Mini-CEX template

Clinical Evaluation Exercise

Name :

Clinical setting – A&E □   Outpatients Dept □    In-Patient □        Acute Admission □

Clinical problem category – Pain □ Airway/Breathing □   CVS/circulation □

Neuro □ Gastro □ Other □

Assessors Position – Consultant □ SpR □ GP □

Please tick the appropriate box	Below expectation s	Borderlin e	Meets expectation s	Above averag e	Unable to commen t
History taking
Examination skills
Communication skills
Clinical Judgement
Professionalism
Organisation/efficienc y
Overall clinical care

Comments (Anything especially good/suggestions for development)

Assessors Signature:                                           PRINT NAME

 

DATE: