Miss Claudia Appiah CID
Transcript of Miss Claudia Appiah CID
![Page 1: Miss Claudia Appiah CID](https://reader031.fdocuments.in/reader031/viewer/2022012417/61726e9ea1826e288942c5b2/html5/thumbnails/1.jpg)
COMPETENCE ACHIEVED OBSERVED BY POSITION
Measuring visual acuity
Pupillary responses
Confrontation visual field
Eye movements & cover test
Slit-lamp biomicroscopy
Ophthalmoscopy
Record of Attendance
ACTIVITY DAY SIGNED POSITION
Day 1 am
Day 1 pm
Day 2 am
Day 2 pm
Day 3 am
Day 3 pm
Day 4 am
Day 4 pm
Day 5 am
Day 5 pm
Please tick grade for each domain
Above Expectations Practical Skills
Has the student demonstrated adequate levels of competence at the practical skills and examination
deemed essential for your firm (including com pletion of in course assessment )?
Comment:
Meets Expectation
Borderline
Below Expectations
Unable to Comment
Above Expectations Communication Skills
Has the student demonstrated good communication skills (towards patients, relatives and colleagues)?
Comment:
Meets Expectation
Borderline
Below Expectations
Unable to Comment
Student Name: Attachment: Hospital: Date:
SPACE FOR
PHOTO
Year 6 Ophthalmology Assessment Form
Continued overleaf
Miss Claudia Appiah
Ophthalmology
Western Eye Hospital
6 August 2012 to 10 August 2012
CID: 513611
![Page 2: Miss Claudia Appiah CID](https://reader031.fdocuments.in/reader031/viewer/2022012417/61726e9ea1826e288942c5b2/html5/thumbnails/2.jpg)
Please indicate if the student has completed all relevant in-course assessments and satisfactorily passed the attachment.
Above Expectations
Consultant Name: Student Signature
Meets Expectations
Borderline
Signature: Date:
Below Expectations
Date:
Yes
Borderline
No Professionalism
Has the student met the requirements for the following areas of professionalism:
Appearance Comment:
Reliability and attendance
Respect for patients
Working with colleagues
Please comment on the student’s strengths:
Please comment on suggested areas of improvement:
If unable to comment on any domains, please give reasons below:
![Page 3: Miss Claudia Appiah CID](https://reader031.fdocuments.in/reader031/viewer/2022012417/61726e9ea1826e288942c5b2/html5/thumbnails/3.jpg)
COMPETENCE ACHIEVED OBSERVED BY POSITION
Measuring visual acuity
Pupillary responses
Confrontation visual field
Eye movements & cover test
Slit-lamp biomicroscopy
Ophthalmoscopy
Record of Attendance
ACTIVITY DAY SIGNED POSITION
Day 1 am
Day 1 pm
Day 2 am
Day 2 pm
Day 3 am
Day 3 pm
Day 4 am
Day 4 pm
Day 5 am
Day 5 pm
Please tick grade for each domain
Above Expectations Practical Skills
Has the student demonstrated adequate levels of competence at the practical skills and examination
deemed essential for your firm (including com pletion of in course assessment )?
Comment:
Meets Expectation
Borderline
Below Expectations
Unable to Comment
Above Expectations Communication Skills
Has the student demonstrated good communication skills (towards patients, relatives and colleagues)?
Comment:
Meets Expectation
Borderline
Below Expectations
Unable to Comment
Student Name: Attachment: Hospital: Date:
SPACE FOR
PHOTO
Year 6 Ophthalmology Assessment Form
Continued overleaf
Mr Miles Alexander Appleyard
Ophthalmology
Western Eye Hospital
6 August 2012 to 10 August 2012
CID: 513400
![Page 4: Miss Claudia Appiah CID](https://reader031.fdocuments.in/reader031/viewer/2022012417/61726e9ea1826e288942c5b2/html5/thumbnails/4.jpg)
Please indicate if the student has completed all relevant in-course assessments and satisfactorily passed the attachment.
