SCHOOL OF MEDICAL LABORATORY SCIENCE – INTERNSHIP PROGRAM

RETURN DEMONSTRATION – DIRECT FECAL SMEAR

Name: Date:
Score:
Agency Rotation:
:

Assessment 1 2 3 4 5 SCORE
Dimension REFER BEGINNER COMPETENT PROFICIENT EXEMPLARY
No Knowledge Limited Adequate Remarkable Professional
Knowledge Knowledge Knowledge Knowledge
Pre-Analytical Phase
Disinfection of Very Undesirable Neutral Desirable Very desirable
Working Area undesirable
disinfection of
disinfection of
working area
disinfection of
working area
disinfection of
working area
disinfection of
working area
working area
Analytical Phase
Dropping of Very undesirable Undesirable Slightly desirable Desirable dropping Perfectly
saine and dropping of dropping of both dropping of both of both solution on desirable
both solution on solution on slide solution on slide slide dropping of both
iodine slide solution on slide
solution on
slide
Picking stool Absolutely Inappropriate Slightly Appropriate picking Absolutely
sample inappropriate picking of stool appropriate of stool sample appropriate
picking of stool sample picking of stool picking of stool
sample sample
Placing of Totally Inappropriate Slightly Appropriate placing Perfectly
coverslip on inappropriate placing of appropriate of coverslip appropriate
placing of coverslip placing of placing of
both smears coverslip coverslip coverslip

Post-Analytical Phase
Recording of Very undesirable Undesirable Desirable Very desirable Absolutely
Results recording of recording of recording of recording of results appropriate
results results results recording of
results
Disposal of Absolutely Inappropriate Slightly Appropriate Absolutely
Soiled or inappropriate disposal of soiled appropriate disposal of soiled or appropriate
disposal of or contaminated disposal of soiled contaminated disposal of soiled
Contaminated soiled or materials or contaminated materials or contaminated
Materials contaminated materials materials
materials
Cleaning of Totally Unacceptable Slightly Acceptable cleaning Perfectly
the Area unacceptable cleaning of area acceptable of area acceptable
cleaning of area cleaning of area cleaning of area
 SCHOOL OF MEDICAL LABORATORY SCIENCE – INTERNSHIP PROGRAM
Handwashing Totally Unacceptable Slightly Acceptable Perfectly
unacceptable handwashing acceptable handwashing acceptable
handwashing handwashing handwashing

TOTAL: