PCMO_Applicant_Skills_Checklist.doc

PCMO APPLICANT SKILLS CHECKLIST

Name ____________________________________________ Date ______________________ Indicate your comfort level with each of the skills listed below by typing or printing an X in the appropriate column.

SKILL

Level of comfort?

I.

Health Education and Prevention

Individual patient education

Planning and conducting group health education sessions (PST, IST, COS

Development of health education handouts and newsletters

Administration of immunizations (IM, SC)

Indications and contraindications for immunization for:

MMR, polio, tetanus

Hepatitis B

Typhoid, meningitis

Administration and interpretation of PPD skin test (intradermal)

INH therapy for PPD converters

Selection of malaria prophylaxis

II.

Clinical Care

Medical history for common health problems

Comprehensive medical history and review of systems

Comprehensive physical examination

Monitoring and management of stable, chronic conditions

Coordinate referrals to specialist(s)

Evaluation and stabilization for acute, severe illnesses

Evaluation and stabilization for major trauma

SOAP note documentation

SKILL

Level of comfort?

Specific examination skills:

Retinal (ophthalmoscopic)

Ear canal and drum

Oral exam (acute dental pain)

Chest (percussion and auscultation)

Cardiac (murmurs)

Breast

Abdominal tenderness or masses

Rectal and prostate

Vaginal - visualization of cervix, PAP

Vaginal - uterus, tubes, ovaries

Basic exam of major joints (shoulder, knee, etc.)

Neurologic status

Mental status

Phlebotomy (venous blood samples)

Administer IM medications

Administer IV medications

Insert IV catheters

Select and administer IV fluids

Insert urethral catheters

Incision and drainage of abscesses

Basic suturing

Biopsy (simple) of skin lesion

Application of casts and splints

Record ECGs

Interpret:

Lab reports (chemistry, serology, hematology)

Chest xray films

Xray films of common fractures/etc

ECG tracings

Contraceptive counseling

STD/HIV risk counseling

SKILL

Level of comfort?

Common skin disorders

Abrasions and burns

Upper respiratory tract infections

Allergic rhinitis

Asthma (outpatient)

Pneumonia

Hypertension

Diarrhea

Gastroenteritis/gastritis

Urinary tract infections

Menstrual disorders

Prenatal care (uncomplicated)

Vaginal discharge

STDs

Forensic evidence collection post sexual assault

Musculoskeletal back pain

Minor orthopedics

Anemia

Diabetes

Hypothyroidism

Seizure disorders

Acute febrile illness

Pulmonary TB (active)

In general, do you provide or prescribe medications for the above conditions:

via written guidelines via consultation with MD via personal knowledge and experience

III. Mental Health Support

Evaluation/limited counseling for:

Interpersonal problems

Anxiety

Depressed mood

Alcohol or drug abuse

Name ___________________________________________ Date ______________________

SKILL

Level of comfort?

Acute depression

Panic attacks

Suicidal ideation

Psychosis

IV. Administration and Program Management

Maintaining medical confidentiality

Planning and budgeting

Medical supplies and pharmacy inventory management

Hospital/clinic assessment

Physician/consultant assessment

Planning and conducting prevention programs (screening programs, smoking cessation, etc.)

Reporting of cases for epidemiological/public health analysis

Additional comments: