Steps: Position of the Patient: Incision and Exposure: Findings: Steps:

Postoperative Advice: PROGRESS REPORT Date

Progress Notes

Long Cases

55

CASE SUMMARY (Write the brief summary about the diagnosis, management and outcome of the case at the time of discharge or when you leave the case.)

Signature (Consultant-in-Charge) ASSESSMENT Evaluator Name:

Diagnosis of the Patient: Does not Meet Expectation 1 2 3

Meets Expectation 4

5

6

Exceeds Expectation 7 8 9

History taking: Clinical examination: Investigations: Treatment plan: Counselling/Communication: Professionalism: Evaluator grading (out of 10)

Feedback given by Evaluator

Feedback received by Learner

(signature)

(signature)

56

Competency Based Logbook and Clinical Manual in General Surgery 8. Clinical Case (Hernia)

1. UHID No.: 3. Patient’s Name: 5. Occupation:

2. Ward/Bed No.: 4. Age/Gender: 6. Address: Clinical History

Chief Complaints (with Duration in Chronological Order)

(1) (2) (3) (4)

History of Present Illness:

Past History (relevant to the diagnosis):

Medical History:

Personal History: Habit: Sedentary/Active/Hard Labour Sleep: Diet:

Addiction: Tobacco/Alcohol/other Appetite: Bowel/Bladder Habits:

Family History: Obstetric and Menstrual History (Females): Treatment History: GENERAL PHYSICAL EXAMINATION Appearance (including built, nutrition, hydration, anaemia, icterus, dyspnoea and cyanosis):

Pulse:

BP:

Resp. Rate:

JVP:

Pedal Oedema:

Lymph Nodes:

Temp.:

Long Cases

57

SYSTEMIC EXAMINATION Abdomen: Inspection: Palpation: Percussion: Auscultation: Rectal/Vaginal Examination: Respiratory System: Cardiovascular System: Nervous System: Local Examination (illustrate by diagram wherever possible):

Clinical Impression: DIFFERENTIAL DIAGNOSIS S. No.

Diagnosis

Points in favour

INVESTIGATIONS Blood/Serum CBC: LFT: Blood Sugar: ECG: Radiological X-rays Chest/Abdomen:

RFT/KFT: Urine Examination: Others:

Points against

Competency Based Logbook and Clinical Manual in General Surgery

58

Ultrasound:

CT Scan/MRI:

Any other investigation: Final Diagnosis: Treatment Plan:

OPERATIVE NOTES Date:

Special Preoperative Preparation:

Premedication(s): Anaesthesia Used: Procedure Planned:

Procedure Executed:

Indication: Operative Steps: Position of the Patient: Incision and Exposure: Findings: Steps:

Postoperative Advice: PROGRESS REPORT Date

Progress Notes

Long Cases

59

CASE SUMMARY (Write the brief summary about the diagnosis, management and outcome of the case at the time of discharge or when you leave the case.)

Signature (Consultant-in-Charge) ASSESSMENT Evaluator Name:

Diagnosis of the Patient: Does not Meet Expectation 1 2 3

Meets Expectation 4

5

6

Exceeds Expectation 7 8 9

History taking: Clinical examination: Investigations: Treatment plan: Counselling/Communication: Professionalism: Evaluator grading (out of 10)

Feedback given by Evaluator

Feedback received by Learner

(signature)

(signature)

60

Competency Based Logbook and Clinical Manual in General Surgery 9. Clinical Case (Abdominal: Hepatobiliary)

1. UHID No.: 3. Patient’s Name: 5. Occupation:

2. Ward/Bed No.: 4. Age/Gender: 6. Address: Clinical History

Chief Complaints (with Duration in Chronological Order)

(1) (2) (3) (4)

History of Present Illness:

Past History (relevant to the diagnosis):

Medical History:

Personal History: Habit: Sedentary/Active/Hard Labour Sleep: Diet:

Addiction: Tobacco/Alcohol/other Appetite: Bowel/Bladder Habits:

Family History: Obstetric and Menstrual History (Females): Treatment History: GENERAL PHYSICAL EXAMINATION Appearance (including built, nutrition, hydration, anaemia, icterus, dyspnoea and cyanosis):

Pulse:

BP:

Resp. Rate:

JVP:

Pedal Oedema:

Lymph Nodes:

Temp.:

Long Cases

61

SYSTEMIC EXAMINATION Abdomen: Inspection: Palpation: Percussion: Auscultation: Rectal/Vaginal Examination: Respiratory System: Cardiovascular System: Nervous System: Local Examination (illustrate by diagram wherever possible):

Clinical Impression: DIFFERENTIAL DIAGNOSIS S. No.

Diagnosis

Points in favour

INVESTIGATIONS Blood/Serum CBC: LFT: Blood Sugar: ECG: Radiological X-rays Chest/Abdomen:

RFT/KFT: Urine Examination: Others:

Points against

Competency Based Logbook and Clinical Manual in General Surgery

62

Ultrasound:

CT Scan/MRI:

Any other investigation: Final Diagnosis: Treatment Plan:

OPERATIVE NOTES Date:

Special Preoperative Preparation:

Premedication(s): Anaesthesia Used: Procedure Planned:

Procedure Executed:

Indication: Operative Steps: Position of the Patient: Incision and Exposure: Findings: Steps:

Postoperative Advice: PROGRESS REPORT Date

Progress Notes

Long Cases

63

CASE SUMMARY (Write the brief summary about the diagnosis, management and outcome of the case at the time of discharge or when you leave the case.)

Signature (Consultant-in-Charge) ASSESSMENT Evaluator Name:

Diagnosis of the Patient: Does not Meet Expectation 1 2 3

Meets Expectation 4

5

6

Exceeds Expectation 7 8 9

History taking: Clinical examination: Investigations: Treatment plan: Counselling/Communication: Professionalism: Evaluator grading (out of 10)

Feedback given by Evaluator

Feedback received by Learner

(signature)

(signature)

64

Competency Based Logbook and Clinical Manual in General Surgery 10. Clinical Case (Abdominal: Hepatobiliary)

1. UHID No.: 3. Patient’s Name: 5. Occupation:

2. Ward/Bed No.: 4. Age/Gender: 6. Address: Clinical History

Chief Complaints (with Duration in Chronological Order)

(1) (2) (3) (4)

History of Present Illness:

Past History (relevant to the diagnosis):

Medical History:

Personal History: Habit: Sedentary/Active/Hard Labour Sleep: Diet:

Addiction: Tobacco/Alcohol/other Appetite: Bowel/Bladder Habits:

Family History: Obstetric and Menstrual History (Females): Treatment History: GENERAL PHYSICAL EXAMINATION Appearance (including built, nutrition, hydration, anaemia, icterus, dyspnoea and cyanosis):

Pulse:

BP:

Resp. Rate:

JVP:

Pedal Oedema:

Lymph Nodes:

Temp.:

Long Cases

65

SYSTEMIC EXAMINATION Abdomen: Inspection: Palpation: Percussion: Auscultation: Rectal/Vaginal Examination: Respiratory System: Cardiovascular System: Nervous System: Local Examination (illustrate by diagram wherever possible):

Clinical Impression: DIFFERENTIAL DIAGNOSIS S. No.

Diagnosis

Points in favour

INVESTIGATIONS Blood/Serum CBC: LFT: Blood Sugar: ECG: Radiological X-rays Chest/Abdomen:

RFT/KFT: Urine Examination: Others:

Points against

Competency Based Logbook and Clinical Manual in General Surgery

66

Ultrasound:

CT Scan/MRI:

Any other investigation: Final Diagnosis: Treatment Plan:

OPERATIVE NOTES Date:

Special Preoperative Preparation:

Premedication(s): Anaesthesia Used: Procedure Planned:

Procedure Executed:

Indication: Operative Steps: Position of the Patient: Incision and Exposure: Findings: Steps:

Postoperative Advice: PROGRESS REPORT Date

Progress Notes

Long Cases

67

CASE SUMMARY (Write the brief summary about the diagnosis, management and outcome of the case at the time of discharge or when you leave the case.)

Signature (Consultant-in-Charge) ASSESSMENT Evaluator Name:

Diagnosis of the Patient: Does not Meet Expectation 1 2 3

Meets Expectation 4

5

6

Exceeds Expectation 7 8 9

History taking: Clinical examination: Investigations: Treatment plan: Counselling/Communication: Professionalism: Evaluator grading (out of 10)

Feedback given by Evaluator

Feedback received by Learner

(signature)

(signature)

68

Competency Based Logbook and Clinical Manual in General Surgery 11. Clinical Case (Abdominal: Gastrointestinal)

1. UHID No.: 3. Patient’s Name: 5. Occupation:

2. Ward/Bed No.: 4. Age/Gender: 6. Address: Clinical History

Chief Complaints (with Duration in Chronological Order)

(1) (2) (3) (4)

History of Present Illness:

Past History (relevant to the diagnosis):

Medical History:

Personal History: Habit: Sedentary/Active/Hard Labour Sleep: Diet:

Addiction: Tobacco/Alcohol/other Appetite: Bowel/Bladder Habits:

Family History: Obstetric and Menstrual History (Females): Treatment History: GENERAL PHYSICAL EXAMINATION Appearance (including built, nutrition, hydration, anaemia, icterus, dyspnoea and cyanosis):

Pulse:

BP:

Resp. Rate:

JVP:

Pedal Oedema:

Lymph Nodes:

Temp.:

Long Cases

69

SYSTEMIC EXAMINATION Abdomen: Inspection: Palpation: Percussion: Auscultation: Rectal/Vaginal Examination: Respiratory System: Cardiovascular System: Nervous System: Local Examination (illustrate by diagram wherever possible):

Clinical Impression: DIFFERENTIAL DIAGNOSIS S. No.

