26/10/2026
Here is the 6-point CBME evaluation for *2023 Batch - Roll No. 1* - Portfolio: *30F, Fever - 10 Days, Vomiting - 8 Days, Loose Stools - 8 Days*
Based on the anonymized text you pasted. Score 0-2 per level. Total /12.
### 1. Remember - Knowledge Recall
*Evidence in portfolio:*
- Demographics with age / sex, chief complaints, HOPI, past history - N/K/C/O HTN, DM, Asthma, Epilepsy, personal history - Diet Mixed, Appetite Decreased, Sleep Disturbed, B & B, general examination, PICCLE - Absent, Pedal edema - Absent, vitals, systemic examination - CVS, CNS, RS, P/A recorded.
- Good details: Fever with chills, intermediate grade, intermittent, evening rise (+), vomiting 3-4 episodes, food contents, nausea (+), non-projectile, loose stools 3 episodes / day, no blood / mucous, no pain during defecation, no feeling of incomplete defecation. Negatives - No cough, cold, SOB, chest pain, palpitations.
- Gaps: No occupation given. No SpO2 recorded. Local Examination of Joints included - Inspection no swelling / redness / deformities, Palpation tenderness present, ROM painful active movements - but no joint complaint in chief complaints, no joint specified. No provisional diagnosis given - left blank.
*Score: 2 / 2*
- Competency met: Systematic documentation, fever + GI symptoms well characterized, negatives included.
### 2. Understand - Comprehension
*Evidence in portfolio:*
- Fever pattern described - intermittent, evening rise, chills.
- GI symptoms described - vomiting + loose stools without blood / mucous.
- But no explanation in own words of what evening rise fever means, or why vomiting + loose stools occur together.
- Joint examination included but not explained - why examine joints in fever + loose stools? No explanation.
*Score: 1 / 2*
- Partial comprehension.
- *Next target:* Explain: Fever with chills + evening rise - think infection - enteric fever, malaria, TB, UTI. Explain: Vomiting + loose stools without blood / mucous = acute gastroenteritis / enteric fever, not dysentery. Explain: Joint tenderness + painful movements in fever = reactive arthritis / viral arthralgia / enteric fever arthralgia - need to link joint exam to fever case.
### 3. Apply - Application to Patient Care
*Evidence in portfolio:*
- No provisional diagnosis given - left blank.
- No investigation plan, no management plan.
- No application of fever + GI symptoms to care - no hydration assessment, no dehydration signs, no stool / blood tests.
*Score: 0 / 2*
- Not met.
- *Next target:* Add: Provisional diagnosis - Acute Febrile Illness with Gastroenteritis - ? Enteric Fever. Add: CBC, Widal / Blood culture, Dengue NS1, Malaria smear / antigen, Urine routine, Stool routine, Electrolytes, LFT, RFT, CRP. Add management - ORS, IV fluids if dehydrated, antiemetic, antipyretic, antibiotics as per culture, diet, hygiene, follow-up. Document hydration - skin turgor, dry tongue, urine output. Clarify which joint was examined and why.
### 4. Analyze - Differentiation & Interpretation
*Evidence in portfolio:*
- No differential diagnosis given.
- No analysis of causes: Enteric fever vs Dengue vs Malaria vs Acute gastroenteritis vs UTI.
- No analysis of evening rise fever - TB vs enteric fever vs malaria.
- No analysis of loose stools without blood / mucous - viral / bacterial gastroenteritis vs enteric fever.
- No analysis of joint tenderness - reactive vs viral.
*Score: 0 / 2*
- Not met.
- *Next target:* Add differential table: Enteric Fever - supports fever 10 days, evening rise, chills, vomiting, loose stools, decreased appetite, disturbed sleep. Dengue - supports fever, vomiting, joint pain / tenderness; against - no rash, no bleeding, no retro-orbital pain mentioned. Malaria - supports fever with chills, intermittent, vomiting; against - no rigors described, no periodicity. Acute Gastroenteritis - supports vomiting + loose stools 8 days; against - fever 10 days longer, evening rise. UTI - supports fever, vomiting; against - bladder normal, no dysuria. Must use duration - 10 days fever = not simple viral gastroenteritis.
### 5. Evaluate - Judgment & Reflection
*Evidence in portfolio:*
- No diagnosis, no justification, no reflection, no self-assessment.
- No discussion of red flags - 10 days fever + 8 days vomiting / loose stools = dehydration, electrolyte loss, need admission.
- No discussion of BP 120/40 - wide pulse pressure, needs re-check.
*Score: 0 / 2*
- Not met.
- *Next target:* Add: Why is 10 days fever not simple gastroenteritis? What is the risk if I miss enteric fever / dengue? What would I do differently - do hydration assessment, ask about travel, water source, contacts, recent antibiotics, specify joint examined? Reflection on fever + GI case in 30F - need to think beyond gastroenteritis when fever persists 10 days.
### 6. Create - Synthesis & New Learning Product
*Evidence in portfolio:*
- No original product - no algorithm, concept map, patient education material.
*Score: 0 / 2*
- Not met.
- *Next target:* Create 1-page algorithm: Fever >7 Days + Vomiting + Loose Stools -> Enteric vs Dengue vs Malaria -> Investigations -> Management, OR patient education sheet for fever + loose stools - ORS, hygiene, safe water, when to return.
### Summary Sheet - Roll No. 1 - 2023 Batch
Bloom Level | Score /2 | Key Feedback
1. Remember | 2 | Good fever + GI history, negatives included
2. Understand | 1 | Fever pattern described, evening rise + joint exam not explained
3. Apply | 0 | No diagnosis, no investigations / management
4. Analyze | 0 | No differentials, 10-day fever not analyzed
5. Evaluate | 0 | No justification, no dehydration / red-flag judgment
6. Create | 0 | No original product
**Total** | **3 / 12** | **Needs Support - Developing**
*Overall CBME Feedback for Roll 1 - Progression:*
- 21M itchy scalp / Psoriasis = 5/12, 50F joint pains / no diagnosis = 3/12, 55M vomiting + swelling / Diabetic Nephropathy = 5/12, 44M SOB + edema / CKD = 5/12, *This portfolio = 3/12*
- *Drop explained:* Previous 2 CKD cases had a diagnosis + reports. This case has no diagnosis at all, and a joint examination with no joint complaint - so Apply and Analyze both drop to 0.
- *Strength:* Best fever history so far - chills, intermediate grade, intermittent, evening rise, plus clear stool description - no blood / mucous, no pain, no incomplete defecation. That rules out dysentery.
- *Critical learning from this case:* 10 days fever is not simple gastroenteritis. Always ask - why joint examination in a fever + loose stools case? If you examine joints, name the joint and link it to fever. And always check hydration - BP 120/40 needs re-check, plus skin turgor, urine output.
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