Here is the 6-point CBME evaluation for *2023 Batch - Roll No. 6* - Portfolio: *32M, Fever - 2 Days*
Based on the anonymized text you pasted. Score 0-2 per level. Total /12.
### 1. Remember - Knowledge Recall
*Evidence in portfolio:*
- Chief complaint, HOPI, past history, personal history, family history, general and systemic examination recorded in structured format.
- Good negative history documented - No burning micturition, nausea, vomiting, diarrhoea, cough, cold, chest pain, SOB.
- Minor gaps: SpO2 not recorded, PICCLE not recorded.
*Score: 2 / 2*
- Competency met: Complete, systematic documentation with relevant negatives.
### 2. Understand - Comprehension
*Evidence in portfolio:*
- Fever described well - with chills & rigors, high grade, continuous, no evening rise.
- But vitals show Temp - Afebrile. No explanation - was fever subsided? Was antipyretic taken? Timing of temperature?
- No explanation in own words of what chills & rigors mean, or pathophysiology of acute febrile illness.
*Score: 1 / 2*
- Partial comprehension.
- *Next target:* Explain fever pattern and why chills/rigors occur. Explain discrepancy between history of high-grade fever and afebrile on examination.
### 3. Apply - Application to Patient Care
*Evidence in portfolio:*
- Provisional diagnosis given as Acute Febrile Illness - very generic.
- No investigation plan, no management plan, no follow-up advice.
- BP 110/60, PR 68, RS 22 - not interpreted or applied to care.
*Score: 1 / 2*
- Partial application. History taken well, but not converted into a care plan.
- *Next target:* Add: CBC, MP / Dengue NS1, Widal, Urine routine, Blood culture if indicated. Add management - antipyretics, hydration, monitoring, red-flag advice, when to return. Add: Keep BP / hydration chart.
### 4. Analyze - Differentiation & Interpretation
*Evidence in portfolio:*
- No differential diagnosis given.
- No analysis of causes of acute febrile illness with chills & rigors - Malaria vs Dengue vs Typhoid vs UTI vs Viral fever.
- Negative history is present but not used to rule in / rule out differentials.
*Score: 0 / 2*
- Not met.
- *Next target:* Add differential table: Malaria - supports chills/rigors; against - no periodicity mentioned. Dengue - supports fever 2 days, daily wage labour / mosquito exposure; against - no rash / body pain mentioned. Typhoid - against - no diarrhoea / continuous fever pattern needs evaluation. UTI - against - no burning micturition. Use negative history to analyze.
### 5. Evaluate - Judgment & Reflection
*Evidence in portfolio:*
- No justification for diagnosis, no reflection, no self-assessment, no patient safety / counseling points.
*Score: 0 / 2*
- Not met.
- *Next target:* Add: Why did I label it Acute Febrile Illness and not a specific cause? What investigations are essential before labeling? What did I learn about taking fever history? Counseling on mosquito prevention, hydration, danger signs.
### 6. Create - Synthesis & New Learning Product
*Evidence in portfolio:*
- No original product - no algorithm, concept map, patient education material, or follow-up plan.
*Score: 0 / 2*
- Not met.
- *Next target:* Create 1-page algorithm: Acute Fever with Chills & Rigors - 2 Days -> History clues -> Investigations -> Red flags, OR patient education sheet for fever care at home in local language.
### Summary Sheet - Roll No. 6 - 2023 Batch
Bloom Level | Score /2 | Key Feedback
1. Remember | 2 | Excellent documentation with relevant negatives
2. Understand | 1 | Fever pattern good, but Afebrile vs high-grade fever not explained
3. Apply | 1 | Generic diagnosis, no investigations / management
4. Analyze | 0 | No differentials
5. Evaluate | 0 | No justification / reflection
6. Create | 0 | No original product
**Total** | **4 / 12** | **Needs Support - Developing**
*Overall CBME Feedback for Roll 6 - Progression:*
- 45F back pain = 5/12, 60M knee + eye = 4/12, 60F fever + knee = 5/12, *This portfolio = 4/12*
- *Strength:* Consistent strength in Remember - documentation is improving, especially negative history.
- *Still to improve:* Portfolio stops at Remember. Must add Analyze - differential table using the negative history already collected, then Evaluate and Create in next portfolio.
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