DEPARTMENT OF OPTOMETRY AND VISION SCIENCE

SCHOOL OF PUBLIC HEALTH AND BIOLOGICAL SCIENCES

MASINDE MULIRO UNIVERSITY OF SCIENCE AND TECHNOLOGY

STUDENTS CLINIC LOGBOOK

NAME: (Surname first) …………………………………………………………………………………………………………………………………………………….
INDEX NO: …………………………………………………………………………………… LEVEL: ………………………………………………....………
ACADEMIC YEAR: …………………………………………………………………………… SEMESTER: ……………………………………………………
COURSE CODE & NAME: ………………………………………………………………………………………………………………………………………………...

INSTRUCTIONS
1. Ensure that your logbook is signed and stamped by the clinical coordinator before you begin clinics.
2. Ensure that you log in every case you attend to during your clinics making sure that each case is scored and signed by the supervisor
1
 Table of Contents
Page No.
Trainee’s personal details 4
Supervisors/Trainer’s particulars 5
Training Blocks/ Rotations 6
Essential information on using this logbook 6
I. Patient Management (case) log 9
Patients’ case Log (In Patients) 10
Patients’ Case Log (Out Patient) 12
II. Procedures’ log 14
List of procedures, number, and Level of Competence 15
1. Soft Skills: 15
Vision recording & Color Vision Evaluation 17
Slit lamp Examination 18
Fundus evaluation & Fundus drawing 19
Tonometry 20
Gonioscopy 21
Tear/ Lacrimal function tests 22
Refraction 23
Diagnostic Competency ( Clinical examination & Investigations) 25
Color Fundus Photography 27
Fundus Fluorescent Angiography 28
OCT 29
Automated Perimetry 30
A-scan / B-scan 31
Biometry 32
Ocular Anesthesia: Surface, Peribulbar & for DCR 33
Conjunctival & corneal FB removal on Slit lamp 34
Suture Removal & Epilation 35
Lid repair & repair of Trauma 36

2
Biopsy of small lid tumors 37
Pterygium Excision 38
Chalazion Incision & curettage 39
Sub-tenon’s & Sub-conjunctival injections 40
Intravitreal injections 41
Lacrimal Probing 46

3
 Trainee’s Personal Details

Photograph

Name ………………………………………………… Date of Birth …….......................... .

Address…………………………………… ......................……………………………………………………………

…………………………………………………………….......................... …………………………………………..

Contact no ……………………............... …………….. E-mail ……........ …………………………………….

Signature:…………………………………

4
Supervisor’s/Trainer’s Particular

Name Designation Department/ Unit

5
Level of Competence / Performance:
The Level of Competence / Performance at which a skill is performed by the student
should be recorded in the given column of the logbook

For Patient Management:

Level 1: Observed
Level 2: Assisted
Level 3: Managed under supervision
Level 4: Managed independently

For Procedures:
Level 1: Observer status
Level 2: Assistant status
Level 3: Performed under supervision
Level 4: Performed independently

8
 Section I.

Patient Management Case Log

9
Patients’ Case Log (In Patient):
(Level 1 & 2)

Sl. Date Reg. no Age Sex Diagnosis/ Level of Supervisor’s

No (year) Problem(s) Competence Signature

10
Patients’ Case Log (In patient):
(Level 3 & 4)

Sl. Date Reg. no Age Sex Diagnosis/ Level of Supervisor’s

No (year) Problem(s) Competence Signature

11
Patients’ Case Log (Out patient) :
(Level 1 & 2)

Sl. Date Reg. no Age Sex Diagnosis/ Level of Supervisor’s

No (year) Problem(s) Competence Signature

12
Patients’ Case Log (Out patient) :
(Level 3 & 4)
Sl. Date Reg. no Age Sex Diagnosis/ Level of Supervisor’s
No (year) Problem(s) Competence Signature

13
 Section II.

Procedure Log

14
Number of procedures / Investigations and level
competence / performance which must be attained during
the Training Program:

SL Investigation/Procedures Level of Minimum No.

