Please assess and mark the following domains (2) (3) NotYet | Borderline | Competent | Professional] NIA Pre-procedure (Room and equipment set up ‘and organkatlon, including ‘tient comfort) Professional approach ‘(including communication, | consent and consideration ‘owards the pale) (©f indications, anatomy, ‘equipment and technique) probability of success Total Max (Max possible _/36): ‘Comments: Gee adfrinert Scanned with CamScannerChie ~ Svpponvt hava WU! herp to catam any’ . ‘Suggestions for development (assessor comments): Self-reflection (fo 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: Stgpot howl 7 An rele pe ‘Agreed Action (intern and Assessor initial): Page 2 of 2 Scanned with CamScanner