Restricted Veterinarian Assessment

Please Note that Comments are required for each section. If a section does NOT pertain to the Restricted Veterinarian's Assessment, please type Not Applicable in the pertaining comment section.

Restricted Member Name*

First NameLast Name

Supervisor's Name *

First NameLast Name

Assessment Date *

Date

A. Knowledge Base (Basic and Clinical)*

Excellent: Commonly displays knowledge beyond entry level expectations.Very Good: Comprehensive knowledge base, recognizes most issues.Satisfactory: Displays adequate knowledge, recognizes limitations, and tries to correct them.Needs Improvement: Adequate knowledge but does not recognize limitations.Unsatisfactory: Lacks basic factual knowledge for adequate knowledge base.

Comments: In this section, please highlight any specific strengths in knowledge base achievements, or, if improvements are needed, outline how the member plans to address any deficiencies.*

B. History Taking/Interview Skills*

Excellent: Comprehensive and consistent questioning, accurate problem identification and further characterization, excellent interview skills.Very Good: Thorough, logical and complete collection of information. Elicits subtle historical points.Satisfactory: All basic areas covered consistently, some minor limitations recognized and being addressed.Needs Improvement: Usually complete but does not recognize limitations in eliciting basic historical points.Unsatisfactory: Consistently incomplete history taking, not addressing limitations in conducting interview.

Comments: In this section, please highlight any specific strengths in history taking/interview skills, or, if improvements are needed, outline how the member plans to address any deficiencies.*

C. Physical Examination*

Excellent: Very thorough, well organized, all important findings detected, finds subtle or difficult signs, excellent gentle control of patient.Very Good: Complete, detects some subtle findings, good restraint and control.Satisfactory: Carefully done, most findings detected, recognizes limitations, and tries to correct them.Needs Improvement: Usually complete, does not recognize areas that are missed.Unsatisfactory: Incomplete, misses obvious findings, major technical deficiencies, rough handling of patients.

Comments: In this section, please highlight any specific strengths in physical examination skills, or, if improvements are needed, outline how the member plans to address any deficiencies.*

D. Clinical Judgement*

Excellent: Excellent assimilation of facts and breadth of reasoning in interpretation. Exceeds expectations.Very Good: Able to integrate complex issues and to develop clear interpretations and next steps.Satisfactory: Able to recognize and describe most issues and form next steps correctly. Does have minor limitations and tries to correct them.Needs Improvement: Limited assimilation of facts and inconsistent generation of plans, limited awareness of gaps.Unsatisfactory: Difficulty generating differential diagnoses, diagnostic and therapeutic plans incomplete and/or not logically derived from data.

Comments: In this section, please highlight any specific strengths in clinical judgement skills, or, if improvements are needed, outline how the member plans to address any deficiencies.*

E. Technical and Procedural Skills*

Excellent: Displays technical expertise beyond entry level expectations.Very Good: Completes most procedures without difficulty, good understanding of risks and benefits.Satisfactory: Completes procedures well, has a reasonable understanding of procedures.Needs Improvement: Challenged on some procedures but an adequate knowledge of what is expected.Unsatisfactory: Difficulty using proper techniques, inadequate knowledge of procedures.

Comments: In this section, please highlight any specific strengths in technical and procedural skills, or, if improvements are needed, outline how the member plans to address any deficiencies.*

F. In-Clinic Patient Care*

Excellent: Exceptionally reliable in meeting responsibilities for organizing, completion, and documenting in-patient care, exceeds entry level expectations. Supportive of other staff in their duties.Very Good: Reliable in the completion of in-patient tasks without prompting, comprehensive follow up, always up to date in tasks and records.Satisfactory: Requires minimal prompting with in-patient responsibilities, follows up on any problems.Needs Improvement: Inconsistent in ability to carry out in-patient responsibilities without reminders and direct oversight, but is aware of challenges and trying to address them.Unsatisfactory: Expected tasks not completed correctly without frequent direct supervision and prompting.

Comments: In this section, please highlight any specific strengths in In-Clinic Patient Care, or, if improvements are needed, outline how the member plans to address any deficiencies.*

G. Oral Presentation Skills*

Excellent: Clear and well organized, listens well to responses, patient with questions, honest in responses.Very Good: Clear and well organized in oral communications/discussions.Satisfactory: Clear and well organized in oral communications/discussions.Needs Improvement: Occasionally lacks clarity and organization in oral presentations/discussions.Unsatisfactory: Lacks clarity and organization in oral presentation/discussion.