Diagnosis

Points in favour

INVESTIGATIONS Blood/Serum CBC: LFT: Blood Sugar: ECG: Radiological X-rays Chest/Abdomen:

RFT/KFT: Urine Examination: Others:

Points against

Competency Based Logbook and Clinical Manual in General Surgery

70

Ultrasound:

CT Scan/MRI:

Any other investigation: Final Diagnosis: Treatment Plan:

OPERATIVE NOTES Date:

Special Preoperative Preparation:

Premedication(s): Anaesthesia Used: Procedure Planned:

Procedure Executed:

Indication: Operative Steps: Position of the Patient: Incision and Exposure: Findings: Steps:

Postoperative Advice: PROGRESS REPORT Date

Progress Notes

Long Cases

71

CASE SUMMARY (Write the brief summary about the diagnosis, management and outcome of the case at the time of discharge or when you leave the case.)

Signature (Consultant-in-Charge) ASSESSMENT Evaluator Name:

Diagnosis of the Patient: Does not Meet Expectation 1 2 3

Meets Expectation 4

5

6

Exceeds Expectation 7 8 9

History taking: Clinical examination: Investigations: Treatment plan: Counselling/Communication: Professionalism: Evaluator grading (out of 10)

Feedback given by Evaluator

Feedback received by Learner

(signature)

(signature)

72

Competency Based Logbook and Clinical Manual in General Surgery 12. Clinical Case (Abdominal: Gastrointestinal)

1. UHID No.: 3. Patient’s Name: 5. Occupation:

2. Ward/Bed No.: 4. Age/Gender: 6. Address: Clinical History

Chief Complaints (with Duration in Chronological Order)

(1) (2) (3) (4)

History of Present Illness:

Past History (relevant to the diagnosis):

Medical History:

Personal History: Habit: Sedentary/Active/Hard Labour Sleep: Diet:

Addiction: Tobacco/Alcohol/other Appetite: Bowel/Bladder Habits:

Family History: Obstetric and Menstrual History (Females): Treatment History: GENERAL PHYSICAL EXAMINATION Appearance (including built, nutrition, hydration, anaemia, icterus, dyspnoea and cyanosis):

Pulse:

BP:

Resp. Rate:

JVP:

Pedal Oedema:

Lymph Nodes:

Temp.:

Long Cases

73

SYSTEMIC EXAMINATION Abdomen: Inspection: Palpation: Percussion: Auscultation: Rectal/Vaginal Examination: Respiratory System: Cardiovascular System: Nervous System: Local Examination (illustrate by diagram wherever possible):

Clinical Impression: DIFFERENTIAL DIAGNOSIS S. No.

Diagnosis

Points in favour

INVESTIGATIONS Blood/Serum CBC: LFT: Blood Sugar: ECG: Radiological X-rays Chest/Abdomen:

RFT/KFT: Urine Examination: Others:

Points against

Competency Based Logbook and Clinical Manual in General Surgery

74

Ultrasound:

CT Scan/MRI:

Any other investigation: Final Diagnosis: Treatment Plan:

OPERATIVE NOTES Date:

Special Preoperative Preparation:

Premedication(s): Anaesthesia Used: Procedure Planned:

Procedure Executed:

Indication: Operative Steps: Position of the Patient: Incision and Exposure: Findings: Steps:

Postoperative Advice: PROGRESS REPORT Date

Progress Notes

Long Cases

75

CASE SUMMARY (Write the brief summary about the diagnosis, management and outcome of the case at the time of discharge or when you leave the case.)

Signature (Consultant-in-Charge) ASSESSMENT Evaluator Name:

Diagnosis of the Patient: Does not Meet Expectation 1 2 3

Meets Expectation 4

5

6

Exceeds Expectation 7 8 9

History taking: Clinical examination: Investigations: Treatment plan: Counselling/Communication: Professionalism: Evaluator grading (out of 10)

Feedback given by Evaluator

Feedback received by Learner

(signature)

(signature)

76

Competency Based Logbook and Clinical Manual in General Surgery 13. Clinical Case (Anorectum)

1. UHID No.: 3. Patient’s Name: 5. Occupation:

2. Ward/Bed No.: 4. Age/Gender: 6. Address: Clinical History

Chief Complaints (with Duration in Chronological Order)

(1) (2) (3) (4)

History of Present Illness:

Past History (relevant to the diagnosis):

Medical History:

Personal History: Habit: Sedentary/Active/Hard Labour Sleep: Diet:

Addiction: Tobacco/Alcohol/other Appetite: Bowel/Bladder Habits:

Family History: Obstetric and Menstrual History (Females): Treatment History: GENERAL PHYSICAL EXAMINATION Appearance (including built, nutrition, hydration, anaemia, icterus, dyspnoea and cyanosis):

Pulse:

BP:

Resp. Rate:

JVP:

Pedal Oedema:

Lymph Nodes:

Temp.:

Long Cases

77

SYSTEMIC EXAMINATION Abdomen: Inspection: Palpation: Percussion: Auscultation: Rectal/Vaginal Examination: Respiratory System: Cardiovascular System: Nervous System: Local Examination (Illustrate by diagram wherever possible):

Clinical Impression: DIFFERENTIAL DIAGNOSIS S. No.

Diagnosis

Points in favour

INVESTIGATIONS Blood/Serum CBC: LFT: Blood Sugar: ECG: Radiological X-rays Chest/Abdomen:

RFT/KFT: Urine Examination: Others:

Points against

Competency Based Logbook and Clinical Manual in General Surgery

78

Ultrasound:

CT Scan/MRI:

Any other investigation: Final Diagnosis: Treatment Plan:

OPERATIVE NOTES Date:

Special Preoperative Preparation:

Premedication(s): Anaesthesia Used: Procedure Planned:

Procedure Executed:

Indication: Operative Steps: Position of the Patient: Incision and Exposure: Findings: Steps:

Postoperative Advice: PROGRESS REPORT Date

Progress Notes

Long Cases

79

CASE SUMMARY (Write the brief summary about the diagnosis, management and outcome of the case at the time of discharge or when you leave the case.)

Signature (Consultant-in-Charge) ASSESSMENT Evaluator Name:

Diagnosis of the Patient: Does not Meet Expectation 1 2 3

Meets Expectation 4

5

6

Exceeds Expectation 7 8 9

History taking: Clinical examination: Investigations: Treatment plan: Counselling/Communication: Professionalism: Evaluator grading (out of 10)

Feedback given by Evaluator

Feedback received by Learner

(signature)

(signature)

80

Competency Based Logbook and Clinical Manual in General Surgery 14. Clinical Case (Anorectum)

1. UHID No.: 3. Patient’s Name: 5. Occupation:

2. Ward/Bed No.: 4. Age/Gender: 6. Address: Clinical History

Chief Complaints (with Duration in Chronological Order)

(1) (2) (3) (4)

History of Present Illness:

Past History (relevant to the diagnosis):

Medical History:

Personal History: Habit: Sedentary/Active/Hard Labour Sleep: Diet:

Addiction: Tobacco/Alcohol/other Appetite: Bowel/Bladder Habits:

Family History: Obstetric and Menstrual History (Females): Treatment History: GENERAL PHYSICAL EXAMINATION Appearance (including built, nutrition, hydration, anaemia, icterus, dyspnoea and cyanosis):

Pulse:

BP:

Resp. Rate:

JVP:

Pedal Oedema:

Lymph Nodes:

Temp.:

Long Cases

81

SYSTEMIC EXAMINATION Abdomen: Inspection: Palpation: Percussion: Auscultation: Rectal/Vaginal Examination: Respiratory System: Cardiovascular System: Nervous System: Local Examination (illustrate by diagram wherever possible):

Clinical Impression: DIFFERENTIAL DIAGNOSIS S. No.

Diagnosis

Points in favour

INVESTIGATIONS Blood/Serum CBC: LFT: Blood Sugar: ECG: Radiological X-rays Chest/Abdomen:

RFT/KFT: Urine Examination: Others:

Points against

Competency Based Logbook and Clinical Manual in General Surgery

82

Ultrasound:

CT Scan/MRI:

Any other investigation: Final Diagnosis: Treatment Plan:

OPERATIVE NOTES Date:

Special Preoperative Preparation:

Premedication(s): Anaesthesia Used: Procedure Planned:

Procedure Executed:

Indication: Operative Steps: Position of the Patient: Incision and Exposure: Findings: Steps:

Postoperative Advice: PROGRESS REPORT Date

Progress Notes

Long Cases

83

CASE SUMMARY (Write the brief summary about the diagnosis, management and outcome of the case at the time of discharge or when you leave the case.)

Signature (Consultant-in-Charge) ASSESSMENT Evaluator Name:

Diagnosis of the Patient: Does not Meet Expectation 1 2 3

Meets Expectation 4

5

6

Exceeds Expectation 7 8 9

History taking: Clinical examination: Investigations: Treatment plan: Counselling/Communication: Professionalism: Evaluator grading (out of 10)

Feedback given by Evaluator

Feedback received by Learner

(signature)

(signature)

84

Competency Based Logbook and Clinical Manual in General Surgery 15. Clinical Case (Urology)

1. UHID No.: 3. Patient’s Name: 5. Occupation:

2. Ward/Bed No.: 4. Age/Gender: 6. Address: Clinical History

Chief Complaints (with Duration in Chronological Order)

(1) (2) (3) (4)

History of Present Illness:

Past History (relevant to the diagnosis):

Medical History:

Personal History: Habit: Sedentary/Active/Hard Labour Sleep: Diet:

Addiction: Tobacco/Alcohol/other Appetite: Bowel/Bladder Habits:

Family History: Obstetric and Menstrual History (Females): Treatment History: GENERAL PHYSICAL EXAMINATION Appearance (including built, nutrition, hydration, anaemia, icterus, dyspnoea and cyanosis):

Pulse:

BP:

Resp. Rate:

JVP:

Pedal Oedema:

Lymph Nodes:

Temp.:

Long Cases

85

SYSTEMIC EXAMINATION Abdomen: Inspection: Palpation: Percussion: Auscultation: Rectal/Vaginal Examination: Respiratory System: Cardiovascular System: Nervous System: Local Examination (illustrate by diagram wherever possible):

Clinical Impression: DIFFERENTIAL DIAGNOSIS S. No.

Diagnosis

Points in favour

INVESTIGATIONS Blood/Serum CBC: LFT: Blood Sugar: ECG: Radiological X-rays Chest/Abdomen:

RFT/KFT: Urine Examination: Others:

Points against

Competency Based Logbook and Clinical Manual in General Surgery

86

Ultrasound:

CT Scan/MRI:

Any other investigation: Final Diagnosis: Treatment Plan:

OPERATIVE NOTES Date:

Special Preoperative Preparation:

Premedication(s): Anaesthesia Used: Procedure Planned:

Procedure Executed:

Indication: Operative Steps: Position of the Patient: Incision and Exposure: Findings: Steps:

Postoperative Advice: PROGRESS REPORT Date

Progress Notes

Long Cases

87

CASE SUMMARY (Write the brief summary about the diagnosis, management and outcome of the case at the time of discharge or when you leave the case.)

Signature (Consultant-in-Charge) ASSESSMENT Evaluator Name:

Diagnosis of the Patient: Does not Meet Expectation 1 2 3

Meets Expectation 4

5

6

Exceeds Expectation 7 8 9

History taking: Clinical examination: Investigations: Treatment plan: Counselling/Communication: Professionalism: Evaluator grading (out of 10)

Feedback given by Evaluator

Feedback received by Learner

(signature)

(signature)

88

Competency Based Logbook and Clinical Manual in General Surgery 16. Clinical Case (Urology)

1. UHID No.: 3. Patient’s Name: 5. Occupation:

2. Ward/Bed No.: 4. Age/Gender: 6. Address: Clinical History

Chief Complaints (with Duration in Chronological Order)

(1) (2) (3) (4)

History of Present Illness:

Past History (relevant to the diagnosis):

Medical History:

Personal History: Habit: Sedentary/Active/Hard Labour Sleep: Diet:

Addiction: Tobacco/Alcohol/other Appetite: Bowel/Bladder Habits:

Family History: Obstetric and Menstrual History (Females): Treatment History: GENERAL PHYSICAL EXAMINATION Appearance (including built, nutrition, hydration, anaemia, icterus, dyspnoea and cyanosis):

Pulse:

BP:

Resp. Rate:

JVP:

Pedal Oedema:

Lymph Nodes:

Temp.:

Long Cases

89

SYSTEMIC EXAMINATION Abdomen: Inspection: Palpation: Percussion: Auscultation: Rectal/Vaginal Examination: Respiratory System: Cardiovascular System: Nervous System: Local Examination (illustrate by diagram wherever possible):

Clinical Impression: DIFFERENTIAL DIAGNOSIS S. No.

Diagnosis

Points in favour

INVESTIGATIONS Blood/Serum CBC: LFT: Blood Sugar: ECG: Radiological X-rays Chest/Abdomen:

RFT/KFT: Urine Examination: Others:

Points against

Competency Based Logbook and Clinical Manual in General Surgery

90

Ultrasound:

CT Scan/MRI:

Any other investigation: Final Diagnosis: Treatment Plan:

OPERATIVE NOTES Date:

Special Preoperative Preparation:

Premedication(s): Anaesthesia Used: Procedure Planned:

Procedure Executed:

Indication: Operative Steps: Position of the Patient: Incision and Exposure: Findings: Steps:

Postoperative Advice: PROGRESS REPORT Date

Progress Notes

Long Cases

91

CASE SUMMARY (Write the brief summary about the diagnosis, management and outcome of the case at the time of discharge or when you leave the case.)

Signature (Consultant-in-Charge) ASSESSMENT Evaluator Name:

Diagnosis of the Patient: Does not Meet Expectation 1 2 3

Meets Expectation 4

5

6

Exceeds Expectation 7 8 9

History taking: Clinical examination: Investigations: Treatment plan: Counselling/Communication: Professionalism: Evaluator grading (out of 10)

Feedback given by Evaluator

Feedback received by Learner

(signature)

(signature)

92

Competency Based Logbook and Clinical Manual in General Surgery 17. Clinical Case (Genitourinary: Testes and Scrotum)

1. UHID No.: 3. Patient’s Name: 5. Occupation:

2. Ward/Bed No.: 4. Age/Gender: 6. Address: Clinical History

Chief Complaints (with Duration in Chronological Order)

(1) (2) (3) (4)

History of Present Illness:

Past History (relevant to the diagnosis):

Medical History:

Personal History: Habit: Sedentary/Active/Hard Labour Sleep: Diet:

Addiction: Tobacco/Alcohol/other Appetite: Bowel/Bladder Habits:

Family History: Obstetric and Menstrual History (Females): Treatment History: GENERAL PHYSICAL EXAMINATION Appearance (including built, nutrition, hydration, anaemia, icterus, dyspnoea and cyanosis):

Pulse:

BP:

Resp. Rate:

JVP:

Pedal Oedema:

Lymph Nodes:

Temp.:

Long Cases

93

SYSTEMIC EXAMINATION Abdomen: Inspection: Palpation: Percussion: Auscultation: Rectal/Vaginal Examination: Respiratory System: Cardiovascular System: Nervous System: Local Examination (illustrate by diagram wherever possible):

Clinical Impression: DIFFERENTIAL DIAGNOSIS S. No.

Diagnosis

Points in favour

INVESTIGATIONS Blood/Serum CBC: LFT: Blood Sugar: ECG: Radiological X-rays Chest/Abdomen:

RFT/KFT: Urine Examination: Others:

Points against

Competency Based Logbook and Clinical Manual in General Surgery

94

Ultrasound:

CT Scan/MRI:

Any other investigation: Final Diagnosis: Treatment Plan:

OPERATIVE NOTES Date:

Special Preoperative Preparation:

Premedication(s): Anaesthesia Used: Procedure Planned:

Procedure Executed:

Indication: Operative Steps: Position of the Patient: Incision and Exposure: Findings: Steps:

Postoperative Advice: PROGRESS REPORT Date

Progress Notes

Long Cases

95

CASE SUMMARY (Write the brief summary about the diagnosis, management and outcome of the case at the time of discharge or when you leave the case.)

Signature (Consultant-in-Charge) ASSESSMENT Evaluator Name:

Diagnosis of the Patient: Does not Meet Expectation 1 2 3

Meets Expectation 4

5

6

Exceeds Expectation 7 8 9

History taking: Clinical examination: Investigations: Treatment plan: Counselling/Communication: Professionalism: Evaluator grading (out of 10)

Feedback given by Evaluator

Feedback received by Learner

(signature)

(signature)

96

Competency Based Logbook and Clinical Manual in General Surgery 18. Clinical Case (Genitourinary)

1. UHID No.: 3. Patient’s Name: 5. Occupation:

2. Ward/Bed No.: 4. Age/Gender: 6. Address: Clinical History

Chief Complaints (with Duration in Chronological Order)

(1) (2) (3) (4)

History of Present Illness:

Past History (relevant to the diagnosis):

Medical History:

Personal History: Habit: Sedentary/Active/Hard Labour Sleep: Diet:

Addiction: Tobacco/Alcohol/other Appetite: Bowel/Bladder Habits:

Family History: Obstetric and Menstrual History (Females): Treatment History: GENERAL PHYSICAL EXAMINATION Appearance (including built, nutrition, hydration, anaemia, icterus, dyspnoea and cyanosis):

Pulse:

BP:

Resp. Rate:

JVP:

Pedal Oedema:

Lymph Nodes:

Temp.:

Long Cases

97

SYSTEMIC EXAMINATION Abdomen: Inspection: Palpation: Percussion: Auscultation: Rectal/Vaginal Examination: Respiratory System: Cardiovascular System: Nervous System: Local Examination (illustrate by diagram wherever possible):

Clinical Impression: DIFFERENTIAL DIAGNOSIS S. No.

Diagnosis

Points in favour

INVESTIGATIONS Blood/Serum CBC: LFT: Blood Sugar: ECG: Radiological X-rays Chest/Abdomen:

RFT/KFT: Urine Examination: Others:

Points against

Competency Based Logbook and Clinical Manual in General Surgery

98

Ultrasound:

CT Scan/MRI:

Any other investigation: Final Diagnosis: Treatment Plan:

OPERATIVE NOTES Date:

Special Preoperative Preparation:

Premedication(s): Anaesthesia Used: Procedure Planned:

Procedure Executed:

Indication: Operative Steps: Position of the Patient: Incision and Exposure: Findings: Steps:

Postoperative Advice: PROGRESS REPORT Date

Progress Notes

Long Cases

99

CASE SUMMARY (Write the brief summary about the diagnosis, management and outcome of the case at the time of discharge or when you leave the case.)