Above Expectations
Consultant Name: Student Signature
Meets Expectations
Borderline
Signature: Date:
Below Expectations
Date:
Yes
Borderline
No Professionalism
Has the student met the requirements for the following areas of professionalism:
Appearance Comment:
Reliability and attendance
Respect for patients
Working with colleagues
Please comment on the student’s strengths:
Please comment on suggested areas of improvement:
If unable to comment on any domains, please give reasons below:
![Page 5: Miss Claudia Appiah CID](https://reader031.fdocuments.in/reader031/viewer/2022012417/61726e9ea1826e288942c5b2/html5/thumbnails/5.jpg)
COMPETENCE ACHIEVED OBSERVED BY POSITION
Measuring visual acuity
Pupillary responses
Confrontation visual field
Eye movements & cover test
Slit-lamp biomicroscopy
Ophthalmoscopy
Record of Attendance
ACTIVITY DAY SIGNED POSITION
Day 1 am
Day 1 pm
Day 2 am
Day 2 pm
Day 3 am
Day 3 pm
Day 4 am
Day 4 pm
Day 5 am
Day 5 pm
Please tick grade for each domain
Above Expectations Practical Skills
Has the student demonstrated adequate levels of competence at the practical skills and examination
deemed essential for your firm (including com pletion of in course assessment )?
Comment:
Meets Expectation
Borderline
Below Expectations
Unable to Comment
Above Expectations Communication Skills
Has the student demonstrated good communication skills (towards patients, relatives and colleagues)?
Comment:
Meets Expectation
Borderline
Below Expectations
Unable to Comment
Student Name: Attachment: Hospital: Date:
SPACE FOR
PHOTO
Year 6 Ophthalmology Assessment Form
Continued overleaf
Mr Mohsin Asharia
Ophthalmology
Western Eye Hospital
6 August 2012 to 10 August 2012
CID: 508790
![Page 6: Miss Claudia Appiah CID](https://reader031.fdocuments.in/reader031/viewer/2022012417/61726e9ea1826e288942c5b2/html5/thumbnails/6.jpg)
Please indicate if the student has completed all relevant in-course assessments and satisfactorily passed the attachment.
Above Expectations
Consultant Name: Student Signature
Meets Expectations
Borderline
Signature: Date:
Below Expectations
Date:
Yes
Borderline
No Professionalism
Has the student met the requirements for the following areas of professionalism:
Appearance Comment:
Reliability and attendance
Respect for patients
Working with colleagues
Please comment on the student’s strengths:
Please comment on suggested areas of improvement:
If unable to comment on any domains, please give reasons below:
![Page 7: Miss Claudia Appiah CID](https://reader031.fdocuments.in/reader031/viewer/2022012417/61726e9ea1826e288942c5b2/html5/thumbnails/7.jpg)
COMPETENCE ACHIEVED OBSERVED BY POSITION
Measuring visual acuity
Pupillary responses
Confrontation visual field
Eye movements & cover test
Slit-lamp biomicroscopy
Ophthalmoscopy
Record of Attendance
ACTIVITY DAY SIGNED POSITION
Day 1 am
Day 1 pm
Day 2 am
Day 2 pm
Day 3 am
Day 3 pm
Day 4 am
Day 4 pm
Day 5 am
Day 5 pm
Please tick grade for each domain
Above Expectations Practical Skills
Has the student demonstrated adequate levels of competence at the practical skills and examination
deemed essential for your firm (including com pletion of in course assessment )?
Comment:
Meets Expectation
Borderline
Below Expectations
Unable to Comment
Above Expectations Communication Skills
Has the student demonstrated good communication skills (towards patients, relatives and colleagues)?
Comment:
Meets Expectation
Borderline
Below Expectations
Unable to Comment
Student Name: Attachment: Hospital: Date:
SPACE FOR
PHOTO
Year 6 Ophthalmology Assessment Form
Continued overleaf
Miss Jayne Atkin
Ophthalmology
Western Eye Hospital
6 August 2012 to 10 August 2012
CID: 598583
![Page 8: Miss Claudia Appiah CID](https://reader031.fdocuments.in/reader031/viewer/2022012417/61726e9ea1826e288942c5b2/html5/thumbnails/8.jpg)
Please indicate if the student has completed all relevant in-course assessments and satisfactorily passed the attachment.
