Tibial Fracture Fixation Team Logo.jpg

Attachment B - Pre-Learning Clinical Confidence Assessment[edit | edit source]

Learner Identification
Date of Assessment (Year-Month-Day):
Name (First Name, Last Name):
De-Identified Unique Study Code for Learner:
Age (years):
Gender: πŸ”² Male

πŸ”² Female

πŸ”² Non-Binary

Country of Practice:
Contact Information (email):
Country Code + Phone Number:
πŸ”² Clinician Status: πŸ”² Resident

πŸ”² Attending Physician

πŸ”² Attending Surgeon

Discipline/Specialty: πŸ”² Medical Officer (Non-Specialist Physician)

πŸ”² General Surgery

πŸ”² Neurological Surgery

πŸ”² Obstetrics and Gynecology

πŸ”² Ophthalmic Surgery

πŸ”² Oral and Maxillofacial Surgery

πŸ”² Otolaryngology

πŸ”² Pediatric Surgery

πŸ”² Plastic and Reconstructive Surgery

πŸ”² Thoracic Surgery

πŸ”² Urology

πŸ”² Vascular Surgery

πŸ”² Other:________________________

Total Years of Post-Fellowship Clinical Practice

Experience:

Work Environment: πŸ”² Community facility

πŸ”² Primary health center

πŸ”² First-level hospital

πŸ”² Second-level hospital

πŸ”² Third-level hospital

Total Years of Residency and Fellowship Training Completed:
Clinical Skill To Be Tested: Modular External Fixation of an Open Tibial Shaft Fracture
Amount of Experience or Training With Modular External Fixation of an Open Tibial Shaft Fracture To Date:

For this pre-learning clinical confidence assessment, please rate your responses from 1-5, with 1 being β€œDisagree” to 5 being β€œAgree.

Cognitive
I know how to perform modular external fixation of an open tibial shaft fracture. Disagree 1 2 3 4 5 Agree
I understand the content of modular external fixation of an open tibial 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 tibial 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 tibial shaft fracture. Disagree 1 2 3 4 5 Agree
I can smoothly complete the operation steps of modular external fixation of an open tibial shaft fracture. Disagree 1 2 3 4 5 Agree
I can monitor my modular external fixation of an open tibial shaft fracture for improvements Disagree 1 2 3 4 5 Agree
I can monitor my modular external fixation of an open tibial 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

Attachment C. Post-Learning Clinical Confidence Assessment[edit | edit source]

Tibial Fracture Fixation Team Logo.jpg
Learner Identification
Date of Assessment (Year-Month-Day):
Name (First Name, Last Name):
De-Identified Unique Study Code for Learner:
Age (years):
Gender: πŸ”² Male

πŸ”² Female

πŸ”² Non-Binary

Country of Practice:
Contact Information (email):
Country Code + Phone Number:
πŸ”² Clinician Status: πŸ”² Resident

πŸ”² Attending Physician

πŸ”² Attending Surgeon

Discipline/Specialty:

πŸ”² Medical Officer (Non-Specialist Physician)

πŸ”² General Surgery

πŸ”² Neurological Surgery

πŸ”² Obstetrics and Gynecology

πŸ”² Ophthalmic Surgery

πŸ”² Oral and Maxillofacial Surgery

πŸ”² Otolaryngology

πŸ”² Pediatric Surgery

πŸ”² Plastic and Reconstructive Surgery

πŸ”² Thoracic Surgery

πŸ”² Urology

πŸ”² Vascular Surgery

πŸ”² Other:________________________

Total Years of Post-Fellowship Clinical Practice

Experience:

Work Environment: πŸ”² Community facility

πŸ”² Primary health center

πŸ”² First-level hospital

πŸ”² Second-level hospital

πŸ”² Third-level hospital

Total Years of Residency and Fellowship Training Completed:
Clinical Skill To Be Tested: Modular External Fixation of an Open Tibial Shaft Fracture
Amount of Experience or Training With Modular External Fixation of an Open Tibial Shaft Fracture To Date:
Amount of Experience or Training With Modular External Fixation of an Open Tibial Shaft Fracture To Date:
Date Range Over Which the Training Materials Were Accessed (Year-Month-Day to Year-Month-Day):
Hours of Study of Online Materials:
Number of Times Procedure Was Practiced With the Simulator:
Duration of Simulator Practice Time:
Site of Clinical Evaluation (Facility Name, City, Country):
Clinical Evaluator(s):
Number of Procedures in Patients


For this post-learning clinical confidence assessment, please rate your responses from 1-5, with 1 being β€œDisagree” to 5 being β€œAgree.”

Cognitive
I know how to perform modular external fixation of an open tibial shaft fracture. Disagree 1 2 3 4 5 Agree
I understand the content of modular external fixation of an open tibial 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 tibial 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 tibial shaft fracture. Disagree 1 2 3 4 5 Agree
I can smoothly complete the operation steps of modular external fixation of an open tibial shaft fracture. Disagree 1 2 3 4 5 Agree
I can monitor my modular external fixation of an open tibial shaft fracture for improvements Disagree 1 2 3 4 5 Agree
I can monitor my modular external fixation of an open tibial 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.0209155

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