Practical Skills and Clinical Internship (Internal Assessment)
This domain is assessed internally through your clinical logbook, procedure record and viva. It tests whether you can perform core procedures safely, in the right order, with correct asepsis, and document them honestly.
Core rules
- Marks come from the practical file and logbook, procedure performance, viva and clinical conduct - every supervised procedure should be entered and countersigned.
- Commonly assessed procedures: hand hygiene, vital signs, bed making, bed bath, oral care, simple wound dressing, bandaging, IM injection, IV fluid monitoring, specimen collection, catheter care, CPR on a manikin.
- Preparation for every procedure: identify the patient with two identifiers, explain the procedure, obtain consent, provide privacy, gather the trolley, check expiry dates, perform hand hygiene.
- Aseptic dressing sequence: clean from the wound centre outwards, one swab used once, clean gloves or forceps for the wound, soiled dressings into the correct bin, date and sign the dressing.
- Specimen collection: label the container before collection, use the correct container, collect midstream urine, avoid contamination, transport promptly.
- Report any abnormal finding immediately to the staff nurse or medical officer and record it in the nurses' notes.
- Professional conduct: punctuality, correct uniform, no mobile phone in the clinical area, and never performing a procedure beyond your competence or without supervision.
Worked example
You are asked to change a simple surgical dressing. Reasoning: hand hygiene protects the patient and you; the old dressing is removed towards the bin, not across the bed; cleaning runs from the clean centre to the dirty surrounding skin so bacteria are not pushed into the wound; each swab is used once; the wound is inspected for redness, discharge or gaping and any such sign is reported and documented with date and signature.
Traps that cost marks
Touching the centre of a sterile dressing with bare fingers; labelling a specimen after collection; writing in the notes before doing the procedure; reusing one swab for the whole wound; skipping hand hygiene because gloves will be worn.