Above Expectations
Consultant Name: Student Signature
Meets Expectations
Borderline
Signature: Date:
Below Expectations
Date:
Yes
Borderline
No Professionalism
Has the student met the requirements for the following areas of professionalism:
Appearance Comment:
Reliability and attendance
Respect for patients
Working with colleagues
Please comment on the student’s strengths:
Please comment on suggested areas of improvement:
If unable to comment on any domains, please give reasons below:
![Page 9: Miss Claudia Appiah CID](https://reader031.fdocuments.in/reader031/viewer/2022012417/61726e9ea1826e288942c5b2/html5/thumbnails/9.jpg)
COMPETENCE ACHIEVED OBSERVED BY POSITION
Measuring visual acuity
Pupillary responses
Confrontation visual field
Eye movements & cover test
Slit-lamp biomicroscopy
Ophthalmoscopy
Record of Attendance
ACTIVITY DAY SIGNED POSITION
Day 1 am
Day 1 pm
Day 2 am
Day 2 pm
Day 3 am
Day 3 pm
Day 4 am
Day 4 pm
Day 5 am
Day 5 pm
Please tick grade for each domain
Above Expectations Practical Skills
Has the student demonstrated adequate levels of competence at the practical skills and examination
deemed essential for your firm (including com pletion of in course assessment )?
Comment:
Meets Expectation
Borderline
Below Expectations
Unable to Comment
Above Expectations Communication Skills
Has the student demonstrated good communication skills (towards patients, relatives and colleagues)?
Comment:
Meets Expectation
Borderline
Below Expectations
Unable to Comment
Student Name: Attachment: Hospital: Date:
SPACE FOR
PHOTO
Year 6 Ophthalmology Assessment Form
Continued overleaf
Mr Rohan Babla
Ophthalmology
Chelsea and Westminster Hospital
6 August 2012 to 10 August 2012
CID: 510089
![Page 10: Miss Claudia Appiah CID](https://reader031.fdocuments.in/reader031/viewer/2022012417/61726e9ea1826e288942c5b2/html5/thumbnails/10.jpg)
Please indicate if the student has completed all relevant in-course assessments and satisfactorily passed the attachment.
Above Expectations
Consultant Name: Student Signature
Meets Expectations
Borderline
Signature: Date:
Below Expectations
Date:
Yes
Borderline
No Professionalism
Has the student met the requirements for the following areas of professionalism:
Appearance Comment:
Reliability and attendance
Respect for patients
Working with colleagues
Please comment on the student’s strengths:
Please comment on suggested areas of improvement:
If unable to comment on any domains, please give reasons below:
![Page 11: Miss Claudia Appiah CID](https://reader031.fdocuments.in/reader031/viewer/2022012417/61726e9ea1826e288942c5b2/html5/thumbnails/11.jpg)
COMPETENCE ACHIEVED OBSERVED BY POSITION
Measuring visual acuity
Pupillary responses
Confrontation visual field
Eye movements & cover test
Slit-lamp biomicroscopy
Ophthalmoscopy
Record of Attendance
ACTIVITY DAY SIGNED POSITION
Day 1 am
Day 1 pm
Day 2 am
Day 2 pm
Day 3 am
Day 3 pm
Day 4 am
Day 4 pm
Day 5 am
Day 5 pm
Please tick grade for each domain
Above Expectations Practical Skills
Has the student demonstrated adequate levels of competence at the practical skills and examination
deemed essential for your firm (including com pletion of in course assessment )?
Comment:
Meets Expectation
Borderline
Below Expectations
Unable to Comment
Above Expectations Communication Skills
Has the student demonstrated good communication skills (towards patients, relatives and colleagues)?
Comment:
Meets Expectation
Borderline
Below Expectations
Unable to Comment
Student Name: Attachment: Hospital: Date:
SPACE FOR
PHOTO
Year 6 Ophthalmology Assessment Form
Continued overleaf
Mr Joseph Anthony Bacarese-Hamilton
Ophthalmology
Chelsea and Westminster Hospital
6 August 2012 to 10 August 2012
CID: 513179
![Page 12: Miss Claudia Appiah CID](https://reader031.fdocuments.in/reader031/viewer/2022012417/61726e9ea1826e288942c5b2/html5/thumbnails/12.jpg)
Please indicate if the student has completed all relevant in-course assessments and satisfactorily passed the attachment.