Signature (Consultant-in-Charge) ASSESSMENT Evaluator Name:

Diagnosis of the Patient: Does not Meet Expectation 1 2 3

Meets Expectation 4

5

6

Exceeds Expectation 7 8 9

History taking: Clinical examination: Investigations: Treatment plan: Counselling/Communication: Professionalism: Evaluator grading (out of 10)

Feedback given by Evaluator

Feedback received by Learner

(signature)

(signature)

100

Competency Based Logbook and Clinical Manual in General Surgery 19. Clinical Case (Paediatric Surgery)

1. UHID No.: 3. Patient’s Name: 5. Occupation:

2. Ward/Bed No.: 4. Age/Gender: 6. Address: Clinical History

Chief Complaints (with Duration in Chronological Order)

(1) (2) (3) (4)

History of Present Illness:

Past History (relevant to the diagnosis):

Medical History:

Personal History: Habit: Sedentary/Active/Hard Labour Sleep: Diet:

Addiction: Tobacco/Alcohol/other Appetite: Bowel/Bladder Habits:

Family History: Obstetric and Menstrual History (Females): Treatment History: GENERAL PHYSICAL EXAMINATION Appearance (including built, nutrition, hydration, anaemia, icterus, dyspnoea and cyanosis):

Pulse:

BP:

Resp. Rate:

JVP:

Pedal Oedema:

Lymph Nodes:

Temp.:

Long Cases

101

SYSTEMIC EXAMINATION Abdomen: Inspection: Palpation: Percussion: Auscultation: Rectal/Vaginal Examination: Respiratory System: Cardiovascular System: Nervous System: Local Examination (illustrate by diagram wherever possible):

Clinical Impression: DIFFERENTIAL DIAGNOSIS S. No.

Diagnosis

Points in favour

INVESTIGATIONS Blood/Serum CBC: LFT: Blood Sugar: ECG: Radiological X-rays Chest/Abdomen:

RFT/KFT: Urine Examination: Others:

Points against

Competency Based Logbook and Clinical Manual in General Surgery

102

Ultrasound:

CT Scan/MRI:

Any other investigation: Final Diagnosis: Treatment Plan:

OPERATIVE NOTES Date:

Special Preoperative Preparation:

Premedication(s): Anaesthesia Used: Procedure Planned:

Procedure Executed:

Indication: Operative Steps: Position of the Patient: Incision and Exposure: Findings: Steps:

Postoperative Advice: PROGRESS REPORT Date

Progress Notes

Long Cases

103

CASE SUMMARY (Write the brief summary about the diagnosis, management and outcome of the case at the time of discharge or when you leave the case.)

Signature (Consultant-in-Charge) ASSESSMENT Evaluator Name:

Diagnosis of the Patient: Does not Meet Expectation 1 2 3

Meets Expectation 4

5

6

Exceeds Expectation 7 8 9

History taking: Clinical examination: Investigations: Treatment plan: Counselling/Communication: Professionalism: Evaluator grading (out of 10)

Feedback given by Evaluator

Feedback received by Learner

(signature)

(signature)

104

Competency Based Logbook and Clinical Manual in General Surgery 20. Clinical Case

1. UHID No.: 3. Patient’s Name: 5. Occupation:

2. Ward/Bed No.: 4. Age/Gender: 6. Address: Clinical History

Chief Complaints (with Duration in Chronological Order)

(1) (2) (3) (4)

History of Present Illness:

Past History (relevant to the diagnosis):

Medical History:

Personal History: Habit: Sedentary/Active/Hard Labour Sleep: Diet:

Addiction: Tobacco/Alcohol/other Appetite: Bowel/Bladder Habits:

Family History: Obstetric and Menstrual History (Females): Treatment History: GENERAL PHYSICAL EXAMINATION Appearance (including built, nutrition, hydration, anaemia, icterus, dyspnoea and cyanosis):

Pulse:

BP:

Resp. Rate:

JVP:

Pedal Oedema:

Lymph Nodes:

Temp.:

Long Cases

105

SYSTEMIC EXAMINATION Abdomen: Inspection: Palpation: Percussion: Auscultation: Rectal/Vaginal Examination: Respiratory System: Cardiovascular System: Nervous System: Local Examination (illustrate by diagram wherever possible):

Clinical Impression: DIFFERENTIAL DIAGNOSIS S. No.

Diagnosis

Points in favour

INVESTIGATIONS Blood/Serum CBC: LFT: Blood Sugar: ECG: Radiological X-rays Chest/Abdomen:

RFT/KFT: Urine Examination: Others:

Points against

Competency Based Logbook and Clinical Manual in General Surgery

106

Ultrasound:

CT Scan/MRI:

Any other investigation: Final Diagnosis: Treatment Plan:

OPERATIVE NOTES Date:

Special Preoperative Preparation:

Premedication(s): Anaesthesia Used: Procedure Planned:

Procedure Executed:

Indication: Operative Steps: Position of the Patient: Incision and Exposure: Findings: Steps:

Postoperative Advice: PROGRESS REPORT Date

Progress Notes

Long Cases

107

CASE SUMMARY (Write the brief summary about the diagnosis, management and outcome of the case at the time of discharge or when you leave the case.)

Signature (Consultant-in-Charge) ASSESSMENT Evaluator Name:

Diagnosis of the Patient: Does not Meet Expectation 1 2 3

Meets Expectation 4

5

6

Exceeds Expectation 7 8 9

History taking: Clinical examination: Investigations: Treatment plan: Counselling/Communication: Professionalism: Evaluator grading (out of 10)

Feedback given by Evaluator

Feedback received by Learner

(signature)

(signature)

108

Competency Based Logbook and Clinical Manual in General Surgery 21. Clinical Case

1. UHID No.: 3. Patient’s Name: 5. Occupation:

2. Ward/Bed No.: 4. Age/Gender: 6. Address: Clinical History

Chief Complaints (with Duration in Chronological Order)

(1) (2) (3) (4)

History of Present Illness:

Past History (relevant to the diagnosis):

Medical History:

Personal History: Habit: Sedentary/Active/Hard Labour Sleep: Diet:

Addiction: Tobacco/Alcohol/other Appetite: Bowel/Bladder Habits:

Family History: Obstetric and Menstrual History (Females): Treatment History: GENERAL PHYSICAL EXAMINATION Appearance (including built, nutrition, hydration, anaemia, icterus, dyspnoea and cyanosis):

Pulse:

BP:

Resp. Rate:

JVP:

Pedal Oedema:

Lymph Nodes:

Temp.:

Long Cases

109

SYSTEMIC EXAMINATION Abdomen: Inspection: Palpation: Percussion: Auscultation: Rectal/Vaginal Examination: Respiratory System: Cardiovascular System: Nervous System: Local Examination (illustrate by diagram wherever possible):

Clinical Impression: DIFFERENTIAL DIAGNOSIS S. No.

Diagnosis

Points in favour

INVESTIGATIONS Blood/Serum CBC: LFT: Blood Sugar: ECG: Radiological X-rays Chest/Abdomen:

RFT/KFT: Urine Examination: Others:

Points against

Competency Based Logbook and Clinical Manual in General Surgery

110

Ultrasound:

CT Scan/MRI:

Any other investigation: Final Diagnosis: Treatment Plan:

OPERATIVE NOTES Date:

Special Preoperative Preparation:

Premedication(s): Anaesthesia Used: Procedure Planned:

Procedure Executed:

Indication: Operative Steps: Position of the Patient: Incision and Exposure: Findings: Steps:

Postoperative Advice: PROGRESS REPORT Date

Progress Notes

Long Cases

111

CASE SUMMARY (Write the brief summary about the diagnosis, management and outcome of the case at the time of discharge or when you leave the case.)

Signature (Consultant-in-Charge) ASSESSMENT Evaluator Name:

Diagnosis of the Patient: Does not Meet Expectation 1 2 3

Meets Expectation 4

5

6

Exceeds Expectation 7 8 9

History taking: Clinical examination: Investigations: Treatment plan: Counselling/Communication: Professionalism: Evaluator grading (out of 10)

Feedback given by Evaluator

Feedback received by Learner

(signature)

(signature)

112

Competency Based Logbook and Clinical Manual in General Surgery 22. Clinical Case

1. 1. UHID No.: 3. Patient’s Name: 5. Occupation:

2. Ward/Bed No.: 4. Age/Gender: 6. Address: Clinical History

Chief Complaints (with Duration in Chronological Order)

(1) (2) (3) (4)

History of Present Illness:

Past History (relevant to the diagnosis):

Medical History:

Personal History: Habit: Sedentary/Active/Hard Labour Sleep: Diet:

Addiction: Tobacco/Alcohol/other Appetite: Bowel/Bladder Habits:

Family History: Obstetric and Menstrual History (Females): Treatment History: GENERAL PHYSICAL EXAMINATION Appearance (including built, nutrition, hydration, anaemia, icterus, dyspnoea and cyanosis):

Pulse:

BP:

Resp. Rate:

JVP:

Pedal Oedema:

Lymph Nodes:

Temp.:

Long Cases

113

SYSTEMIC EXAMINATION Abdomen: Inspection: Palpation: Percussion: Auscultation: Rectal/Vaginal Examination: Respiratory System: Cardiovascular System: Nervous System: Local Examination (illustrate by diagram wherever possible):

Clinical Impression: DIFFERENTIAL DIAGNOSIS S. No.