No Competence required
Soft Skills:
1 Vision recording & Color Vision Evaluation 1,2,3,4 100
2 Slit lamp Examination 1,2,3,4 100
3 Fundus evaluation & Fundus drawing 1,2,3,4 50
4 Tonometry 1,2,3,4 100
5 Gonioscopy 1,2,3,4 50
6 Tear/ Lacrimal function tests 1,2,3,4 100
Refraction 1,2,3,4 100
Diagnostic Competency ( Clinical 1,2,3,4 50
examination & Investigations )
Data Interpretation of Investigation 1,2,3,4 100
reports
1 Color Fundus Photography 1,2,3,4
2 Fundus Fluorescent Angiography 1,2,3,4 50
3 OCT 1,2,3,4 50
4 Automated Perimetry 1,2,3,4 50
5 A-scan / B-scan 1,2,3,4 50
6 Biometry 1,2,3,4 50
Surgical Competency
1 Ocular Anesthesia: Surface, Peribulbar & for 1,2,3,4 50
DCR
2 Conjunctival & corneal FB removal on Slit 1,2,3,4 20
lamp
3 Suture Removal & Epilation 1,2,3,4 20
4 Lid repair & repair of Trauma 1,2,3,4 20
5 Biopsy of small lid tumors 1,2,3,4 20