Above Expectations
Consultant Name: Student Signature
Meets Expectations
Borderline
Signature: Date:
Below Expectations
Date:
Yes
Borderline
No Professionalism
Has the student met the requirements for the following areas of professionalism:
Appearance Comment:
Reliability and attendance
Respect for patients
Working with colleagues
Please comment on the student’s strengths:
Please comment on suggested areas of improvement:
If unable to comment on any domains, please give reasons below:
![Page 13: Miss Claudia Appiah CID](https://reader031.fdocuments.in/reader031/viewer/2022012417/61726e9ea1826e288942c5b2/html5/thumbnails/13.jpg)
COMPETENCE ACHIEVED OBSERVED BY POSITION
Measuring visual acuity
Pupillary responses
Confrontation visual field
Eye movements & cover test
Slit-lamp biomicroscopy
Ophthalmoscopy
Record of Attendance
ACTIVITY DAY SIGNED POSITION
Day 1 am
Day 1 pm
Day 2 am
Day 2 pm
Day 3 am
Day 3 pm
Day 4 am
Day 4 pm
Day 5 am
Day 5 pm
Please tick grade for each domain
Above Expectations Practical Skills
Has the student demonstrated adequate levels of competence at the practical skills and examination
deemed essential for your firm (including com pletion of in course assessment )?
Comment:
Meets Expectation
Borderline
Below Expectations
Unable to Comment
Above Expectations Communication Skills
Has the student demonstrated good communication skills (towards patients, relatives and colleagues)?
Comment:
Meets Expectation
Borderline
Below Expectations
Unable to Comment
Student Name: Attachment: Hospital: Date:
SPACE FOR
PHOTO
Year 6 Ophthalmology Assessment Form
Continued overleaf
Mr Thomas Fraser Badenoch
Ophthalmology
Western Eye Hospital
6 August 2012 to 10 August 2012
CID: 468845
![Page 14: Miss Claudia Appiah CID](https://reader031.fdocuments.in/reader031/viewer/2022012417/61726e9ea1826e288942c5b2/html5/thumbnails/14.jpg)
Please indicate if the student has completed all relevant in-course assessments and satisfactorily passed the attachment.
Above Expectations
Consultant Name: Student Signature
Meets Expectations
Borderline
Signature: Date:
Below Expectations
Date:
Yes
Borderline
No Professionalism
Has the student met the requirements for the following areas of professionalism:
Appearance Comment:
Reliability and attendance
Respect for patients
Working with colleagues
Please comment on the student’s strengths:
Please comment on suggested areas of improvement:
If unable to comment on any domains, please give reasons below:
![Page 15: Miss Claudia Appiah CID](https://reader031.fdocuments.in/reader031/viewer/2022012417/61726e9ea1826e288942c5b2/html5/thumbnails/15.jpg)
COMPETENCE ACHIEVED OBSERVED BY POSITION
Measuring visual acuity
Pupillary responses
Confrontation visual field
Eye movements & cover test
Slit-lamp biomicroscopy
Ophthalmoscopy
Record of Attendance
ACTIVITY DAY SIGNED POSITION
Day 1 am
Day 1 pm
Day 2 am
Day 2 pm
Day 3 am
Day 3 pm
Day 4 am
Day 4 pm
Day 5 am
Day 5 pm
Please tick grade for each domain
Above Expectations Practical Skills
Has the student demonstrated adequate levels of competence at the practical skills and examination
deemed essential for your firm (including com pletion of in course assessment )?
Comment:
Meets Expectation
Borderline
Below Expectations
Unable to Comment
Above Expectations Communication Skills
Has the student demonstrated good communication skills (towards patients, relatives and colleagues)?
Comment:
Meets Expectation
Borderline
Below Expectations
Unable to Comment
Student Name: Attachment: Hospital: Date:
SPACE FOR
PHOTO
Year 6 Ophthalmology Assessment Form
Continued overleaf
Mr Kingsley Balachandran
Ophthalmology
Hillingdon Hospital
6 August 2012 to 10 August 2012
CID: 449600
![Page 16: Miss Claudia Appiah CID](https://reader031.fdocuments.in/reader031/viewer/2022012417/61726e9ea1826e288942c5b2/html5/thumbnails/16.jpg)
Please indicate if the student has completed all relevant in-course assessments and satisfactorily passed the attachment.
