CBD: Patient Undergoing Assessment for Respiratory Disease
Attempt Number:
The nature and focus of this assessment has been explained to me and I agree to undertake
this assessment.
Student Name:
Criteria
Student Signature:
Achieved Comments
Yes/No
Understands clinical principles
relevant to the case
Can discuss relevant health and
safety issues
Can discuss the quality control
procedures to ensure the
results are accurate
Can discuss the significance of
the results with reference to the
reason for referral
Uses appropriate resources to
aid in the interpretation of the
results
Is aware of the importance of
audit trail
Awareness of the limits of
responsibility
Awareness of professional
aspects of the case
Outcome of the assessment
Pass/Fail (Delete as appropriate)
Assessor’s name
Assessor’s signature
Student’s signature
Comments and suggestions for improvement
Date:
Assessor
Initials