Page 16 of 17

EN4.{1-2,5,9} | Ear Symptoms and External Ear Disorders — Assignment

Grading Rubric — Ear Symptoms and External Ear Disorders — Assignment Rubric

Criterion	Points	Full-marks descriptor
EN4.1 & EN4.2 — History, Clinical Features and Investigation of Ear Symptoms and External Ear Disease	8 pts	Exceeds: Correctly identifies the referred otalgia mechanism with the specific nerve involved; names all relevant extra-auricular sources with their nerve pathways; accurately describes the hallmark findings of malignant OE (exposed bone, diabetes, Pseudomonas) and differentiates from ordinary OE; lists investigation protocol including ESR, CT temporal bone, and Pseudomonas culture
EN4.5 — CSOM Classification, Diagnosis and Management Principles	6 pts	Exceeds: Correctly classifies both CSOM types with the correct perforation site, presence/absence of cholesteatoma, and specific complication risk for each; clearly states management principle (medical vs surgical) with justification; correctly identifies safe myringotomy quadrant with anatomical reasoning
EN4.9 — Wax Removal Technique: Indications, Contraindications and Safe Procedure	4 pts	Exceeds: Lists all four major contraindications to ear syringing; correctly recommends micro-suction/dry instrumentation for the patient with perforation history; explains the anatomical reason for the EAC's natural self-cleaning (epithelial migration) and why this fails with impaction; describes the correct water temperature and stream direction for safe syringing
Quality of Clinical Reasoning and Communication	2 pts	Exceeds: Responses are logically structured; clinical reasoning is explicit (symptom → mechanism → examination finding → management); ENT terminology used correctly; case answers directly address the clinical scenario without tangential material