Above Expectations
Consultant Name: Student Signature
Meets Expectations
Borderline
Signature: Date:
Below Expectations
Date:
Yes
Borderline
No Professionalism
Has the student met the requirements for the following areas of professionalism:
Appearance Comment:
Reliability and attendance
Respect for patients
Working with colleagues
Please comment on the student’s strengths:
Please comment on suggested areas of improvement:
If unable to comment on any domains, please give reasons below:
![Page 17: Miss Claudia Appiah CID](https://reader031.fdocuments.in/reader031/viewer/2022012417/61726e9ea1826e288942c5b2/html5/thumbnails/17.jpg)
COMPETENCE ACHIEVED OBSERVED BY POSITION
Measuring visual acuity
Pupillary responses
Confrontation visual field
Eye movements & cover test
Slit-lamp biomicroscopy
Ophthalmoscopy
Record of Attendance
ACTIVITY DAY SIGNED POSITION
Day 1 am
Day 1 pm
Day 2 am
Day 2 pm
Day 3 am
Day 3 pm
Day 4 am
Day 4 pm
Day 5 am
Day 5 pm
Please tick grade for each domain
Above Expectations Practical Skills
Has the student demonstrated adequate levels of competence at the practical skills and examination
deemed essential for your firm (including com pletion of in course assessment )?
Comment:
Meets Expectation
Borderline
Below Expectations
Unable to Comment
Above Expectations Communication Skills
Has the student demonstrated good communication skills (towards patients, relatives and colleagues)?
Comment:
Meets Expectation
Borderline
Below Expectations
Unable to Comment
Student Name: Attachment: Hospital: Date:
SPACE FOR
PHOTO
Year 6 Ophthalmology Assessment Form
Continued overleaf
Mr Joshua Balogun-Lynch
Ophthalmology
Western Eye Hospital
6 August 2012 to 10 August 2012
CID: 508815
![Page 18: Miss Claudia Appiah CID](https://reader031.fdocuments.in/reader031/viewer/2022012417/61726e9ea1826e288942c5b2/html5/thumbnails/18.jpg)
Please indicate if the student has completed all relevant in-course assessments and satisfactorily passed the attachment.
Above Expectations
Consultant Name: Student Signature
Meets Expectations
Borderline
Signature: Date:
Below Expectations
Date:
Yes
Borderline
No Professionalism
Has the student met the requirements for the following areas of professionalism:
Appearance Comment:
Reliability and attendance
Respect for patients
Working with colleagues
Please comment on the student’s strengths:
Please comment on suggested areas of improvement:
If unable to comment on any domains, please give reasons below:
![Page 19: Miss Claudia Appiah CID](https://reader031.fdocuments.in/reader031/viewer/2022012417/61726e9ea1826e288942c5b2/html5/thumbnails/19.jpg)
COMPETENCE ACHIEVED OBSERVED BY POSITION
Measuring visual acuity
Pupillary responses
Confrontation visual field
Eye movements & cover test
Slit-lamp biomicroscopy
Ophthalmoscopy
Record of Attendance
ACTIVITY DAY SIGNED POSITION
Day 1 am
Day 1 pm
Day 2 am
Day 2 pm
Day 3 am
Day 3 pm
Day 4 am
Day 4 pm
Day 5 am
Day 5 pm
Please tick grade for each domain
Above Expectations Practical Skills
Has the student demonstrated adequate levels of competence at the practical skills and examination
deemed essential for your firm (including com pletion of in course assessment )?
Comment:
Meets Expectation
Borderline
Below Expectations
Unable to Comment
Above Expectations Communication Skills
Has the student demonstrated good communication skills (towards patients, relatives and colleagues)?
Comment:
Meets Expectation
Borderline
Below Expectations
Unable to Comment
Student Name: Attachment: Hospital: Date:
SPACE FOR
PHOTO
Year 6 Ophthalmology Assessment Form
Continued overleaf
Mr Jermaine Bamfo
Ophthalmology
Hillingdon Hospital
6 August 2012 to 10 August 2012
CID: 470992
![Page 20: Miss Claudia Appiah CID](https://reader031.fdocuments.in/reader031/viewer/2022012417/61726e9ea1826e288942c5b2/html5/thumbnails/20.jpg)
Please indicate if the student has completed all relevant in-course assessments and satisfactorily passed the attachment.
