Pre-Learning Clinical Confidence Assessment[edit | edit source]
Learner Identification | |
---|---|
Date of Assessment (Year-Month-Day): | |
Name (First Name, Last Name): | |
Age (years): | |
Gender: | 🔲 Male 🔲 Female 🔲 Non-Binary |
Country of Practice: | |
Contact Information (email): | |
Country Code + Phone Number: | |
Clinician Status: | 🔲 Resident 🔲 Attending Physician 🔲 Attending Surgeon |
Discipline/Specialty: | 🔲 Medical Officer (Non-Specialist Physician) 🔲 General Surgery 🔲 Neurological Surgery 🔲 Obstetrics and Gynecology 🔲 Ophthalmic Surgery 🔲 Oral and Maxillofacial Surgery 🔲 Otolaryngology 🔲 Pediatric Surgery 🔲 Plastic and Reconstructive Surgery 🔲 Thoracic Surgery 🔲 Urology 🔲 Vascular Surgery 🔲 Other:________________________ |
Total Years of Post-Fellowship Clinical Practice Experience: | |
Work Environment: | 🔲 Community facility 🔲 Primary health center 🔲 First-level hospital 🔲 Second-level hospital 🔲 Third-level hospital |
Total Years of Residency and Fellowship Training Completed: | |
Clinical Skill To Be Tested: | Modular External Fixation of an Open Humeral Shaft Fracture |
Amount of Experience or Training With Modular External Fixation of an Open Humeral Shaft Fracture To Date: |
For this pre-learning clinical confidence assessment, please rate your responses from 1-5, with 1 being “Disagree” to 5 being “Agree.
Cognitive | |||||||
---|---|---|---|---|---|---|---|
I know how to perform modular external fixation of an open humeral shaft fracture. | Disagree | 1 | 2 | 3 | 4 | 5 | Agree |
I understand the content of modular external fixation of an open humeral shaft fracture and can demonstrate it to others. | Disagree | 1 | 2 | 3 | 4 | 5 | Agree |
I can verbally explain the purpose and principle of operating modular external fixation of an open humeral shaft fracture. | Disagree | 1 | 2 | 3 | 4 | 5 | Agree |
I can verbally explain the sequence and interrelationship between each step. | Disagree | 1 | 2 | 3 | 4 | 5 | Agree |
Psychomotor | |||||||
I can precisely imitate the instructed steps and actions of modular external fixation of an open humeral shaft fracture. | Disagree | 1 | 2 | 3 | 4 | 5 | Agree |
I can smoothly complete the operation steps of modular external fixation of an open humeral shaft fracture. | Disagree | 1 | 2 | 3 | 4 | 5 | Agree |
I can monitor my modular external fixation of an open humeral shaft fracture for improvements | Disagree | 1 | 2 | 3 | 4 | 5 | Agree |
I can monitor my modular external fixation of an open humeral shaft fracture operations and make proper adjustments as needed | Disagree | 1 | 2 | 3 | 4 | 5 | Agree |
Adapted from the L-SES (Learning Self-Efficacy Scale) for Clinical skill assessment described in Kang Y-N, Chang C-H, Kao C-C, Chen C-Y, Wu C-C (2019) Development of a short and universal learning self-efficacy scale for clinical skills. PLoS ONE 14(1): e0209155. https://doi.org/10.1371/journal.pone.020915
Acknowledgements[edit | edit source]
This work is funded by a grant from the Intuitive Foundation. Any research, findings, conclusions, or recommendations expressed in this work are those of the author(s), and not of the Intuitive Foundation.