Skill Performance Evaluation: Rectal Examination

Directions: You will have 5 minutes to complete the skill. All critical (C) steps and 80% of the noncritical steps
must be performed or verbalized.
Start: End:
Performed Verbalized

Washes hands and dons appropriate personal protective equipment C

Introduces self to patient using first and last name. Y/N

Notes general appearance and vital signs. Y/N

Positions the patient. Y/N

Inspection
1. Explain inspection steps to patient Y/N
2. Note: sacrococcygeal or perianal lesions, masses, ulcers, inflammation, rashes,
Y/N
excoriations, tufts of hair
Palpation
Anal canal
1. Lubricate finger and place on anus, ask patient to strain Y/N

2. Reassure patient Y/N

3. Insert finger with relaxation of sphincter and aim for umbilicus Y/N

4. Note: sphincter tone, tenderness, induration, irregularities, or nodules. Y/N

Rectum
1. Advance finger to the rectum Y/N

2. Rotate hand clockwise and counterclockwise to palpate bilaterally and posteriorly Y/N

3. Palpate for nodules, irregularities, induration Y/N

Posterior prostate gland (male patients)
1. Tell patient that you will be going to feel the prostate gland and he may feel an urge to
Y/N
urinate.
2. Sweep finger over the prostate gland and note its size, shape, and consistency; any
Y/N Y/N
nodules or tenderness
Remove fingers and note character of fecal matter; test for occult blood. Y/N

Adequate exposure was maintained for all inspection steps. C

Adequate draping was maintained for all steps. C

Evaluation: #Y = #C =
min. = 13/16 min. = 3
Comments on quality of performance: Needs remediation?

Y/N

Student: Evaluator: Date:

Developed by Albany Medical College, Center for Physician Assistant Studies | Bickley: Bates’ Guide to Physical Examination
and History Taking, Twelfth Edition. Copyright © 2017 Wolters Kluwer Health