Above Expectations
Consultant Name: Student Signature
Meets Expectations
Borderline
Signature: Date:
Below Expectations
Date:
Yes
Borderline
No Professionalism
Has the student met the requirements for the following areas of professionalism:
Appearance Comment:
Reliability and attendance
Respect for patients
Working with colleagues
Please comment on the student’s strengths:
Please comment on suggested areas of improvement:
If unable to comment on any domains, please give reasons below:
![Page 21: Miss Claudia Appiah CID](https://reader031.fdocuments.in/reader031/viewer/2022012417/61726e9ea1826e288942c5b2/html5/thumbnails/21.jpg)
COMPETENCE ACHIEVED OBSERVED BY POSITION
Measuring visual acuity
Pupillary responses
Confrontation visual field
Eye movements & cover test
Slit-lamp biomicroscopy
Ophthalmoscopy
Record of Attendance
ACTIVITY DAY SIGNED POSITION
Day 1 am
Day 1 pm
Day 2 am
Day 2 pm
Day 3 am
Day 3 pm
Day 4 am
Day 4 pm
Day 5 am
Day 5 pm
Please tick grade for each domain
Above Expectations Practical Skills
Has the student demonstrated adequate levels of competence at the practical skills and examination
deemed essential for your firm (including com pletion of in course assessment )?
Comment:
Meets Expectation
Borderline
Below Expectations
Unable to Comment
Above Expectations Communication Skills
Has the student demonstrated good communication skills (towards patients, relatives and colleagues)?
Comment:
Meets Expectation
Borderline
Below Expectations
Unable to Comment
Student Name: Attachment: Hospital: Date:
SPACE FOR
PHOTO
Year 6 Ophthalmology Assessment Form
Continued overleaf
Mr Unmesh Bandyopadhyay
Ophthalmology
Western Eye Hospital
6 August 2012 to 10 August 2012
CID: 471651
![Page 22: Miss Claudia Appiah CID](https://reader031.fdocuments.in/reader031/viewer/2022012417/61726e9ea1826e288942c5b2/html5/thumbnails/22.jpg)
Please indicate if the student has completed all relevant in-course assessments and satisfactorily passed the attachment.
Above Expectations
Consultant Name: Student Signature
Meets Expectations
Borderline
Signature: Date:
Below Expectations
Date:
Yes
Borderline
No Professionalism
Has the student met the requirements for the following areas of professionalism:
Appearance Comment:
Reliability and attendance
Respect for patients
Working with colleagues
Please comment on the student’s strengths:
Please comment on suggested areas of improvement:
If unable to comment on any domains, please give reasons below:
![Page 23: Miss Claudia Appiah CID](https://reader031.fdocuments.in/reader031/viewer/2022012417/61726e9ea1826e288942c5b2/html5/thumbnails/23.jpg)
COMPETENCE ACHIEVED OBSERVED BY POSITION
Measuring visual acuity
Pupillary responses
Confrontation visual field
Eye movements & cover test
Slit-lamp biomicroscopy
Ophthalmoscopy
Record of Attendance
ACTIVITY DAY SIGNED POSITION
Day 1 am
Day 1 pm
Day 2 am
Day 2 pm
Day 3 am
Day 3 pm
Day 4 am
Day 4 pm
Day 5 am
Day 5 pm
Please tick grade for each domain
Above Expectations Practical Skills
Has the student demonstrated adequate levels of competence at the practical skills and examination
deemed essential for your firm (including com pletion of in course assessment )?
Comment:
Meets Expectation
Borderline
Below Expectations
Unable to Comment
Above Expectations Communication Skills
Has the student demonstrated good communication skills (towards patients, relatives and colleagues)?
Comment:
Meets Expectation
Borderline
Below Expectations
Unable to Comment
Student Name: Attachment: Hospital: Date:
SPACE FOR
PHOTO
Year 6 Ophthalmology Assessment Form
Continued overleaf
Miss Danielle Banfield
Ophthalmology
Western Eye Hospital
6 August 2012 to 10 August 2012
CID: 554971
![Page 24: Miss Claudia Appiah CID](https://reader031.fdocuments.in/reader031/viewer/2022012417/61726e9ea1826e288942c5b2/html5/thumbnails/24.jpg)
Please indicate if the student has completed all relevant in-course assessments and satisfactorily passed the attachment.