Diagnosis

Points in favour

INVESTIGATIONS Blood/Serum CBC: LFT: Blood Sugar: ECG: Radiological X-rays Chest/Abdomen:

RFT/KFT: Urine Examination: Others:

Points against

Competency Based Logbook and Clinical Manual in General Surgery

114

Ultrasound:

CT Scan/MRI:

Any other investigation: Final Diagnosis: Treatment Plan:

OPERATIVE NOTES Date:

Special Preoperative Preparation:

Premedication(s): Anaesthesia Used: Procedure Planned:

Procedure Executed:

Indication: Operative Steps: Position of the Patient: Incision and Exposure: Findings: Steps:

Postoperative Advice: PROGRESS REPORT Date

Progress Notes

Long Cases

115

CASE SUMMARY (Write the brief summary about the diagnosis, management and outcome of the case at the time of discharge or when you leave the case.)

Signature (Consultant-in-Charge) ASSESSMENT Evaluator Name:

Diagnosis of the Patient: Does not Meet Expectation 1 2 3

Meets Expectation 4

5

6

Exceeds Expectation 7 8 9

History taking: Clinical examination: Investigations: Treatment plan: Counselling/Communication: Professionalism: Evaluator grading (out of 10)

Feedback given by Evaluator

Feedback received by Learner

(signature)

(signature)

116

Competency Based Logbook and Clinical Manual in General Surgery 23. Clinical Case

1. UHID No.: 3. Patient’s Name: 5. Occupation:

2. Ward/Bed No.: 4. Age/Gender: 6. Address: Clinical History

Chief Complaints (with Duration in Chronological Order)

(1) (2) (3) (4)

History of Present Illness:

Past History (relevant to the diagnosis):

Medical History:

Personal History: Habit: Sedentary/Active/Hard Labour Sleep: Diet:

Addiction: Tobacco/Alcohol/other Appetite: Bowel/Bladder Habits:

Family History: Obstetric and Menstrual History (Females): Treatment History: GENERAL PHYSICAL EXAMINATION Appearance (including built, nutrition, hydration, anaemia, icterus, dyspnoea and cyanosis):

Pulse:

BP:

Resp. Rate:

JVP:

Pedal Oedema:

Lymph Nodes:

Temp.:

Long Cases

117

SYSTEMIC EXAMINATION Abdomen: Inspection: Palpation: Percussion: Auscultation: Rectal/Vaginal Examination: Respiratory System: Cardiovascular System: Nervous System: Local Examination (illustrate by diagram wherever possible):

Clinical Impression: DIFFERENTIAL DIAGNOSIS S. No.

Diagnosis

Points in favour

INVESTIGATIONS Blood/Serum CBC: LFT: Blood Sugar: ECG: Radiological X-rays Chest/Abdomen:

RFT/KFT: Urine Examination: Others:

Points against

Competency Based Logbook and Clinical Manual in General Surgery

118

Ultrasound:

CT Scan/MRI:

Any other investigation: Final Diagnosis: Treatment Plan:

OPERATIVE NOTES Date:

Special Preoperative Preparation:

Premedication(s): Anaesthesia Used: Procedure Planned:

Procedure Executed:

Indication: Operative Steps: Position of the Patient: Incision and Exposure: Findings: Steps:

Postoperative Advice: PROGRESS REPORT Date

Progress Notes

Long Cases

119

CASE SUMMARY (Write the brief summary about the diagnosis, management and outcome of the case at the time of discharge or when you leave the case.)

Signature (Consultant-in-Charge) ASSESSMENT Evaluator Name:

Diagnosis of the Patient: Does not Meet Expectation 1 2 3

Meets Expectation 4

5

6

Exceeds Expectation 7 8 9

History taking: Clinical examination: Investigations: Treatment plan: Counselling/Communication: Professionalism: Evaluator grading (out of 10)

Feedback given by Evaluator

Feedback received by Learner

(signature)

(signature)

120

Competency Based Logbook and Clinical Manual in General Surgery 24. Clinical Case

1. UHID No.: 3. Patient’s Name: 5. Occupation:

2. Ward/Bed No.: 4. Age/Gender: 6. Address: Clinical History

Chief Complaints (with Duration in Chronological Order)

(1) (2) (3) (4)

History of Present Illness:

Past History (relevant to the diagnosis):

Medical History:

Personal History: Habit: Sedentary/Active/Hard Labour Sleep: Diet:

Addiction: Tobacco/Alcohol/other Appetite: Bowel/Bladder Habits:

Family History: Obstetric and Menstrual History (Females): Treatment History: GENERAL PHYSICAL EXAMINATION Appearance (including built, nutrition, hydration, anaemia, icterus, dyspnoea and cyanosis):

Pulse:

BP:

Resp. Rate:

JVP:

Pedal Oedema:

Lymph Nodes:

Temp.:

Long Cases

121

SYSTEMIC EXAMINATION Abdomen: Inspection: Palpation: Percussion: Auscultation: Rectal/Vaginal Examination: Respiratory System: Cardiovascular System: Nervous System: Local Examination (illustrate by diagram wherever possible):

Clinical Impression: DIFFERENTIAL DIAGNOSIS S. No.

Diagnosis

Points in favour

INVESTIGATIONS Blood/Serum CBC: LFT: Blood Sugar: ECG: Radiological X-rays Chest/Abdomen:

RFT/KFT: Urine Examination: Others:

Points against

Competency Based Logbook and Clinical Manual in General Surgery

122

Ultrasound:

CT Scan/MRI:

Any other investigation: Final Diagnosis: Treatment Plan:

OPERATIVE NOTES Date:

Special Preoperative Preparation:

Premedication(s): Anaesthesia Used: Procedure Planned:

Procedure Executed:

Indication: Operative Steps: Position of the Patient: Incision and Exposure: Findings: Steps:

Postoperative Advice: PROGRESS REPORT Date

Progress Notes

Long Cases

123

CASE SUMMARY (Write the brief summary about the diagnosis, management and outcome of the case at the time of discharge or when you leave the case.)

Signature (Consultant-in-Charge) ASSESSMENT Evaluator Name:

Diagnosis of the Patient: Does not Meet Expectation 1 2 3

Meets Expectation 4

5

6

Exceeds Expectation 7 8 9

History taking: Clinical examination: Investigations: Treatment plan: Counselling/Communication: Professionalism: Evaluator grading (out of 10)

Feedback given by Evaluator

Feedback received by Learner

(signature)

(signature)

124

Competency Based Logbook and Clinical Manual in General Surgery 25. Clinical Case

1. UHID No.: 3. Patient’s Name: 5. Occupation:

2. Ward/Bed No.: 4. Age/Gender: 6. Address: Clinical History

Chief Complaints (with Duration in Chronological Order)

(1) (2) (3) (4)

History of Present Illness:

Past History (relevant to the diagnosis):

Medical History:

Personal History: Habit: Sedentary/Active/Hard Labour Sleep: Diet:

Addiction: Tobacco/Alcohol/other Appetite: Bowel/Bladder Habits:

Family History: Obstetric and Menstrual History (Females): Treatment History: GENERAL PHYSICAL EXAMINATION Appearance (including built, nutrition, hydration, anaemia, icterus, dyspnoea and cyanosis):

Pulse:

BP:

Resp. Rate:

JVP:

Pedal Oedema:

Lymph Nodes:

Temp.:

Long Cases

125

SYSTEMIC EXAMINATION Abdomen: Inspection: Palpation: Percussion: Auscultation: Rectal/Vaginal Examination: Respiratory System: Cardiovascular System: Nervous System: Local Examination (illustrate by diagram wherever possible):

Clinical Impression: DIFFERENTIAL DIAGNOSIS S. No.

Diagnosis

Points in favour

INVESTIGATIONS Blood/Serum CBC: LFT: Blood Sugar: ECG: Radiological X-rays Chest/Abdomen:

RFT/KFT: Urine Examination: Others:

Points against

Competency Based Logbook and Clinical Manual in General Surgery

126

Ultrasound:

CT Scan/MRI:

Any other investigation: Final Diagnosis: Treatment Plan:

OPERATIVE NOTES Date:

Special Preoperative Preparation:

Premedication(s): Anaesthesia Used: Procedure Planned:

Procedure Executed:

Indication: Operative Steps: Position of the Patient: Incision and Exposure: Findings: Steps:

Postoperative Advice: PROGRESS REPORT Date

Progress Notes

Long Cases

127

CASE SUMMARY (Write the brief summary about the diagnosis, management and outcome of the case at the time of discharge or when you leave the case.)

