Resident Evaluation
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Resident Monthly Rotation Evaluation
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Resident 6 Month Faculty Advisor Evaluation
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Resident End of the Year Evaluation
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Resident 360 Evaluation: filled out by peers, faculty and nurses
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Resident Post Graduate Survey and Evaluation
Program Evaluations
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Rotation and Special Topic Evaluations
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EM Lecture Evaluation
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EM Resident Anonymous Annual Faculty Evaluations
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End of the Year Program Evaluation
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GME End of the Year Questionnaire
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EM Faculty Peer Review
FROM: LSUHSC-New Orleans Emergency Medicine Residency Program (or may be complete online in ResidencyPartner)
(504) 903-3594 Fax: 903-0321
TRAINEE_________________________________ __ SERVICE: _______________
DATE OF ROTATION__________________________ LOCATION: _____________________________
Scale: (na) Not Applicable, not observed, Unacceptable, Acceptable, Outstanding If Unacceptable or Outstanding, please provide example.
MEDICAL KNOWLEDGE :
|
□ na
|
□ Inadequate: Does not display understanding of basic science or clinical information, or unable to relate knowledge to cases. Does not recognize life-threatening conditions. Unable to sequence critical actions.
Example:
|
□ Acceptable. Has appropriate knowledge base for level of training and is able to relate it to clinical setting. Recognizes life-threatening conditions; may require assistance in sequencing critical actions.
|
□ Outstanding. Superior knowledge & mature application of knowledge to clinical setting. Consistently able to sequence critical actions for patient care and generate a differential diagnosis for an undifferentiated patient.
Example:
|
PATIENT CARE: H&P, Differential Diagnosis
|
□ na
|
□ Inadequate: Incomplete or inaccurate, misses major problems.
Unable to make appropriate differential diagnosis or problem list.
Example:
|
□ Acceptable. Usually complete and accurate, identifying major & minor problems with an appropriate differential diagnosis list.
|
□ Outstanding. Comprehensive information, thorough, precise. Mature analysis & synthesis of data by priority, extensive differential diagnosis.
Example:
|
PATIENT CARE: Procedural Skills
|
□ na
|
□ Inadequate: Doesn’t use proper technique, awkward, bypasses steps, avoids procedures or disorganized.
Example:
|
□ Adequate: Uses proper technique, organizes equipment; Occasional difficulty with complicated procedures.
|
□ Outstanding. Precise, efficient performance with ease & dexterity, puts patient at ease
Example:
|
PATIENT CARE: Diagnostic Tests & Consultations
|
□ na
|
□ Inadequate: Overlooks basic tests, unable to interpret results, consults are inappropriate or untimely.
Example:
|
□ Adequate: Orders & interprets diagnostic tests, consults appropriately.
|
□ Outstanding. Has planned alternative strategies based on pending diagnostic test results. Consultations are timely and well-coordinated with plan of care.
Example:
|
PATIENT CARE: Decision-making
|
□ na
|
□ Inadequate: Decisions are risky, unsafe or inappropriate.
Example:
|
□ Adequate: Decisions typically accurate and safe, uses common sense. Able to triage patients and problems by level of acuity.
|
□ Outstanding. Mature, safe, decisions based on sound integration of data & reason. Prioritizing and critical actions are consistently appropriate.
Example:
|
PRACTICE-BASED LEARNING: Evidence Based Medicine And Self-Education
|
□ na
|
□ Inadequate: Doesn’t know patients, no reading or online learning evident.
Example:
|
□ Adequate: Supplements patient care with current literature, textbooks or online readings.
|
□ Outstanding. Extensive supplemental reading, knows disease process of own and other patients.
Example:
|
PRACTICE-BASED LEARNING: Teaching
|
□ na
|
□ Inadequate: Does not participate in teaching students or other residents.
Example:
|
□ Adequate: Participates in teaching opportunities. Actively teaches students & junior residents, motivates learning.
|
□ Outstanding. Develops teaching opportunities, motivates, and teaches with enthusiasm and dedication.
Example:
|
SYSTEMS-BASED PRACTICE: Resource Utilization
|
□ na
|
□ Inadequate: Unable to formulate an appropriate, resource- or cost-effective management plan.
