CRITERIA FOR ASSESSMENT

PAEDIATRICS & CHILD HEALTH LONG CASE OF PERFORMANCE

ASSESSMENT DOMAINS > ACCURACY OF ACCURACY OF THE SYNTHESIS & UNDERSTANDING THE IMPACT DEVELOPMENT AND DISCUSSION
HISTORY CLINICAL PRIORITISATION OF OF THE ILLNESS ON THE OF AN APPROPRIATE
EXAMINATION CLINICAL PROBLEMS PATIENT AND FAMILY MANAGEMENT PLAN

6
Excellent • Sophisticated interpretation
of the history
Performance
• Focuses on key issues
• Shows perceptiveness in
extracting difficult information
• No need to clarify details
• Actively seeks subtle
signs that might enhance
diagnosis
• Superior organisation of
difficult examination
• No need to clarify details
• Identifies all major and minor
problems
• Very careful prioritisation which
includes a long term view
• Recognises social impact of
disease
• Shows mature understanding of
subtle, difficult, or intimate aspects of
patient’s functioning
• Demonstrates balance when
discussing issues and sophisticated
use of external social support
• Superior construction of management plan, including
long term impact
• Highly developed and discriminating use of investigations
• Mature recognition and interpretation of inconsistent
results

5
• Emphasis on appropriate • Includes important • Confidently identifies • Shows persistence in exploring • Proposes appropriate management plan with good
Better than details relative negative signs essential problems subtle psychological issues, or understanding of social impact lifestyle and psychological
Expected • Appreciates subtleties • Appreciates significance • Shows maturity in issues that impact on the patient or aspects of disease
Standard • Interprets significant aspects of more subtle signs recognising lesser issues family • Good use of discriminating investigations

4
of the history • Accurate interpretation of results
LEVEL OF PERFORMANCE

• Reasonably complete,
Expected accurate and detailed history
Standard • Minimal need to clarify details
• Timely and well structured
• Correctly identifies most
important physical signs
• Identifies all key problems
• Arranges problems in order
of priority
• Understands patient’s physical and
psychological functioning in relation
to disease
• Appreciates impact of treatment and
prognosis on patient and family
• Proposes an appropriate and realistic management plan
for the major issues
• Provides a sensible, balanced approach to investigations
• Interprets most investigations correctly

3
• Some interpretation • Recognises important side effects of proposed treatment

• Incomplete, inadequately • Omission and/or incorrect • Problems poorly prioritised • Fails to recognise some important • Some errors in arranging a management plan
Below detailed and/or inaccurate reporting of some aspects of the disease on patient or
• Significant problems • Erratic and non-discriminatory use of investigations
Expected history, and/or poorly timed important signs undervalued family • Errors in the interpretation of tests
Standard • Need to clarify important • Misses some aspects affecting • Lacking adequate appreciation of complications
details functioning or reaction to illness of treatment

2
Well Below • Poorly organised • Many significant signs not • Poor understanding of • Poor understanding of the impact of • Inappropriate or poorly directed management plan
• Incomplete, inadequately recognised significant problems disease on patient and family • Poor understanding of useful investigations
Expected
detailed and/or inaccurate • Requires substantial • Shows little concern about • Inability to interpret investigations
Standard history, and/or poorly timed prompting psychological aspects • Major inability to appreciate side effects of treatment
• Inaccuracies or lack of detail
• Repetitive, poorly structured

1
• Historical details not clarified

• No clear structure • Minimal attention to detail • Most key management • Impact of disease not explored at all, • Poorly directed management plan without consideration
Very Poor with the examination issues unidentified or unable to be discussed of major issues
• Focused only on single
Performance problem • No attempt to establish • Very poor ordering of investigations without consideration
• Minimal detail priority of expense or potential complications
• No attempt to interpret investigations
• No understanding of side effects of treatment

EPA EPA 1, EPA2 EPA 1 EPA 1 EPA 1, EPA2 EPA 1, EPA4, EPA 6
Competencies Medical expertise, Medical expertise Medical expertise, judgement Medical expertise, communication, Medical expertise, communication, ethics and professional
communication, (cultural and decision making ethics and professional behaviour, behaviour, judgement and decision making
competence) judgement and decision making, (cultural
competence)

NOTE: In coming to an overall assessment score, not all domains will be equally weighted or always applicable due to variability of patient cases Version 1.6 ● April 2020
 CRITERIA FOR ASSESSMENT
PAEDIATRICS & CHILD HEALTH SHORT CASE OF PERFORMANCE

ASSESSMENT DOMAINS > INTERACTION WITH EXAMINATION EXAMINATION INTERPRETATION AND SYNTHESIS OF INVESTIGATIONS/
PATIENT/FAMILY TECHNIQUE ACCURACY PHYSICAL FINDINGS MANAGEMENT
Candidates SHOULD achieve the
expected standard in terms of their

6
interaction with the patient/family

Excellent • Exceeds expected standard • Highly fluent, accurate and within
time
Performance
• Makes adjustment to routine
where appropriate
• Includes and completes additional
complimentary examination
• Correctly identifies all
essential and desirable signs
• Establishes the most likely diagnosis on the basis of
examination
• Provides a reasonable differential diagnosis based on
physical findings
• Considers all likely alternatives with a
higher level justification
• Correctly interprets investigations
and integrates with examination
findings without prompting
• Recognises and discusses areas
of doubt
• Uses results to support differential

5
elements unprompted • Able to rule out unlikely diagnoses diagnosis and discussion

Better than • Meets expected standard • Fluent and accurate and within • Correctly identifies all • Identifies the most likely diagnosis. • Correctly interprets all major
time essential and most desirable • Provides a reasonable differential diagnosis based on investigations
Expected signs
• Makes adjustment to routine physical findings
Standard where appropriate • Considers likely alternatives with justification

4
• Introduces him/herself to the patient • Undertakes systematic • Detects most essential signs • Provides sensible provisional diagnosis and discusses • Reasonable interpretation of
LEVEL OF PERFORMANCE

Expected • Shows respect for patient as
Standard indicated by preservation of patient’s
modesty, seeking permission for
sensitive aspects of examination
• Recognises and modifies
examination when painful
examination of required area
or system without unnecessary
duplication
• Demonstrates confidence in the
examination
• Completes assigned tasks in
• Reports significant
negative findings
• Does not find major signs
that are not present
appropriate differential diagnoses investigations
• Recognises most inconsistencies in interpretation and • Suggests appropriate line of
findings investigation and integrates them
• Requires minimal prompting with examination findings
• Does not propose diagnoses inconsistent with signs

3
appropriate time

• Inappropriate and insensitive • Examination incomplete or lacking • Misses essential signs • Not confident with a diagnosis and/or provides • Does not offer appropriate
Below approach to patient fluency or systematic approach. diagnoses not consistent with signs investigations
• Fails to look for or identify
Expected • Includes unnecessary duplication important negative findings • List of differential diagnoses poorly developed and/or • Misinterprets or is unable to
Standard inconsistent with signs integrate investigations with
• Unable to consider alternative explanations for findings examination findings
• Requires more than minor prompting to reconsider

2
options

• Unduly rough, clumsy or causes • Very slow and requires substantial • Misses essential signs • Unable to suggest a reasonable diagnosis • Unable to use investigations to
Well Below pain without adjustment or apology prompting and guidance assist in diagnosis
• Finds abnormalities that are • Advances diagnoses inconsistent with signs
Expected • Required examination incomplete not present • Requires substantial prompting • Inappropriate dependence on
Standard • Fails to look for important • Unable to reconsider additional information which may investigations

1
negative findings alter diagnosis

Very Poor • Requiring examiners to intervene • Slow examination not completed in • Misses all essential signs • Unable to suggest a reasonable diagnosis • Unable to suggest reasonable
appropriate time • Finds abnormalities that are • Unable to interpret the physical signs elicited investigations
Performance
• Cannot perform appropriate not present • Misinterprets information provided
examination of system • Fails to look for important
negative findings

EPA EPA 1, EPA 2 EPA 1 EPA 1 EPA 1 EPA 1, EPA 6

Competencies Medical expertise, communication, Medical expertise, judgement and Medical expertise, judgement Medical expertise, judgement and decision making Medical expertise, judgement and
ethics and professional behaviour decision making and decision making decision making

NOTE: In coming to an overall assessment score, not all domains will be equally weighted or always applicable due to variability of patient cases Version 1.6 ● April 2020