Signature (Consultant-in-Charge) ASSESSMENT Evaluator Name:

Diagnosis of the Patient: Does not Meet Expectation 1 2 3

Meets Expectation 4

5

6

Exceeds Expectation 7 8 9

History taking: Clinical examination: Investigations: Treatment plan: Counselling/Communication: Professionalism: Evaluator grading (out of 10)

Feedback given by Evaluator

Feedback received by Learner

(signature)

(signature)

128

Competency Based Logbook and Clinical Manual in General Surgery Section 4: Instruments

Name of the instrument:

Diagram

Identifying features:

Indications of use:

Contraindications:

Name of the instrument:

Diagram

Identifying features:

Indications of use:

Contraindications:

Name of the instrument:

Identifying features:

Indications of use:

Contraindications:

Diagram

Instruments

129

Section 4: Instruments Name of the instrument:

Diagram

Identifying features:

Indications of use:

Contraindications:

Name of the instrument:

Diagram

Identifying features:

Indications of use:

Contraindications:

Name of the instrument:

Identifying features:

Indications of use:

Contraindications:

Diagram

130

Competency Based Logbook and Clinical Manual in General Surgery Section 4: Instruments

Name of the instrument:

Diagram

Identifying features:

Indications of use:

Contraindications:

Name of the instrument:

Diagram

Identifying features:

Indications of use:

Contraindications:

Name of the instrument:

Identifying features:

Indications of use:

Contraindications:

Diagram

Instruments

131

Section 4: Instruments Name of the instrument:

Diagram

Identifying features:

Indications of use:

Contraindications:

Name of the instrument:

Diagram

Identifying features:

Indications of use:

Contraindications:

Name of the instrument:

Identifying features:

Indications of use:

Contraindications:

Diagram

132

Competency Based Logbook and Clinical Manual in General Surgery Section 4: Instruments

Name of the instrument:

Diagram

Identifying features:

Indications of use:

Contraindications:

Name of the instrument:

Diagram

Identifying features:

Indications of use:

Contraindications:

Name of the instrument:

Identifying features:

Indications of use:

Contraindications:

Diagram

Instruments

133

Section 4: Instruments Name of the instrument:

Diagram

Identifying features:

Indications of use:

Contraindications:

Name of the instrument:

Diagram

Identifying features:

Indications of use:

Contraindications:

Name of the instrument:

Identifying features:

Indications of use:

Contraindications:

Diagram

134

Competency Based Logbook and Clinical Manual in General Surgery Section 4: Instruments

Name of the instrument:

Diagram

Identifying features:

Indications of use:

Contraindications:

Name of the instrument:

Diagram

Identifying features:

Indications of use:

Contraindications:

Name of the instrument:

Identifying features:

Indications of use:

Contraindications:

Diagram

Instruments

135

Section 4: Instruments Name of the instrument:

Diagram

Identifying features:

Indications of use:

Contraindications:

Name of the instrument:

Diagram

Identifying features:

Indications of use:

Contraindications:

Name of the instrument:

Identifying features:

Indications of use:

Contraindications:

Diagram

136

Competency Based Logbook and Clinical Manual in General Surgery Section 4: Instruments

Name of the instrument:

Diagram

Identifying features:

Indications of use:

Contraindications:

Name of the instrument:

Diagram

Identifying features:

Indications of use:

Contraindications:

Name of the instrument:

Identifying features:

Indications of use:

Contraindications:

Diagram

Instruments

137

Section 4: Instruments Name of the instrument:

Diagram

Identifying features:

Indications of use:

Contraindications:

Name of the instrument:

Diagram

Identifying features:

Indications of use:

Contraindications:

Name of the instrument:

Identifying features:

Indications of use:

Contraindications:

Diagram

138

Competency Based Logbook and Clinical Manual in General Surgery Section 4: Instruments

Name of the instrument:

Diagram

Identifying features:

Indications of use:

Contraindications:

Name of the instrument:

Diagram

Identifying features:

Indications of use:

Contraindications:

Name of the instrument:

Identifying features:

Indications of use:

Contraindications:

Diagram

Instruments

139

Section 4: Instruments Name of the instrument:

Diagram

Identifying features:

Indications of use:

Contraindications:

Name of the instrument:

Diagram

Identifying features:

Indications of use:

Contraindications:

Name of the instrument:

Identifying features:

Indications of use:

Contraindications:

Diagram

140

Competency Based Logbook and Clinical Manual in General Surgery Section 4: Instruments

Name of the instrument:

Diagram

Identifying features:

Indications of use:

Contraindications:

Name of the instrument:

Diagram

Identifying features:

Indications of use:

Contraindications:

Name of the instrument:

Identifying features:

Indications of use:

Contraindications:

Diagram

Instruments

141

Section 4: Instruments Name of the instrument:

Diagram

Identifying features:

Indications of use:

Contraindications:

Name of the instrument:

Diagram

Identifying features:

Indications of use:

Contraindications:

Name of the instrument:

Identifying features:

Indications of use:

Contraindications:

Diagram

142

Competency Based Logbook and Clinical Manual in General Surgery Section 4: Instruments

Name of the instrument:

Diagram

Identifying features:

Indications of use:

Contraindications:

Name of the instrument:

Diagram

Identifying features:

Indications of use:

Contraindications:

Name of the instrument:

Identifying features:

Indications of use:

Contraindications:

Diagram

Simulation Based Teaching

143

Section 5: Simulation Based Teaching Sr. No.

Competency number and description of the activity

Maximum number of attempts allowed for the activity

No. of attempts taken by the learner (with date of each attempt)

Any remedial training needed? (Yes/No) If yes then state the reason(s)

Rating 1. Scope for further improvement 2. Satisfactory (All attempts at the activity must be rated separately)

Simulation Based Teaching

1.

2.

3.

4.

5.

Final decision of faculty C–Completed N–Not completed

Feedback conveyed by faculty (Yes/No) Signature of faculty (with date)

Feedback received by learner (Yes/No) Signature of learner (with date)

144

Competency Based Logbook and Clinical Manual in General Surgery Section 5: Simulation Based Teaching

Sr. No.

Competency number and description of the activity

Maximum number of attempts allowed for the activity

No. of attempts taken by the learner (with date of each attempt)

Any remedial training needed? (Yes/No) If yes then state the reason(s)

Rating 1. Scope for further improvement 2. Satisfactory (All attempts at the activity must be rated separately)

Simulation Based Teaching

6.

7.

8.

9.

10.

Final decision of faculty C–Completed N–Not completed

Feedback conveyed by faculty (Yes/No) Signature of faculty (with date)

Feedback received by learner (Yes/No) Signature of learner (with date)

Simulation Based Teaching

145

Section 5: Simulation Based Teaching Sr. No.

Competency number and description of the activity

Maximum number of attempts allowed for the activity

No. of attempts taken by the learner (with date of each attempt)

Any remedial training needed? (Yes/No) If yes then state the reason(s)

Rating 1. Scope for further improvement 2. Satisfactory (All attempts at the activity must be rated separately)

Simulation Based Teaching

11.

12.

13.

14.

15.

Final decision of faculty C–Completed N–Not completed

Feedback conveyed by faculty (Yes/No) Signature of faculty (with date)

Feedback received by learner (Yes/No) Signature of learner (with date)

146

Competency Based Logbook and Clinical Manual in General Surgery Section 5: Simulation Based Teaching

Sr. No.

Competency number and description of the activity

Maximum number of attempts allowed for the activity

No. of attempts taken by the learner (with date of each attempt)

Any remedial training needed? (Yes/No) If yes then state the reason(s)

Rating 1. Scope for further improvement 2. Satisfactory (All attempts at the activity must be rated separately)

Simulation Based Teaching

16.

17.

18.

19.

20.

Final decision of faculty C–Completed N–Not completed

Feedback conveyed by faculty (Yes/No) Signature of faculty (with date)

Feedback received by learner (Yes/No) Signature of learner (with date)

Simulation Based Teaching

147

Section 5A: Certifiable Skills and Assessment of Skills 2nd Professional MBBS Skill: Basic Wound Care Sr. No. Competency addressed/ description of the activity

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

Maximum number of attempts allowed for the activity

No. of attempts taken by the learner (with date of each attempt)

Any remedial training needed? (Yes/No) If yes then state the reason(s)

Rating 1. Scope for further improvement 2. Satisfactory (All attempts at the activity must be rated separately)

Final decision of faculty C–Completed N–Not completed

Feedback conveyed by faculty (Yes/No) Signature of faculty (with date)

Feedback received by learner (Yes/No) Signature of learner (with date)

Competency Based Logbook and Clinical Manual in General Surgery

148

Assessment Skill being assessed: Basic Wound Care Steps

Date: Does not Meet Expectation 1 2 3

Feedback received by learner: Yes/No Whether the learner has acquired the skill: Yes/No Assessed/Certified by: (Name and Signature)

Meets Expectation 4 5 6

Exceeds Expectation 7 8 9

Simulation Based Teaching

149

2nd Professional MBBS Skill: Basic Bandaging Sr. No. Competency addressed/ description of the activity

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

Maximum number of attempts allowed for the activity

No. of attempts taken by the learner (with date of each attempt)

Any remedial training needed? (Yes/No) If yes then state the reason(s)

Rating 1. Scope for further improvement 2. Satisfactory (All attempts at the activity must be rated separately)

Final decision of faculty C–Completed N–Not completed

Feedback conveyed by faculty (Yes/No) Signature of faculty (with date)

Feedback received by learner (Yes/No) Signature of learner (with date)

Competency Based Logbook and Clinical Manual in General Surgery

150

Assessment Skill being assessed: Basic Bandaging Steps

Date: Does not Meet Expectation 1 2 3

Feedback received by learner: Yes/No Whether the learner has acquired the skill: Yes/No Assessed/Certified by: (Name and Signature)

Meets Expectation 4 5 6

Exceeds Expectation 7 8 9

Simulation Based Teaching

151

2nd Professional MBBS Skill: Communication Skills (Informed Consent) Sr. No. Competency addressed/ description of the activity

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

Maximum number of attempts allowed for the activity

No. of attempts taken by the learner (with date of each attempt)

Any remedial training needed? (Yes/No) If yes then state the reason(s)

Rating 1. Scope for further improvement 2. Satisfactory (All attempts at the activity must be rated separately)

Final decision of faculty C–Completed N–Not completed

Feedback conveyed by faculty (Yes/No) Signature of faculty (with date)

Feedback received by learner (Yes/No) Signature of learner (with date)

