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4) (2)
‘Competent
3)
Professional | NIA
(4)
‘Pre-procedure
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Professional approach
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7
(Ot dications, anatomy,
‘equipment and technique)
7
‘Technical aspects of
(out inca perermance
useful return)
“JN
NIN
Total
Max (Max possible /36):
‘Comments:
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‘Self-reflection (to be completed by the Intern) - what did you learn from this experience,
‘what would you do differently next time. What steps can you implement to ensure the next
time you perform this procedure you will do it more professionally:
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‘Agreed Action (Intern and Assessor initial):
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