Examinee knocked on the door before entering.
_9225
threshold:
Rating Description
3.0 pts_3172
This area will be used by the assessor to leave
comments related to this criterion.
/
5.0 pts
--
Examinee introduced self by name.
_3180
threshold:
Rating Description
3.0 pts_3701
This area will be used by the assessor to leave
comments related to this criterion.
/
5.0 pts
--
Examinee identified his/her role or position.
_4006
threshold:
Rating Description
3.0 pts_5047
This area will be used by the assessor to leave
comments related to this criterion.
/
5.0 pts
--
Examinee correctly used patient’s name.
_6755
threshold:
Rating Description
3.0 pts_7740
This area will be used by the assessor to leave
comments related to this criterion.
/
5.0 pts
--
Examinee made eye contact with the SP.
_7895
threshold:
Rating Description
3.0 pts_2066
This area will be used by the assessor to leave
comments related to this criterion.
/
5.0 pts
--
Examinee asked an open-ended question and actively listened to the response.
_5813
threshold:
Rating Description
3.0 pts_1586
This area will be used by the assessor to leave
comments related to this criterion.
/
5.0 pts
--
Examinee asked the SP to list his/her concerns and listened to the response without interrupting.
_9436
threshold:
Rating Description
3.0 pts_8780
This area will be used by the assessor to leave
comments related to this criterion.
/
5.0 pts
--
Examinee summarized the SP’s concerns, often using the SP’s own words.
_6009
threshold:
Rating Description
3.0 pts_599
This area will be used by the assessor to leave
comments related to this criterion.
/
5.0 pts
--
Question asked: Chief complaint
_1273
threshold:
Rating Description
3.0 pts_7374
This area will be used by the assessor to leave
comments related to this criterion.
/
5.0 pts
--
Onset
_8786
threshold:
Rating Description
3.0 pts_6479
This area will be used by the assessor to leave
comments related to this criterion.
/
5.0 pts
--
Constant/intermittent
_514
threshold:
This area will be used by the assessor to leave
comments related to this criterion.
/
5.0 pts
--
Frequency
_6591
threshold:
This area will be used by the assessor to leave
comments related to this criterion.
/
5.0 pts
--
Progression
_5102
threshold:
This area will be used by the assessor to leave
comments related to this criterion.
/
5.0 pts
--
Severity on a scale
_6614
threshold:
This area will be used by the assessor to leave
comments related to this criterion.
/
5.0 pts
--
Location
_8616
threshold:
This area will be used by the assessor to leave
comments related to this criterion.
/
5.0 pts
--
Duration
_3017
threshold:
This area will be used by the assessor to leave
comments related to this criterion.
/
5.0 pts
--
Radiation (changes its location)
_6302
threshold:
This area will be used by the assessor to leave
comments related to this criterion.
/
5.0 pts
--
Quality
_2120
threshold:
This area will be used by the assessor to leave
comments related to this criterion.
/
5.0 pts
--
Aura (warning that the headache is about to come)
_4206
threshold:
This area will be used by the assessor to leave
comments related to this criterion.
/
5.0 pts
--
Timing (the same time every day/ morning/evening)
_5891
threshold:
This area will be used by the assessor to leave
comments related to this criterion.
/
5.0 pts
--
Alleviating factors
_6867
threshold:
This area will be used by the assessor to leave
comments related to this criterion.
/
5.0 pts
--
Exacerbating factors
_3059
threshold:
This area will be used by the assessor to leave
comments related to this criterion.
/
5.0 pts
--
Nausea/vomiting association
_5052
threshold:
This area will be used by the assessor to leave
comments related to this criterion.
/
5.0 pts
--
Headache wakes you up from sleep?
_8624
threshold:
This area will be used by the assessor to leave
comments related to this criterion.
/
5.0 pts
--
Do you have any Visual changes/tears/red eye
_354
threshold:
This area will be used by the assessor to leave
comments related to this criterion.
/
5.0 pts
--
Do you have any Weakness/numbness?
_3782
threshold:
This area will be used by the assessor to leave
comments related to this criterion.
/
5.0 pts
--
Do you have any Speech difficulties?
_5118
threshold:
This area will be used by the assessor to leave
comments related to this criterion.
/
5.0 pts
--
Runny nose during the attack?
_7109
threshold:
This area will be used by the assessor to leave
comments related to this criterion.
/
5.0 pts
--
Similar episodes before
_5277
threshold:
This area will be used by the assessor to leave
comments related to this criterion.
/
5.0 pts
--
do you have any Weight/appetite changes
_150
threshold:
This area will be used by the assessor to leave
comments related to this criterion.
/
5.0 pts
--
Do you have Joint pain or fatigue?
_214
threshold:
This area will be used by the assessor to leave
comments related to this criterion.
/
5.0 pts
--
Asked patient about stress
_6262
threshold:
This area will be used by the assessor to leave
comments related to this criterion.
/
5.0 pts
--
Asked about Head trauma
_6920
threshold:
This area will be used by the assessor to leave
comments related to this criterion.
/
5.0 pts
--
Current medications and dose (if patient knows)
_8668
threshold:
This area will be used by the assessor to leave
comments related to this criterion.
/
5.0 pts
--
Past medical history
_935
threshold:
This area will be used by the assessor to leave
comments related to this criterion.
/
5.0 pts
--
Past surgical history
_8041
threshold:
This area will be used by the assessor to leave
comments related to this criterion.
/
5.0 pts
--
Family history
_2899
threshold:
This area will be used by the assessor to leave
comments related to this criterion.
/
5.0 pts
--
Occupation
_1566
threshold:
This area will be used by the assessor to leave
comments related to this criterion.
/
5.0 pts
--
Alcohol, Tabacco, Illicit drug use
_4869
threshold:
Rating Description
3.0 pts_3561
This area will be used by the assessor to leave
comments related to this criterion.
/
5.0 pts
--
Social history
_8805
threshold:
This area will be used by the assessor to leave
comments related to this criterion.
/
5.0 pts
--
Sexual activity (how many partners, types of sex, history of STDs in patient and partner(s), use of contraception - condoms, oral pills, etc)
_9182
threshold:
Rating Description
3.0 pts_6263
This area will be used by the assessor to leave
comments related to this criterion.
/
5.0 pts
--
Drug allergies and if present on what and what type of reaction
_1623
threshold:
This area will be used by the assessor to leave
comments related to this criterion.
/
5.0 pts
--
Description of criterion
threshold:
5 pts
This area will be used by the assessor to leave
comments related to this criterion.
/
5 pts
--
Total Points:
210.0 out of 210.0
Find Rubric
