STRUCTURED CLINICAL OBSERVATION

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					                               STRUCTURED CLINICAL OBSERVATION
                                      Pediatrics Clerkship
                                         TMC Nursery


Student:                                          Date:

Attending:


Student: Give this form to a preceptor before going to see a patient; tell the preceptor which room you
will be in.

Preceptor: Indicate the portion of visit and particular items observes.
Specific Observations or Comments:

General                                                Heart
          Introduces self/preceptor                                 Palpates for position
          Uses appropriate exam sequence                            Auscultation
Assesses maturity                                                   Identification of murmur present
          Term                                         Abdomen
          Preterm                                                   Palpates: Liver Spleen Kidney
Assesses intrauterine growth                                        Inspects Umbilicus
          SGA                                          Genitalia
          AGA                                                       Examines and identifies abnormalities
          LGA                                                       Male:
Skin                                                                      Hypospadias
          Notes findings                                                  Hernias/hydroceles
Head                                                   Anus
          Palpates fontanels/sutures                                Visual check for patency
          Notes caput succedaneum                      Spine
          Notes subgaleal hemorrhage                              Dimples/sinus tracts
Eyes                                                              Scoliosis/masses
          Check red reflex                             Extremities
Ears/Nose/Throat                                                  Pulses
          Position                                                Hip dislocation:
          Pre-auricular pits                                               Gluteal folds
          Checks for cleft-palate                                          Barlow/Ortolani
Thorax                                                 Reflexes
          Symmetry                                                Checks: Moro Root Palmar grasp
          Breast tissue                                           Babinski sign
Lungs                                                             DTR's
          Observes rate, depth of breathing                       Cranial Nerves
          Auscultates (with correct findings)                     Active/Passive tone
                                                                  Spontaneous motor activity
                                                                  Cry

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posted:10/1/2011
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