Caran a re aurea Please assess and mark | NotYet | Borderline | Competent | Professional | NIA the following domains | Competent an 2) (3) (4) Pro-procedure (icone eto ‘equipment sot up ‘and organtzation, including patient comfort) ‘Professional approach ‘(including communication, consent ond consideration towards the patient) Knowledge {(0f indications, anatomy, eet equipment and technique) Max (Max possible /36): | Total Sy ee Scanned with CamScanner‘Suggestions for development (assessor comments): Opec Plas nerctores— ri pe tmeads mrhrow black | ‘Seifrefiection (to be completed by the Intern) — what did you Team 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: tv leaner fe nor yt Boek me “Agreed Action (Intern and Assessor initial): Page 2 of 2 Scanned with CamScanner