Here is the same 6-point CBME evaluation for *2023 Batch - Roll No. 20* for record:
### 1. Remember - Knowledge Recall
*Evidence in portfolio:*
- Demographics with occupation, chief complaints, HOPI, past history - N/K/C/O HTN, DM, Epilepsy, TB, Asthma, personal history, family history, general examination, PICCLE, vitals, systemic examination recorded.
- Good details: Both knee joints, insidious onset, gradually progressive, stiffness, tingling, numbing. History of trauma 2 years back on back due to RTA recorded.
- Gaps: SpO2 not recorded. Duration of stiffness not recorded. Joint / back / neurological examination not recorded.
*Score: 2 / 2*
- Competency met: Systematic documentation.
### 2. Understand - Comprehension
*Evidence in portfolio:*
- Pain pattern described.
- But tingling, numbing not explained. Trauma 2 years back not linked to pain starting 8 months back. Pallor (+) not explained.
*Score: 1 / 2*
- Partial comprehension.
- *Next target:* Explain tingling / numbing = neuropathic / nerve compression, not typical OA pain. Explain pallor.
### 3. Apply - Application to Patient Care
*Evidence in portfolio:*
- Provisional diagnosis - Osteoarthritis.
- No investigation plan, no management plan, no neurological examination.
*Score: 1 / 2*
- Partial application.
- *Next target:* Add: X-ray both knees, X-ray LS spine, CBC, ESR/CRP, RA factor, Vitamin D, Vitamin B12 for tingling / numbing, Blood sugar. Add management - analgesics, physiotherapy, posture, exercises, follow-up. Add neurological examination.
### 4. Analyze - Differentiation & Interpretation
*Evidence in portfolio:*
- No differential diagnosis given. No analysis of tingling / numbing, trauma, stiffness, pallor.
*Score: 0 / 2*
- Not met.
- *Next target:* Add differential table: Osteoarthritis vs Lumbar radiculopathy / Disc prolapse post-trauma vs Rheumatoid arthritis vs Vitamin B12 deficiency / Peripheral neuropathy. OA alone does not explain tingling / numbing.
### 5. Evaluate - Judgment & Reflection
*Evidence in portfolio:*
- No justification for OA despite tingling / numbing. No reflection, no counseling.
*Score: 0 / 2*
- Not met.
- *Next target:* Add: Why OA when tingling present? Risk of missing nerve compression / B12 deficiency? What would I do differently?
### 6. Create - Synthesis & New Learning Product
*Evidence in portfolio:*
- No original product.
*Score: 0 / 2*
- Not met.
- *Next target:* Create concept map: Joint Pain + Tingling -> Mechanical vs Inflammatory vs Neuropathic, OR patient education sheet for back care + knee exercises.
### Summary Sheet - Roll No. 20 - 2023 Batch
Bloom Level | Score /2 | Key Feedback
1. Remember | 2 | Good documentation, trauma history captured
2. Understand | 1 | Tingling / numbing + trauma not explained
3. Apply | 1 | OA stated, no investigations / management / neuro exam
4. Analyze | 0 | No differentials, tingling / numbing not analyzed
5. Evaluate | 0 | No justification for OA despite neuropathic symptoms
6. Create | 0 | No original product
**Total** | **4 / 12** | **Needs Support - Developing**
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