Comments: In this section, please highlight any specific strengths in Oral Presentation Skills, or, if improvements are needed, outline how the member plans to address any deficiencies.*

H. Written Records and Notes*

Excellent: Records are completed following MVMA By-laws in a timely, legible, and logical manner with strong documentation of discussions and contacts with owners. Beyond entry level expectations.Very Good: Records are clear, complete and follow MVMA By-Laws.Satisfactory: Records are complete and follow MVMA By-Laws.Needs Improvement: Records follws MVMA By-Laws but are not always timely or complete.

Comments: In this section, please highlight any specific strengths in Written Records and Note taking, or, if improvements are needed, outline how the member plans to address any deficiencies.*

I. Interpersonal Skills (Client/Practice Team)*

Excellent: Attentive, composed and expressive in verbal and non-verbal communications with both clients and practice teams. Clear explanations, exceeding entry level standards.Very Good: Strong verbal and non-verbal connections with clients and practice teams. Skill set is beyond entry level standard but inconsistently applied.Satisfactory: Effective verbal and non-verbal skills in relating to clients and practice team.Unsatisfactory: Awkward when communicating and often results in negative impression.

Comments: In this section, please highlight any specific strengths in Interpersonal Skills, or, if improvements are needed, outline how the member plans to address any deficiencies.*

J. Self-Directed Learning/Initiative/Motivation*

Excellent: Experienced and competent in self-directed learning. Needs no guidance or support. A very motivated learner who sets and achieves goals regularly.Very Good: Sets attainable goals and follows through. Follows-up quickly when a gap in information is self-identified.Satisfactory: Motivated to set appropriate goals to advance but occasionally needs direction to be effective. Follows up on all recommended reading and remains current.Needs Improvement: Inconsistent goal setting and monitoring of progress. Occasionally lacking timely follow-up when gaps in current knowledge are apparent.Unsatisfactory: Is not setting and attaining goals or showing improvement in knowledge base.

Comments: In this section, please highlight any specific strengths in self-directed learning/initiative/motivations achievements, or, if improvements are needed, outline how the member plans to address any deficiencies.*

K. Professional and Ethical Behaviour*

Excellent: Is well-versed on MVMA Code of Ethics and By-Laws for ethics and professionalism, and is respectful and open in application of work practices. Demonstrates transparency, accountability, and responsible management of cases. Is consistently supportive and helpful and easily engenders trust and confidence.Very Good: Is aware of MVMA Code of Ethics and By-Laws for ethics and professionalism, and can apply the principles consistently. Is dependably respectful and fair to all clients, staff, and other registrants.Satisfactory: Is aware of MVMA Code of Ethics and By-Laws for ethics and professionalism, and is gaining confidence in applying them with consistency and full understanding. Is respectful and fair in dealing with clients, staff, and other registrants.Needs Improvement: Does not yet demonstrate a full awareness and understanding of applying the MVMA Code of Ethics and By-laws on ethics and professionalism. Show inconsistency in being respectful and fair to clients, staff, and other registrants, leading to some lack of trust.Unsatisfactory: Blames others for failures and mistakes. Is lacking honesty with clients and staff. Shows little interest in becoming familiar with the MVMA Code of Ethics and By-Laws on ethics and professionalism.

Comments: In this section, please highlight any specific strengths in professional and ethical behaviour achievements, or, if improvements are needed, outline how the member plans to address any deficiencies.*

Has the Restricted Member successfully completed the Preliminary Surgical Examination (PSA)?*

YesNo

A. PSA Candidate Manual https://www.canadianveterinarians.net/accreditation-and-national-examining-board/national-examining-board/preliminary-surgical-assessment-psa/#PSACandidateManuals*

The Restricted Member and Supervisor have reviewed the PSA Candidate Manual.The Restricted Member and Supervisor have NOT reviewed the PSA Candidate Manual.

B. Patient Preparation for Surgery

The Restricted Member will be required to demonstrate appropriate:

- Skin preparation

- Patient Positioning

Comments on Restricted Members opportunities to practice these skills and current skill level:*

C. Surgeon Preparation for Surgery

The Restricted Member will be required to demonstrate appropriate:

- Attire & Scrubbing

- Gowning/Gloving

- Draping

Comments on Restricted Members opportunities to practice these skills and current skill level:*

D. Midline Celiotomy and Closure

The Restricted Member will be required to demonstrate appropriate:

- Instrument Handling

- Surgical Incision

- Abdominal Wall Closure

- Subcutaneous and Skin Closure

- Aseptic Technique

Comments on Restricted Members opportunities to practice these skills and current skill level:*

Has the Restricted Member completed the PSA but not yet completed the CPE?*

YesNo

A. CPE Manual of Administration https://www.canadianveterinarians.net/accreditation-and-national-examining-board/national-examining-board/clinical-proficiency-examination-cpe/*

The Restricted Member and Supervisor have reviewed the CPE Manual of Administration.The Restricted Member and Supervisor have NOT reviewed the CPE Manual of Administration.

