SKILLS FORM NAME: STUDENT ID NUMBER:
INTERNSHIP YEAR TRANING DURATION: FROM TO
-The intern must performed/ assisted the skill under supervision of a privileged staff.
-Please circle the department which the skill was performed/assisted.
Psychomotor Skill Department Name Signature
(A) Be able to accurately measure and record:
1-Blood pressure an adult or children (Med, GS, P, OB, ER, FM) 2-Pulse and respiratory rate (Med, GS, P, OB, ER, FM)
3-Core body temperature (Med, GS, P, OB, ER, FM)
4-Oxygen saturation levels using a pulse
oximeter (Med, GS, P, OB, ER, FM)
5-Blood sugar levels (glucometer) (Med, GS, P, OB, ER, FM) 6-Blood pressure in adult and children (Med, GS, P, OB, ER, FM) (B) Be able to safely:
1-Hand wash before and after patient contact
and procedures (Med,GS, P, ER, FM)
2-Perform venepuncture (Med, P, ER)
3-Administer an intramuscular injection (Med, ER, FM) 4-Administer a subcutaneous injection (Med,GS, FM) 5-Perform intravenous cannulation (Med,GS, P, ER) 6-Set up an intravenous infusion (ER)
7-Administer intravenous drug (GS, P, ER) 8-Order intravenous fluid and electrolyte
therapies (GS, P, ER)
9-Administer oxygen therapy (P, ER)
10-Administer nebulizer (P, ER, FM)
(C) In the cardiopulmonary system, medical education graduates will be able to accurately:
Set up and record a 12 lead electrocardiogram (GS, ER) Take and prepare for transport an arterial gas
simple (GS, P)
(D) In child health, medical education graduates will be able to accurately assess:
Infant respiratory distress (P)
Infant/child dehydration (P)
An Apgar score (P)
(E) In the gastrointestinal system, medical education graduates will be able to safely:
Insert a nasogastric tube (Med,GS, P, ER) Perform a rectal examination (Med, ER)
(F) In mental health, medical education graduates will be able to accurately:
Perform a mini-mental state examination (Med, ER)
Assess suicide risk (ER)
KING ABDULAZIZ UNIVERSITY
Faculty of Medicine Jeddah, Saudi Arabia
INTERNS EVALUATION (HOUSE OFFICERS)
(G) In the neurological system medical education graduates will be able to accurately:
Estimate a Glasgow Coma Score (Med,GS, P, ER) Identify focal neurological signs (Med,P, ER)
Identify papilloedema (ER)
(H) In ophthalmology, medical education graduates will be able to accurately (and safely):
Assess visual fields (ER)
Assess and record visual acuity (ER)
Perform eye irrigation (ER)
(I) In otolaryngology, medical education graduates will be able to accurately (and safely):
Perform otoscopy (P, ER, FM)
(J) In surgery, medical education graduates will be able to accurately (and safely):
Perform sterile dressing of wounds (GS, P, OB, ER)
Scrub, gown and glove (GS, P, OB, ER, FM)
Perform local anaesthesia (GS, OB, ER)
Suture simple wounds (GS, P, OB, ER)
Remove simple skin lesions (OB)
Remove sutures (GS, OB)
Dispose of used sharps and waste (GS, P, ER)
(K) In trauma emergencies, medical education graduates will be able to accurately (and safely):
Perform a primary trauma survey (P, ER)
Apply a cervical collar (ER)
Apply pressure haemostasis (ER)
Handle unconscious patients (ER)
(L) In the uro-genital system, medical education graduates will be able to accurately (and safely):
Test urine a dipstick (P, ER, FM)
Catheterise a male and female bladder (GS, P, ER)
(M) In women’s health, medical education graduates will be able to accurately (and safely):
Assess the fundal height (OB)
Detect foetal heart sounds (OB)
Perform urine pregnancy testing (OB) Perform a gynaecological pelvic examination (OB)
Perform a PAP smear (OB)
(N) In basic life support, medical education graduates will:
Apply the theory of basic airway management,
ventilator and circulatory support (ER) Demonstrate competency in basic airway
management, ventilator and circulatory support (ER)
(O) In advanced life support. medical education graduates will:
Perform advanced airway management
including the use of laryngeal mask (ER) Recognize malignant arrhythmias, use
resuscitation/drug protocols and manual defibrillation
(ER) Participate in decision-making and debriefing
regarding cessation of resuscitation (ER)
Psychomotor Skill Department Name Signature (P) Optional procedures
Measure peak flow
Perform and record spirometry Perform a proctoscopy
Perform a faecal occult blood analysis Perform direct ophthalmoscopy Perform an eyelid eversion Remove a corneal foreign body Perform an anterior rhinoscopy Irrigate an external auditory canal Insert an anterior nasal pack Insert an external ear canal wick Immobilise joints
Apply plaster immobilization Take a urethral swap
Demonstrate competency in the use of semi- automatic or automatic defibrillators Inject or aspirate joints