Competency Based Logbook and Clinical Manual in General Surgery

152

Assessment Skill being assessed: Communication Skills (Informed Consent) Steps

Does not Meet Expectation 1 2 3

Feedback received by learner: Yes/No Whether the learner has acquired the skill: Yes/No Assessed/Certified by: (Name and Signature)

Meets Expectation 4 5 6

Date: Exceeds Expectation 7 8 9

Simulation Based Teaching

153

3rd Professional MBBS (Part I) Skill: Early Management of Trauma and Trauma Life Support Sr. No. Competency addressed/ description of the activity

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

Maximum number of attempts allowed for the activity

No. of attempts taken by the learner (with date of each attempt)

Any remedial training needed? (Yes/No) If yes then state the reason(s)

Rating 1. Scope for further improvement 2. Satisfactory (All attempts at the activity must be rated separately)

Final decision of faculty C–Completed N–Not completed

Feedback conveyed by faculty (Yes/No) Signature of faculty (with date)

Feedback received by learner (Yes/No) Signature of learner (with date)

Competency Based Logbook and Clinical Manual in General Surgery

154

Assessment Skill being assessed: Early Management of Trauma and Trauma Life Support Steps

Does not Meet Expectation 1 2 3

Feedback received by learner: Yes/No Whether the learner has acquired the skill: Yes/No Assessed/Certified by: (Name and Signature)

Meets Expectation 4 5 6

Date: Exceeds Expectation 7 8 9

Simulation Based Teaching

155

3rd Professional MBBS (Part I) Skill: Bladder Catheterization Sr. No. Competency addressed/ description of the activity

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

Maximum number of attempts allowed for the activity

No. of attempts taken by the learner (with date of each attempt)

Any remedial training needed? (Yes/No) If yes then state the reason(s)

Rating 1. Scope for further improvement 2. Satisfactory (All attempts at the activity must be rated separately)

Final decision of faculty C–Completed N–Not completed

Feedback conveyed by faculty (Yes/No) Signature of faculty (with date)

Feedback received by learner (Yes/No) Signature of learner (with date)

Competency Based Logbook and Clinical Manual in General Surgery

156

Assessment Skill being assessed: Bladder Catheterization Steps

Does not Meet Expectation 1 2 3

Feedback received by learner: Yes/No Whether the learner has acquired the skill: Yes/No Assessed/Certified by: (Name and Signature)

Date: Meets Expectation 4 5 6

Exceeds Expectation 7 8 9

Simulation Based Teaching

157

3rd Professional MBBS (Part I) Skill: Communication Skills (Breaking Bad News) Sr. No. Competency addressed/ description of the activity

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

Maximum number of attempts allowed for the activity

No. of attempts taken by the learner (with date of each attempt)

Any remedial training needed? (Yes/No) If yes then state the reason(s)

Rating 1. Scope for further improvement 2. Satisfactory (All attempts at the activity must be rated separately)

Final decision of faculty C–Completed N–Not completed

Feedback conveyed by faculty (Yes/No) Signature of faculty (with date)

Feedback received by learner (Yes/No) Signature of learner (with date)

Competency Based Logbook and Clinical Manual in General Surgery

158

Assessment Skill being assessed: Communication Skills (Breaking Bad News) Steps

Does not Meet Expectation 1 2 3

Feedback received by learner: Yes/No Whether the learner has acquired the skill: Yes/No Assessed/Certified by: (Name and Signature)

Meets Expectation 4 5 6

Date: Exceeds Expectation 7 8 9

Simulation Based Teaching

159

3rd Professional MBBS (Part II) Skill: Basic Suturing Skills Sr. No. Competency addressed/ description of the activity

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

Maximum number of attempts allowed for the activity

No. of attempts taken by the learner (with date of each attempt)

Any remedial training needed? (Yes/No) If yes then state the reason(s)

Rating 1. Scope for further improvement 2. Satisfactory (All attempts at the activity must be rated separately)

Final decision of faculty C–Completed N–Not completed

Feedback conveyed by faculty (Yes/No) Signature of faculty (with date)

Feedback received by learner (Yes/No) Signature of learner (with date)

Competency Based Logbook and Clinical Manual in General Surgery

160

Assessment Skill being assessed: Basic Suturing Skills Steps

Date: Does not Meet Expectation 1 2 3

Feedback received by learner: Yes/No Whether the learner has acquired the skill: Yes/No Assessed/Certified by: (Name and Signature)

Meets Expectation 4 5 6

Exceeds Expectation 7 8 9

Simulation Based Teaching

161

3rd Professional MBBS (Part II) Skill: Incision and Drainage of Superficial Abscess Sr. No. Competency addressed/ description of the activity

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

Maximum number of attempts allowed for the activity

No. of attempts taken by the learner (with date of each attempt)

Any remedial training needed? (Yes/No) If yes then state the reason(s)

Rating 1. Scope for further improvement 2. Satisfactory (All attempts at the activity must be rated separately)

Final decision of faculty C–Completed N–Not completed

Feedback conveyed by faculty (Yes/No) Signature of faculty (with date)

Feedback received by learner (Yes/No) Signature of learner (with date)

Competency Based Logbook and Clinical Manual in General Surgery

162

Assessment Skill being assessed: Incision and Drainage of Superficial Abscess Steps

Does not Meet Expectation 1 2 3

Feedback received by learner: Yes/No Whether the learner has acquired the skill: Yes/No Assessed/Certified by: (Name and Signature)

Meets Expectation 4 5 6

Date: Exceeds Expectation 7 8 9

Simulation Based Teaching

163

3rd Professional MBBS (Part II) Skill: Maintenance of Airway Sr. No. Competency addressed/ description of the activity

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

Maximum number of attempts allowed for the activity

No. of attempts taken by the learner (with date of each attempt)

Any remedial training needed? (Yes/No) If yes then state the reason(s)

Rating 1. Scope for further improvement 2. Satisfactory (All attempts at the activity must be rated separately)

Final decision of faculty C–Completed N–Not completed

Feedback conveyed by faculty (Yes/No) Signature of faculty (with date)

Feedback received by learner (Yes/No) Signature of learner (with date)

Competency Based Logbook and Clinical Manual in General Surgery

164

Assessment Skill being assessed: Maintenance of Airway Steps

Does not Meet Expectation 1 2 3

Feedback received by learner: Yes/No Whether the learner has acquired the skill: Yes/No Assessed/Certified by: (Name and Signature)

Date: Meets Expectation 4 5 6

Exceeds Expectation 7 8 9

Simulation Based Teaching

165

3rd Professional MBBS (Part II) Skill: Chest Drainage Sr. No. Competency addressed/ description of the activity

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

Maximum number of attempts allowed for the activity

No. of attempts taken by the learner (with date of each attempt)

Any remedial training needed? (Yes/No) If yes then state the reason(s)

Rating 1. Scope for further improvement 2. Satisfactory (All attempts at the activity must be rated separately)

Final decision of faculty C–Completed N–Not completed

Feedback conveyed by faculty (Yes/No) Signature of faculty (with date)

Feedback received by learner (Yes/No) Signature of learner (with date)

Competency Based Logbook and Clinical Manual in General Surgery

166

Assessment Skill being assessed: Chest Drainage Steps

Date: Does not Meet Expectation 1 2 3

Feedback received by learner: Yes/No Whether the learner has acquired the skill: Yes/No Assessed/Certified by: (Name and Signature)

Meets Expectation 4 5 6

Exceeds Expectation 7 8 9

Simulation Based Teaching

167

Assessment Skill being assessed: Steps

Date: Does not Meet Expectation 1 2 3

Feedback received by learner: Yes/No Whether the learner has acquired the skill: Yes/No Assessed/Certified by: (Name and Signature)

Meets Expectation 4 5 6

Exceeds Expectation 7 8 9

Competency Based Logbook and Clinical Manual in General Surgery

168

Assessment Skill being assessed: Steps

Date: Does not Meet Expectation 1 2 3

Feedback received by learner: Yes/No Whether the learner has acquired the skill: Yes/No Assessed/Certified by: (Name and Signature)

Meets Expectation 4 5 6

Exceeds Expectation 7 8 9

Simulation Based Teaching

169

Assessment Skill being assessed: Steps

Date: Does not Meet Expectation 1 2 3

Feedback received by learner: Yes/No Whether the learner has acquired the skill: Yes/No Assessed/Certified by: (Name and Signature)

Meets Expectation 4 5 6

Exceeds Expectation 7 8 9

Competency Based Logbook and Clinical Manual in General Surgery

170

Assessment Skill being assessed: Steps

Date: Does not Meet Expectation 1 2 3

Feedback received by learner: Yes/No Whether the learner has acquired the skill: Yes/No Assessed/Certified by: (Name and Signature)

Meets Expectation 4 5 6

Exceeds Expectation 7 8 9

Simulation Based Teaching

171

Assessment Skill being assessed: Steps

Date: Does not Meet Expectation 1 2 3

Feedback received by learner: Yes/No Whether the learner has acquired the skill: Yes/No Assessed/Certified by: (Name and Signature)

Meets Expectation 4 5 6

Exceeds Expectation 7 8 9

172

Competency Based Logbook and Clinical Manual in General Surgery Skills in General Surgery and Simulation Based Teaching

(This page may be used to record the salient points of the discussion as well as any activities, assignments or assessments on the topic) Sub-topic:

Date:

1. Please describe briefly what was discussed OR details of activity/assignment/assessment:

2. What did you learn from the discussion OR the activity/assignment/assessment:

3. Do you feel that the knowledge you have acquired will help you become a better doctor? Please explain in your own words.