B. Anesthesia*

The Restricted Member has successfully completed the anesthesia component of the CPE (if so, skip to section C)The Restricted Member has NOT successfully completed the anestesia component of the CPE

The Restricted Member will be required to:

- Select appropriate anesthetic drugs and plan for a prolonged (over 3 hours) anesthetic period and calculate correct doses
- Perform a preanesthetic examination to determine a patient’s anesthetic risk status
- Select, assemble, and use appropriate anesthetic equipment and accessories
- Premedicate, induce and maintain general anesthesia in a canine patient
- Monitor and maintain a patient under general anesthesia
- Discuss recovery of the patient from anesthesia, to include postoperative pain management

Comments on Restricted Members opportunities to practice these skills and current skill level:*

C. Equine Practice*

The Restricted Member has successfully completed the equine practice component of the CPE (if so, skip to section D)The Restricted Member has NOT successfully completed the equine practice component of the CPE

The Restricted Member will be required to:

- Evaluate a clinical case

- Perform and/or discuss designated clinical technique

- Evaluate lameness

Comments on Restricted Members opportunities to practice these skills and current skill level:*

D. Food Animal Practice*

The Restricted Member has successfully completed the food animal component of the CPE (if so, skip to section E)The Restricted Member has NOT successfully completed the food animal component of the CPE

The Restricted Member will be required to:

- Evaluate an adult bovine clinical case, including evaluation of herd health and regulatory issues
- Evaluate a bovine calf or a caprine or ovine clinical case, including evaluation of herd health and regulatory issues
- Perform designated clinical skill procedures
- Perform bovine reproductive procedures
- List drugs prohibited for extra-label use in food animals in the United States or Canada

Comments on Restricted Members opportunities to practice these skills and current skill level:*

E. Necropsy*

The Restricted Member has successfully completed the necropsy component of the CPE (if so, skip to section F)The Restricted Member has NOT successfully completed the necropsy component of the CPE

The Restricted Member will be required to:

- Perform a necropsy in an orderly manner, including using appropriate instruments safely and adept and safe handling of all sharps.
- Dissect the heart under direct observation of an examiner.
- Describe findings as normal or abnormal in writing, and if abnormal, briefly listing what the abnormality is.
- Take tissue samples for histopathology; and remove the head for rabies testing.

Comments on Restricted Members opportunities to practice these skills and current skill level:*

F. Radiographic Positioning*

The Restricted Member has successfully completed the radiographic positioning component of the CPE (if so, skip to section G)The Restricted Member has NOT successfully completed the radiographic positioning component of the CPE

The Restricted Member will be required to:

- Determine anatomical structures and views necessary to radiographically diagnose a clinical condition and produce diagnostic quality radiographic images of those structures.

Comments on Restricted Members opportunities to practice these skills and current skill level:*

G. Small Animal Medicine*

The Restricted Member has successfully completed the small animal medicine component of the CPE (if so, skip to section H)The Restricted Member has NOT successfully completed the small animal medicine component of the CPE

The Restricted Member will be required to:

- Evaluate a clinical small animal (canine or feline patient) medicine case.
- Write medical management plans and a prescription for a selected drug based on a case description of a hospitalized canine or feline patient and orally communicate treatment plans.
- Describe and/or perform clinical techniques commonly used in small animal veterinary practice.

Comments on Restricted Members opportunities to practice these skills and current skill level:*

H. Surgery*

The Restricted Member has successfully completed the surgery component of the CPE (if so, skip to section end)The Restricted Member has NOT successfully completed the surgery component of the CPE

The Restricted Member will be required to:

- Prepare the patient for a surgical procedure.
- Prepare himself/herself for a surgical procedure.
- Perform the surgical procedure.

Comments on Restricted Members opportunities to practice these skills and current skill level:*

Supervisor Signature*

Date*

Date

Restricted Member Signature*

Date*

Date

Restricted Veterinarian Assessment

PART A

Part B - Preparation for the Preliminary Surgical Examination (PSA)

Part C - Preparation for the Clinical Proficiency Examination (CPE)