Above Expectations
Consultant Name: Student Signature
Meets Expectations
Borderline
Signature: Date:
Below Expectations
Date:
Yes
Borderline
No Professionalism
Has the student met the requirements for the following areas of professionalism:
Appearance Comment:
Reliability and attendance
Respect for patients
Working with colleagues
Please comment on the student’s strengths:
Please comment on suggested areas of improvement:
If unable to comment on any domains, please give reasons below:
![Page 25: Miss Claudia Appiah CID](https://reader031.fdocuments.in/reader031/viewer/2022012417/61726e9ea1826e288942c5b2/html5/thumbnails/25.jpg)
COMPETENCE ACHIEVED OBSERVED BY POSITION
Measuring visual acuity
Pupillary responses
Confrontation visual field
Eye movements & cover test
Slit-lamp biomicroscopy
Ophthalmoscopy
Record of Attendance
ACTIVITY DAY SIGNED POSITION
Day 1 am
Day 1 pm
Day 2 am
Day 2 pm
Day 3 am
Day 3 pm
Day 4 am
Day 4 pm
Day 5 am
Day 5 pm
Please tick grade for each domain
Above Expectations Practical Skills
Has the student demonstrated adequate levels of competence at the practical skills and examination
deemed essential for your firm (including com pletion of in course assessment )?
Comment:
Meets Expectation
Borderline
Below Expectations
Unable to Comment
Above Expectations Communication Skills
Has the student demonstrated good communication skills (towards patients, relatives and colleagues)?
Comment:
Meets Expectation
Borderline
Below Expectations
Unable to Comment
Student Name: Attachment: Hospital: Date:
SPACE FOR
PHOTO
Year 6 Ophthalmology Assessment Form
Continued overleaf
Miss Venetia Flavia Barrett
Ophthalmology
Western Eye Hospital
6 August 2012 to 10 August 2012
CID: 431213
![Page 26: Miss Claudia Appiah CID](https://reader031.fdocuments.in/reader031/viewer/2022012417/61726e9ea1826e288942c5b2/html5/thumbnails/26.jpg)
Please indicate if the student has completed all relevant in-course assessments and satisfactorily passed the attachment.
Above Expectations
Consultant Name: Student Signature
Meets Expectations
Borderline
Signature: Date:
Below Expectations
Date:
Yes
Borderline
No Professionalism
Has the student met the requirements for the following areas of professionalism:
Appearance Comment:
Reliability and attendance
Respect for patients
Working with colleagues
Please comment on the student’s strengths:
Please comment on suggested areas of improvement:
If unable to comment on any domains, please give reasons below:
![Page 27: Miss Claudia Appiah CID](https://reader031.fdocuments.in/reader031/viewer/2022012417/61726e9ea1826e288942c5b2/html5/thumbnails/27.jpg)
COMPETENCE ACHIEVED OBSERVED BY POSITION
Measuring visual acuity
Pupillary responses
Confrontation visual field
Eye movements & cover test
Slit-lamp biomicroscopy
Ophthalmoscopy
Record of Attendance
ACTIVITY DAY SIGNED POSITION
Day 1 am
Day 1 pm
Day 2 am
Day 2 pm
Day 3 am
Day 3 pm
Day 4 am
Day 4 pm
Day 5 am
Day 5 pm
Please tick grade for each domain
Above Expectations Practical Skills
Has the student demonstrated adequate levels of competence at the practical skills and examination
deemed essential for your firm (including com pletion of in course assessment )?
Comment:
Meets Expectation
Borderline
Below Expectations
Unable to Comment
Above Expectations Communication Skills
Has the student demonstrated good communication skills (towards patients, relatives and colleagues)?
Comment:
Meets Expectation
Borderline
Below Expectations
Unable to Comment
Student Name: Attachment: Hospital: Date:
SPACE FOR
PHOTO
Year 6 Ophthalmology Assessment Form
Continued overleaf
Miss Kylie Emma Louise Beale
Ophthalmology
Western Eye Hospital
6 August 2012 to 10 August 2012
CID: 390479
![Page 28: Miss Claudia Appiah CID](https://reader031.fdocuments.in/reader031/viewer/2022012417/61726e9ea1826e288942c5b2/html5/thumbnails/28.jpg)
Please indicate if the student has completed all relevant in-course assessments and satisfactorily passed the attachment.
