What you must demonstrate
- Wash hands and obtain consent
- Position and expose appropriately
- Inspect before palpation
- Perform focused maneuvers
- State omitted completion steps
- Summarize key findings
11-minute performance map
1. Opening and immediate safety
Introduce yourself, confirm identity, explain the task, obtain consent and identify instability before routine questioning.
2. Focused assessment
Clarify onset, progression, severity, associated features, discriminating positives/negatives and the most relevant background risks.
3. Targeted examination
Perform only the examination maneuvers needed to assess severity, confirm localization and discriminate the leading diagnoses.
4. Synthesize
Give a one-sentence summary, leading diagnosis and two to four prioritized alternatives including the dangerous diagnosis you cannot miss.
5. Investigations
Choose tests that answer a specific diagnostic or safety question; state urgent tests first.
6. Immediate management
Treat instability, begin syndrome-specific care, consult early when needed and define disposition.
7. Communication and safety net
Explain the plan, check understanding, address concerns and state exact deterioration/return criteria.
Focused history prompts
Define the presentation
- Onset, chronology, triggers and progression.
- Severity and effect on function.
- Associated symptoms that support the leading diagnosis.
- Relevant negatives that reduce dangerous alternatives.
Risk context
- Relevant past medical/surgical/obstetric/psychiatric history.
- Medications, allergies and adherence.
- Family, social, substance, travel/exposure or safeguarding factors as applicable.
- Patient ideas, concerns, expectations and goals.
Dangerous alternatives to prioritize
- Pain during examination
- Unstable patient
- Need for chaperone
- Failure to preserve dignity
- Unsafe maneuver
- Missing immediate escalation
Targeted investigations
Targeted bedside measurements generated by the examination question
Focused laboratory tests based on the leading diagnosis
Appropriate imaging/physiologic studies rather than broad testing
Urgent escalation tests when red flags are present
Immediate management and disposition
- Treat instability before completing the routine examination.
- Use examination findings to prioritize the differential and next test.
- Start immediate treatment for time-critical findings.
- State consultation, disposition and safety-netting clearly.
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