Here is the 6-point CBME evaluation for *2023 Batch - Roll No. 35* - Portfolio: *60M, Both Knee Pains - 1 Yr, Right Eye Complaint*
Based on the anonymized text you pasted. Score 0-2 per level. Total /12.
### 1. Remember - Knowledge Recall
*Evidence in portfolio:*
- Chief complaints, HOPI, past history - HTN & DM 1 yr, medication history - Telmisartan + Amlodipine, Coversyl, personal history, vitals, systemic examination all recorded in structured format.
*Score: 2 / 2*
- Competency met: Complete, systematic documentation. Good recall of case facts.
### 2. Understand - Comprehension
*Evidence in portfolio:*
- Knee pain described as insidious onset, progressive, no aggravating / relieving factors.
- Right eye complaint is listed as "Right eye" only - no description of pain, redness, vision loss, discharge, duration.
- No explanation of pathophysiology in own words.
*Score: 1 / 2*
- Partial comprehension. Knee pain understood, eye complaint not understood / not elaborated.
- *Next target:* Describe eye symptom in detail - onset, pain, vision, redness, photophobia - and explain how DM / HTN / age can affect eye and knee.
### 3. Apply - Application to Patient Care
*Evidence in portfolio:*
- History + examination applied to provisional diagnosis - Osteoarthritis.
- No investigation plan, no management plan, no eye examination documented.
*Score: 1 / 2*
- Partial application. Diagnosis applied to knee, but not to eye. No plan for patient care.
- *Next target:* Add: X-ray both knees, Blood sugar / HbA1c, BP monitoring, Eye - Visual acuity, Fundus examination for diabetic / hypertensive retinopathy, Ophthalmology referral. Add management - analgesics, physiotherapy, weight advice, DM/HTN control.
### 4. Analyze - Differentiation & Interpretation
*Evidence in portfolio:*
- Single provisional diagnosis - Osteoarthritis.
- No differential diagnosis, no analysis of why both knees, no analysis of DM + HTN as risk factors, no analysis of eye pain.
- Vitals - BP 130/90, PR 85 - not interpreted.
*Score: 0 / 2*
- Not met. No analysis or differentiation.
- *Next target:* Add differentials - Osteoarthritis vs Rheumatoid arthritis vs Gout / Pseudogout vs Diabetic arthropathy. For eye - Conjunctivitis vs Uveitis vs Diabetic retinopathy vs Cataract vs Glaucoma. Give for / against points for each.
### 5. Evaluate - Judgment & Reflection
*Evidence in portfolio:*
- No justification for why Osteoarthritis was chosen over others.
- No reflection, no self-assessment, no patient safety / counseling points.
*Score: 0 / 2*
- Not met.
- *Next target:* Add: Why I chose Osteoarthritis? What did I miss in eye history? What would I do differently? Counseling on alcohol / smoking cessation, DM/HTN adherence, fall risk in daily wage worker.
### 6. Create - Synthesis & New Learning Product
*Evidence in portfolio:*
- No original product - no concept map, algorithm, patient education material, or follow-up plan.
*Score: 0 / 2*
- Not met.
- *Next target:* Create 1-page concept map linking DM + HTN + Age -> Knee degeneration + Eye complications, OR patient education sheet for knee care and eye care in local language.
### Summary Sheet - Roll No. 35 - 2023 Batch
Bloom Level | Score /2 | Key Feedback
1. Remember | 2 | Excellent documentation
2. Understand | 1 | Eye complaint incomplete, no pathophysiology
3. Apply | 1 | No investigations / management / eye exam
4. Analyze | 0 | No differentials
5. Evaluate | 0 | No reflection / justification
6. Create | 0 | No original product
**Total** | **4 / 12** | **Needs Support - Developing**
*Overall CBME Feedback for Roll 35:*
Strong in Remember. This is a two-system case (Knee + Eye) but portfolio treats it as single-system. Next portfolio must focus on Analyze -> Evaluate -> Create, especially completing eye history and linking systemic diseases DM / HTN to both complaints.
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