Above Expectations
Consultant Name: Student Signature
Meets Expectations
Borderline
Signature: Date:
Below Expectations
Date:
Yes
Borderline
No Professionalism
Has the student met the requirements for the following areas of professionalism:
Appearance Comment:
Reliability and attendance
Respect for patients
Working with colleagues
Please comment on the student’s strengths:
Please comment on suggested areas of improvement:
If unable to comment on any domains, please give reasons below:
![Page 29: Miss Claudia Appiah CID](https://reader031.fdocuments.in/reader031/viewer/2022012417/61726e9ea1826e288942c5b2/html5/thumbnails/29.jpg)
COMPETENCE ACHIEVED OBSERVED BY POSITION
Measuring visual acuity
Pupillary responses
Confrontation visual field
Eye movements & cover test
Slit-lamp biomicroscopy
Ophthalmoscopy
Record of Attendance
ACTIVITY DAY SIGNED POSITION
Day 1 am
Day 1 pm
Day 2 am
Day 2 pm
Day 3 am
Day 3 pm
Day 4 am
Day 4 pm
Day 5 am
Day 5 pm
Please tick grade for each domain
Above Expectations Practical Skills
Has the student demonstrated adequate levels of competence at the practical skills and examination
deemed essential for your firm (including com pletion of in course assessment )?
Comment:
Meets Expectation
Borderline
Below Expectations
Unable to Comment
Above Expectations Communication Skills
Has the student demonstrated good communication skills (towards patients, relatives and colleagues)?
Comment:
Meets Expectation
Borderline
Below Expectations
Unable to Comment
Student Name: Attachment: Hospital: Date:
SPACE FOR
PHOTO
Year 6 Ophthalmology Assessment Form
Continued overleaf
Mr Thomas Beaney
Ophthalmology
Charing Cross Hospital
6 August 2012 to 10 August 2012
CID: 598070
![Page 30: Miss Claudia Appiah CID](https://reader031.fdocuments.in/reader031/viewer/2022012417/61726e9ea1826e288942c5b2/html5/thumbnails/30.jpg)
Please indicate if the student has completed all relevant in-course assessments and satisfactorily passed the attachment.
Above Expectations
Consultant Name: Student Signature
Meets Expectations
Borderline
Signature: Date:
Below Expectations
Date:
Yes
Borderline
No Professionalism
Has the student met the requirements for the following areas of professionalism:
Appearance Comment:
Reliability and attendance
Respect for patients
Working with colleagues
Please comment on the student’s strengths:
Please comment on suggested areas of improvement:
If unable to comment on any domains, please give reasons below:
![Page 31: Miss Claudia Appiah CID](https://reader031.fdocuments.in/reader031/viewer/2022012417/61726e9ea1826e288942c5b2/html5/thumbnails/31.jpg)
COMPETENCE ACHIEVED OBSERVED BY POSITION
Measuring visual acuity
Pupillary responses
Confrontation visual field
Eye movements & cover test
Slit-lamp biomicroscopy
Ophthalmoscopy
Record of Attendance
ACTIVITY DAY SIGNED POSITION
Day 1 am
Day 1 pm
Day 2 am
Day 2 pm
Day 3 am
Day 3 pm
Day 4 am
Day 4 pm
Day 5 am
Day 5 pm
Please tick grade for each domain
Above Expectations Practical Skills
Has the student demonstrated adequate levels of competence at the practical skills and examination
deemed essential for your firm (including com pletion of in course assessment )?
Comment:
Meets Expectation
Borderline
Below Expectations
Unable to Comment
Above Expectations Communication Skills
Has the student demonstrated good communication skills (towards patients, relatives and colleagues)?
Comment:
Meets Expectation
Borderline
Below Expectations
Unable to Comment
Student Name: Attachment: Hospital: Date:
SPACE FOR
PHOTO
Year 6 Ophthalmology Assessment Form
Continued overleaf
Miss Hannah Beckett
Ophthalmology
Charing Cross Hospital
6 August 2012 to 10 August 2012
CID: 597668
![Page 32: Miss Claudia Appiah CID](https://reader031.fdocuments.in/reader031/viewer/2022012417/61726e9ea1826e288942c5b2/html5/thumbnails/32.jpg)
Please indicate if the student has completed all relevant in-course assessments and satisfactorily passed the attachment.
Above Expectations
Consultant Name: Student Signature
Meets Expectations
Borderline
Signature: Date:
Below Expectations
Date:
Yes
Borderline
No Professionalism
Has the student met the requirements for the following areas of professionalism:
Appearance Comment:
Reliability and attendance
Respect for patients
Working with colleagues
Please comment on the student’s strengths:
Please comment on suggested areas of improvement:
If unable to comment on any domains, please give reasons below: