Required Structured Clinical Observation (SCO)
Date
Observer
Trainee
Patient Gender
M
F
Patient Age
Newborn (1-31 days)
Infant (32 days - 11mos)
Toddler (1-4 yrs)
School-age (5-11 yrs)
Adolescent (>12 yrs)
Portion of Visit and Items Observed (Check all that apply)
Data Gathering
Physical Exam
Information Giving
Interim history (well child)
CC/HPI
Diet/Sleep/Elimination
PMH/Health Maint/CAM
ROS/HEADSS
Development/School History
Family History
Social/Cultural History
HEENT
Cardiac
Pulmonary
Abdominal
Genitourinary
Orthopedic
Neurological
Other
Anticipatory Guidance
Medical Home
Diagnosis explanation
Management
Follow-up instructions
Other
Key Feedback Points
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