Feedback Received (Yes/No):

Simulation Based Teaching

173

Skills in General Surgery and Simulation Based Teaching (This page may be used to record the salient points of the discussion as well as any activities, assignments or assessments on the topic) Sub-topic:

Date:

1. Please describe briefly what was discussed OR details of activity/assignment/assessment:

2. What did you learn from the discussion OR the activity/assignment/assessment:

3. Do you feel that the knowledge you have acquired will help you become a better doctor? Please explain in your own words.

Feedback Received (Yes/No):

174

Competency Based Logbook and Clinical Manual in General Surgery Section 6: Attitude, Ethics and Communication (AETCOM)

Sr. No.

Competency number and description of the activity

Maximum number of attempts allowed for the activity

No. of attempts taken by the learner (with date of each attempt)

Any remedial training needed? (Yes/No) If yes then state the reason(s)

Rating 1. Scope for further improvement 2. Satisfactory (All attempts at the activity must be rated separately)

Final decision of faculty C–Completed N–Not completed

Attitude, Ethics and Communication (AETCOM)

1.

2.

3.

4.

5.

Feedback conveyed by faculty (Yes/No) Signature of faculty (with date)

Feedback received by learner (Yes/No) Signature of learner (with date)

Attitude, Ethics and Communication (AETCOM)

175

Section 6: Attitude, Ethics and Communication (AETCOM) Sr. No.

Competency number and description of the activity

Maximum number of attempts allowed for the activity

No. of attempts taken by the learner (with date of each attempt)

Any remedial training needed? (Yes/No) If yes then state the reason(s)

Rating 1. Scope for further improvement 2. Satisfactory (All attempts at the activity must be rated separately)

Final decision of faculty C–Completed N–Not completed

Attitude, Ethics and Communication (AETCOM)

6.

7.

8.

9.

10.

Feedback conveyed by faculty (Yes/No) Signature of faculty (with date)

Feedback received by learner (Yes/No) Signature of learner (with date)

176

Competency Based Logbook and Clinical Manual in General Surgery Section 6: Attitude, Ethics and Communication (AETCOM)

Sr. No.

Competency number and description of the activity

Maximum number of attempts allowed for the activity

No. of attempts taken by the learner (with date of each attempt)

Any remedial training needed? (Yes/No) If yes then state the reason(s)

Rating 1. Scope for further improvement 2. Satisfactory (All attempts at the activity must be rated separately)

Final decision of faculty C–Completed N–Not completed

Attitude, Ethics and Communication (AETCOM)

11.

12.

13.

14.

15.

Feedback conveyed by faculty (Yes/No) Signature of faculty (with date)

Feedback received by learner (Yes/No) Signature of learner (with date)

Attitude, Ethics and Communication (AETCOM)

177

Section 6: Attitude, Ethics and Communication (AETCOM) Sr. No.

Competency number and description of the activity

Maximum number of attempts allowed for the activity

No. of attempts taken by the learner (with date of each attempt)

Any remedial training needed? (Yes/No) If yes then state the reason(s)

Rating 1. Scope for further improvement 2. Satisfactory (All attempts at the activity must be rated separately)

Final decision of faculty C–Completed N–Not completed

Attitude, Ethics and Communication (AETCOM)

16.

17.

18.

19.

20.

Feedback conveyed by faculty (Yes/No) Signature of faculty (with date)

Feedback received by learner (Yes/No) Signature of learner (with date)

178

Competency Based Logbook and Clinical Manual in General Surgery Section 6: Attitude, Ethics and Communication (AETCOM)

(This page may be used to record the salient points of the discussion as well as any activities, assignments or assessments on the topic) Sub-topic:

Date:

1. Please describe briefly what was discussed OR details of activity/assignment/assessment:

2. What did you learn from the discussion OR the activity/assignment/assessment:

3. Do you feel that the knowledge you have acquired will help you become a better doctor? Please explain in your own words.

Feedback Received (Yes/No):

Attitude, Ethics and Communication (AETCOM)

179

Section 6: Attitude, Ethics and Communication (AETCOM) (This page may be used to record the salient points of the discussion as well as any activities, assignments or assessments on the topic) Sub-topic:

Date:

1. Please describe briefly what was discussed OR details of activity/assignment/assessment:

2. What did you learn from the discussion OR the activity/assignment/assessment:

3. Do you feel that the knowledge you have acquired will help you become a better doctor? Please explain in your own words.

Feedback Received (Yes/No):

180

Competency Based Logbook and Clinical Manual in General Surgery Section 6: Attitude, Ethics and Communication (AETCOM)

(This page may be used to record the salient points of the discussion as well as any activities, assignments or assessments on the topic) Sub-topic:

Date:

1. Please describe briefly what was discussed OR details of activity/assignment/assessment:

2. What did you learn from the discussion OR the activity/assignment/assessment:

3. Do you feel that the knowledge you have acquired will help you become a better doctor? Please explain in your own words.

Feedback Received (Yes/No):

Attitude, Ethics and Communication (AETCOM)

181

Section 6: Attitude, Ethics and Communication (AETCOM) (This page may be used to record the salient points of the discussion as well as any activities, assignments or assessments on the topic) Sub-topic:

Date:

1. Please describe briefly what was discussed OR details of activity/assignment/assessment:

2. What did you learn from the discussion OR the activity/assignment/assessment:

3. Do you feel that the knowledge you have acquired will help you become a better doctor? Please explain in your own words.

Feedback Received (Yes/No):

182

Competency Based Logbook and Clinical Manual in General Surgery Section 7: Integration

Sr. No.

Competency number and description of the activity

Maximum number of attempts allowed for the activity

No. of attempts taken by the learner (with date of each attempt)

Any remedial training needed? (Yes/No) If yes then state the reason(s)

Integration

1.

2.

3.

4.

5.

Rating 1. Scope for further improvement 2. Satisfactory (All attempts at the activity must be rated separately)

Final decision of faculty C–Completed N–Not completed

Feedback conveyed by faculty (Yes/No) Signature of faculty (with date)

Feedback received by learner (Yes/No) Signature of learner (with date)

Integration

183

Section 7: Integration Sr. No.

Competency number and description of the activity

Maximum number of attempts allowed for the activity

No. of attempts taken by the learner (with date of each attempt)

Any remedial training needed? (Yes/No) If yes then state the reason(s)

Integration

6.

7.

8.

9.

10.

Rating 1. Scope for further improvement 2. Satisfactory (All attempts at the activity must be rated separately)

Final decision of faculty C–Completed N–Not completed

Feedback conveyed by faculty (Yes/No) Signature of faculty (with date)

Feedback received by learner (Yes/No) Signature of learner (with date)

184

Competency Based Logbook and Clinical Manual in General Surgery Section 7: Integration

Sr. No.

Competency number and description of the activity

Maximum number of attempts allowed for the activity

No. of attempts taken by the learner (with date of each attempt)

Any remedial training needed? (Yes/No) If yes then state the reason(s)

Integration

11.

12.

13.

14.

15.

Rating 1. Scope for further improvement 2. Satisfactory (All attempts at the activity must be rated separately)

Final decision of faculty C–Completed N–Not completed

Feedback conveyed by faculty (Yes/No) Signature of faculty (with date)

Feedback received by learner (Yes/No) Signature of learner (with date)

Integration

185

Section 7: Integration Sr. No.

Competency number and description of the activity

Maximum number of attempts allowed for the activity

No. of attempts taken by the learner (with date of each attempt)

Any remedial training needed? (Yes/No) If yes then state the reason(s)

Integration

16.

17.

18.

19.

20.

Rating 1. Scope for further improvement 2. Satisfactory (All attempts at the activity must be rated separately)

Final decision of faculty C–Completed N–Not completed

Feedback conveyed by faculty (Yes/No) Signature of faculty (with date)

Feedback received by learner (Yes/No) Signature of learner (with date)

186

Competency Based Logbook and Clinical Manual in General Surgery Section 7: Integration

(This page may be used to record the salient points of the discussion as well as any activities, assignments or assessments on the topic) Sub-topic:

Date:

1. Please describe briefly what was discussed OR details of activity/assignment/assessment:

2. What did you learn from the discussion OR the activity/assignment/assessment:

3. Do you feel that the knowledge you have acquired will help you become a better doctor? Please explain in your own words.

Feedback Received (Yes/No):

Integration

187

Section 7: Integration (This page may be used to record the salient points of the discussion as well as any activities, assignments or assessments on the topic) Sub-topic:

Date:

1. Please describe briefly what was discussed OR details of activity/assignment/assessment:

2. What did you learn from the discussion OR the activity/assignment/assessment:

3. Do you feel that the knowledge you have acquired will help you become a better doctor? Please explain in your own words.

Feedback Received (Yes/No):

188

Competency Based Logbook and Clinical Manual in General Surgery Final Summary

Sr. No.

Section

Date (dd/mm/yy)

Overall assessment (complete/incomplete)

Signature of the faculty-incharge/HOD (with date)

Competencies

Short Cases

Long Cases

Final Summary

189

Final Summary Sr. No.

Section

Date (dd/mm/yy)

Overall assessment (complete/incomplete)

Signature of the faculty-incharge/HOD (with date)

Instruments

Simulation Based Teaching A.

Certifiable Skills and Assessment of Skills

Attitude, Ethics and Communication (AETCOM)

190

Competency Based Logbook and Clinical Manual in General Surgery Final Summary

Sr. No.

Section

Date (dd/mm/yy)

Overall assessment (complete/incomplete)

Signature of the faculty-incharge/HOD (with date)

Integration