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MINI CEX PERFORMANCE FORM
INTRODUCTION/CLOSURE COMPLETED?
PATIENT
COMPLEXITY OF CASE
FOCUS
MEDICAL INTERVIEWING SKILLS
PHYSICAL EXAMINATION SKILLS
HUMANISTIC QUALITIES/PROFESSIONALISM
CLINICAL JUDGEMENT
COUNSELING SKILLS
ORGANIZATION-EFFICIENCY
OVERALL CLINICAL COMPETENCE
EMPATHY/BEDSIDE MANNER/COUNSELING COMPLETED?
EYE CONTACT MADE? PROFESSIONALISM DISPLAYED THROUGHOUT ENCOUNTER?
HISTORICAL QUESTIONS COMPLETED? ANY MISSING?
PHYSICAL EXAM COMPLETED? PLEASE SPECIFY WHICH STEPS WERE MISSED.
SPOKEN ENGLISH CLEAR? UNDERSTANDABLE? WHAT WORDS WERE MISPRONOUNCED?
MEDICAL TERMINOLOGY USED?GIVE EXAMPLES? DID DOCTOR MAKE IT EASY AND USE LAYMENS TERMS?
DIFFERENTIALS CORRECT? WHAT DID DOCTOR GIVE AS IMPRESSION? IF INCORRECT TYPE OUT WHAT IT SHOULD HAVE BEEN, IF NONE GIVEN TYPE "INCOMPLETE" THEN TYPE OUT WHAT IT SHOULD HAVE BEEN.
DIAGNOSTIC STUDIES/ TESTS GIVEN? IF INCOMPLETE TYPE "INCOMPLETE"
WAS ENCOUNTER FINISHED ON TIME? WAS ENCOUNTER ACCEPTABLE? WHAT IS DOCTORS MAIN WEAKNESS?
SANITIZED HANDS BEFORE ENCOUNTER BEFORE PHYSICAL AND BEFORE LEAVING?
OVERALL PERFORMANCE
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