exams nac guideline rating scale

8/20/2019 Exams NAC Guideline Rating Scale

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The following are descriptors of ACCEPTABLE performance levels per competency.

HISTORY TAKING

Expectations: Acquires from the patient, family or other source a chronologic, medically logical description of pertinent

events. Gathers information in sufcient breadth and depth to permit a clear denition of the patient’s problem(s).

PHYSICAL EXAMINATION

Expectations: Elicits physical ndings in an efcient logical sequence that documents the presence or absence of

abnormalities, and supports a denition of the patient’s problem(s). Sensitive to the patient’s comfort and modesty;

explains actions to the patient.

ORGANIZATION

Expectations: Approaches interaction in a coherent, succinct and systematic manner. Manages time effectively

(including oral questions).

COMMUNICATION SKILLS

Expectations: Uses a patient-centered approach: establishes trust and respect, and shows sensitivity. Provides clear

information and conrms patient’s understanding throughout clinical encounter: encourages questions, and uses

repetition and summarizing to conrm and/or reinforce understanding. Respects condentiality. Avoids use of

jargon /slang. If applicable, negotiates a mutually acceptable plan of management and treatment. Demonstrates

appropriate non-verbal communication (e.g., eye contact, gesture, posture and use of silence).

LANGUAGE FLUENCYExpectations: Speaks clearly (volume and rate) with clear pronunciation; accent does not hinder interaction. Uses

coherent ow of words, phrases, sentences and verb tenses to convey intended meaning. Uses appropriate choice of

words and expressions for the context (e.g., vocabulary).

DIAGNOSIS

Expectations: Discriminates important from unimportant information and reaches a reasonable differential diagnosis

and/or diagnosis.

DATA INTERPRETATION

Expectations: Interprets investigative data appropriately in the context of the patient’s problem(s).

INVESTIGATIONSExpectations: Selects suitable laboratory or diagnostic studies to elucidate or conrm the diagnosis; takes into

consideration associated risks and benets.

THERAPEUTICS AND MANAGEMENT

Expectations: Discusses therapeutic management, including but not limited to pharmacotherapy*, adverse effects and

patient safety, disease prevention and health promotion, when appropriate. Selects appropriate treatments (including

monitoring, counseling, follow-up); considers risks and benets of therapy and instructs the patient accordingly.

* Drug classes are more likely to be required than specifc drugs (except when required in urgent circumstances), and

dosages are typically not expected.

COMPETENCY DESCRIPTORSFor case specic guidelines, see CASE INFORMATION FOR EXAMINERS

MCC | NAC COMPETENCY DESCRIPTORS | P1

N

ollaboration

ational

ssessment

UNACCEPTABLEas compared to a recent

graduate from a

Canadian medical school

BORDERLINEUNACCEPTABLE

as compared to a recentgraduate from a


BORDERLINEACCEPTABLE



ACCEPTABLEas compared to a recent

graduate from a


ABOVEthe level expected of arecent graduate from a


8/20/2019 Exams NAC Guideline Rating Scale

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UNACCEPTABLE as compared to a recent graduate from a Canadian medical school

• History elicited (if applicable) is incomplete and unstructured• Physical examination (if applicable) is incomplete and unstructured• Organization and time management skills are clearly decient• Communication skills and language uency are clearly decient• Diagnosis/Differential diagnosis (if applicable) is inappropriate• Data interpretation (if applicable) is incorrect

• Investigation plan (if applicable) is inappropriate• Therapeutics and management priorities were not appropriate to the patient and the clinical case

BORDERLINE UNACCEPTABLEas compared to a recent graduate from a Canadian medical school

• History elicited (if applicable) is somewhat incomplete and/or unstructured• Physical examination (if applicable) is somewhat incomplete and/or unstructured• Organization and time management skills are somewhat decient• Communication skills and language uency are somewhat decient• Diagnosis/Differential diagnosis (if applicable) is limited or indiscriminate• Data interpretation (if applicable) is poor and/or insufcient• Investigation plan (if applicable) is poor

• Therapeutics and management priorities are poorly identied and somewhat inappropriate

BORDERLINE ACCEPTABLEas compared to a recent graduate from a Canadian medical school

• History elicited (if applicable) is reasonably structured and includes some of the essential elements• Physical examination (if applicable) is reasonably structured and includes some of the essential elements• Organization and time management skills are just adequate• Communication skills and language uency are just adequate• Diagnosis/Differential diagnosis (if applicable) is just adequate and developed in a somewhat logical manner • Data interpretation (if applicable) is somewhat correct and/or sufcient• Investigation plan (if applicable) is just adequate• Therapeutics and management priorities are somewhat appropriate to the patient and the clinical case

ACCEPTABLEas compared to a recent graduate from a Canadian medical school

• History elicited (if applicable) includes most of the essential elements• Physical examination (if applicable) includes most of the essential elements• Organization and time management skills are good• Communication skills and language uency are good• Diagnosis/Differential diagnosis (if applicable) is logical and demonstrates a good understanding of the presentation• Data interpretation (if applicable) is succinct and correct• Investigation plan (if applicable) is appropriate and demonstrates a judicious choice of resources• Therapeutics and management priorities were appropriate to the patient and the clinical case

ABOVEthe level expected of a recent graduate from a Canadian medical school

• Knowledge, skills and clinical judgment clearly exceed the above criteria for an ACCEPTABLE candidate

RATING SCALE CRITERIA

The criteria below are meant to help support and guide examiner discrimination between

the rating designations (e.g., between BORDERLINE ACCEPTABLE and ACCEPTABLE).

N

ollaboration

ational

ssessment

MCC | NAC COMPETENCY RATING SCALE | P2

UNACCEPTABLEas compared to a recent

graduate from a


BORDERLINEUNACCEPTABLE



BORDERLINEACCEPTABLE



ACCEPTABLEas compared to a recent

graduate from a


ABOVEthe level expected of arecent graduate from a


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