15
6 Pterygium Excision 1,2,3,4 30

7 Chalazion Incision & curettage 1,2,3,4 30

8 Sub-tenon’s & Sub-conjunctival injections 1,2,3,4 30
14 Lacrimal Probing 1,2,3 10

16
Vision recording & Color Vision Evaluation

Sl. Date Reg. Age Sex Diagnosis/ Complication Level Supervisor’s

No. No. (years) Indication of signature
performance

17
Slit lamp Examination

Sl. Date Reg. Age Sex Diagnosis/ Complication Level Supervisor’s

No. No. (years) Indication of signature
performance

18
Fundus evaluation & Fundus drawing

Sl. Date Reg. Age Sex Diagnosis/ Complication Level Supervisor’s

No. No. (years) Indication of signature
performance

19
Tonometry

Sl. Date Reg. Age Sex Diagnosis/ Complication Level Supervisor’s

No. No. (years) Indication of signature
performance

20
Gonioscopy

Sl. Date Reg. Age Sex Diagnosis/ Complication Level Supervisor’s

No. No. (years) Indication of signature
performance

21
Tear/ Lacrimal function tests

Sl. Date Reg. Age Sex Diagnosis/ Complication Level Supervisor’s

No. No. (years) Indication of signature
performance

22
Refraction

Sl. Date Reg. Age Sex Diagnosis/ Complication Level Supervisor’s

No. No. (years) Indication of signature
performance

23
Refraction

Sl. Date Reg. Age Sex Diagnosis/ Complication Level Supervisor’s

No. No. (years) Indication of signature
performance

24
Diagnostic Competency (Clinical examination & Investigations)

Sl. Date Reg. Age Sex Diagnosis/ Complication Level Supervisor’s

No. No. (years) Indication of signature
performance

25
Diagnostic Competency (Clinical examination & Investigations)

Sl. Date Reg. Age Sex Diagnosis/ Complication Level Supervisor’s

No. No. (years) Indication of signature
performance

26
Color Fundus Photography

Sl. Date Reg. Age Sex Diagnosis/ Complication Level Supervisor’s

No. No. (years) Indication of signature
performance

27
Fundus Fluorescent Angiography

Sl. Date Reg. Age Sex Diagnosis/ Complication Level Supervisor’s

No. No. (years) Indication of signature
performance

28
OCT

Sl. Date Reg. Age Sex Diagnosis/ Complication Level Supervisor’s

No. No. (years) Indication of signature
performance

29
Automated Perimetry

Sl. Date Reg. Age Sex Diagnosis/ Complication Level Supervisor’s

No. No. (years) Indication of signature
performance

30
A-Scan/ B-Scan

Sl. Date Reg. Age Sex Diagnosis/ Complication Level Supervisor’s

No. No. (years) Indication of signature
performance

31
Biometry

Sl. Date Reg. Age Sex Diagnosis/ Complication Level Supervisor’s

No. No. (years) Indication of signature
performance

32
Ocular Anesthesia: Surface, Peribulbar & for DCR

Sl. Date Reg. Age Sex Diagnosis/ Complication Level Supervisor’s

No. No. (years) Indication of signature
performance

33
Conjunctival & corneal FB removal on Slit lamp

Sl. Date Reg. Age Sex Diagnosis/ Complication Level Supervisor’s

No. No. (years) Indication of signature
performance

34
Suture Removal & Epilation

Sl. Date Reg. Age Sex Diagnosis/ Complication Level Supervisor’s

No. No. (years) Indication of signature
performance

35
Lid repair & repair of Trauma

Sl. Date Reg. Age Sex Diagnosis/ Complication Level Supervisor’s

No. No. (years) Indication of signature
performance

36
Biopsy of small lid tumors

Sl. Date Reg. Age Sex Diagnosis/ Complication Level Supervisor’s

No. No. (years) Indication of signature
performance

37
Pterygium Excision

Sl. Date Reg. Age Sex Diagnosis/ Complication Level Supervisor’s

No. No. (years) Indication of signature
performance

38
Chalazion Incision & curettage

Sl. Date Reg. Age Sex Diagnosis/ Complication Level Supervisor’s

No. No. (years) Indication of signature
performance

39
Sub-tenon’s & Sub-conjunctival injections

Sl. Date Reg. Age Sex Diagnosis/ Complication Level Supervisor’s

No. No. (years) Indication of signature
performance

40
Tarsorraphy

Sl. Date Reg. Age Sex Diagnosis/ Complication Level Supervisor’s

No. No. (years) Indication of signature
performance

44
Lacrimal Probing

Sl. Date Reg. Age Sex Diagnosis/ Complication Level Supervisor’s

No. No. (years) Indication of signature
performance

46
 VI. Summary Sheets
i) Summary of Patient Management Log:

Sl. Events/ Tasks Minimum requisite Number

No. number for the performed
training period
1 Patients’ case log(In Patient) 30

2 Patients’ case log(out Patient) 20

ii). Summary of the Academic Activities:

Sl. Events/ Tasks Minimum requisite Number

No. number / % for the performed/
training period %
performed
c Science Lectures attended 70% of schedule
1
lecture
70% of schedule
2 cal Lectures attended
lecture

70% of schedule
3 Tutorials/small group teaching attended
lecture

4 Journal club presentation 5

5 Grand round/ clinical meeting presentations 30

58
iii) Summary of Practical Procedures:

SL Investigation/Procedures Level of Minimum No. Total

No Competence required during Number
the training done
period
Soft Skills:
1 Vision recording & Color Vision 1,2,3,4 100
Evaluation
2 Slit lamp Examination 1,2,3,4 100
3 Fundus evaluation & Fundus 1,2,3,4 50
drawing
4 Tonometry 1,2,3,4 100
5 Gonioscopy 1,2,3,4 50
6 Tear/ Lacrimal function tests 1,2,3,4 100
Refraction 1,2,3,4 100
Diagnostic Competency 1,2,3,4 50
(Clinical examination &
Investigations)
Data Interpretation of 1,2,3,4 100
Investigation reports
1 Color Fundus Photography 1,2,3,4 50
2 Fundus Fluorescent Angiography 1,2,3,4 50
3 OCT 1,2,3,4 50
4 Automated Perimetry 1,2,3,4 50
5 A-scan / B-scan 1,2,3,4 50
6 Biometry 1,2,3,4 50
Surgical Competency
1 Ocular Anesthesia: Surface, 1,2,3 50
Peribulbar & for DCR
2 Conjunctival & corneal FB 1,2,3 20
removal on Slit lamp

59
SL Investigation/Procedures Level of Minimum No. Total
No Competence required during Number
the training done
period
3 Suture Removal & Epilation 1,2,3 20
4 Lid repair & repair of Trauma 1,2,3 20
6 Pterygium Excision 1,2,3 30
7 Chalazion Incision & curettage 1,2,3 30
8 Sub-tenon’s & Sub-conjunctival 1,2,3 30
injections
12 Tarsorraphy 1,2,3 10
14 Lacrimal Probing 1,2,3 10

Trainee’s signature and date…………………...……………………………....................

Trainee’s Name : .......................................................................................

Session : ...............................................………………………………………………….