Example:
|
□ Adequate: Management and discharge plan is appropriate for patient, with consideration given to patient and hospital resources.
|
□ Outstanding. Management plan is typically comprehensive, precise, and resource- & cost-effective.
Example:
|
PROFESSIONALISM: Work Habits
|
□ na
|
□ Inadequate: Poor attendance, shirks responsibility, frequently late, prolonged absence on shifts. Prevaricates.
Example:
|
□ Adequate: Attends required activities, accepts responsibility, usually punctual and organized. Occasionally performs extra functions, showing some independent initiative.
|
□ Outstanding. Consistently attends extra functions, displays leadership role, highly efficient. Stays late to help.
Example:
|
PROFESSIONALISM: Insight And Self-Assessment
|
□ na
|
□ Inadequate: Doesn’t accept criticism, displays little insight.
Example:
|
□ Adequate: Accepts constructive criticism, appropriately asks for assistance and feedback.
|
□ Outstanding. Assesses own limitations & responds constructively to feedback.
Example:
|
PROFESSIONALISM: Ethical and cultural sensitivity
|
□ na
|
□ Inadequate: Not responsive to patient’s age, culture, disability or gender issues. Unaware of patient as a person.
Example:
|
□ Adequate: Responsive to patient’s age, culture or gender issues. Demonstrates respect, compassion and integrity.
|
□ Outstanding. Consistently acts as an outstanding role model, demonstrating compassion and integrity in response to cultural, gender, age or disability issues.
Example:
|
INTERPERSONAL & COMMUNICATION SKILLS: Team Member
|
□ na
|
□ Inadequate: Doesn’t work well with others. Alienating, disrespectful to nurses, peers, consultants.
Example:
|
□ Adequate: Maintains good working relationship with team. Respected by nurses, peers, consultants.
|
□ Outstanding. Highly regarded by team. Consensus-builder. Role model.
Example:
|
INTERPERSONAL & COMMUNICATION SKILLS: Verbal, nonverbal and documentation skills
|
□ na
|
□ Inadequate: Unable to create or sustain a therapeutic or ethical relationship with patients. Ineffective listener. Unacceptable documentation.
Example:
|
□ Adequate: Creates and sustains therapeutic and ethical relationships with patients and families. Effective listening, verbal, nonverbal and writing skills.
|
□ Outstanding. Excellent verbal, nonverbal and writing skills. A role model
Example:
|
SUMMARY RATING:
|
□ na
|
□ Inadequate
|
□ Adequate
|
□ Outstanding
|
EVALUATOR: ______ SIGNATURE____________________________________ DATE:
ADDITIONAL COMMENTS:____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
360 degree Annual Evaluation
To be complete online via residencypartner.
MEDICAL KNOWLEDGE :
|
□ na
|
□ Inadequate: Does not display understanding of basic science or clinical information, or unable to relate knowledge to cases. Does not recognize life-threatening conditions. Unable to sequence critical actions.
Example:
|
□ Acceptable. Has appropriate knowledge base for level of training and is able to relate it to clinical setting. Recognizes life-threatening conditions; may require assistance in sequencing critical actions.
|
□ Outstanding. Superior knowledge & mature application of knowledge to clinical setting. Consistently able to sequence critical actions for patient care and generate a differential diagnosis for an undifferentiated patient.
Example:
|
PATIENT CARE: H&P, Differential Diagnosis
|
□ na
|
□ Inadequate: Incomplete or inaccurate, misses major problems.
Unable to make appropriate differential diagnosis or problem list.
Example:
|
□ Acceptable. Usually complete and accurate, identifying major & minor problems with an appropriate differential diagnosis list.
|
□ Outstanding. Comprehensive information, thorough, precise. Mature analysis & synthesis of data by priority, extensive differential diagnosis.
Example:
|
PATIENT CARE: Procedural Skills
|
□ na
|
□ Inadequate: Doesn’t use proper technique, awkward, bypasses steps, avoids procedures or disorganized.
Example:
|
□ Adequate: Uses proper technique, organizes equipment; Occasional difficulty with complicated procedures.
|
□ Outstanding. Precise, efficient performance with ease & dexterity, puts patient at ease
Example:
|
PATIENT CARE: Diagnostic Tests & Consultations
|
□ na
|
□ Inadequate: Overlooks basic tests, unable to interpret results, consults are inappropriate or untimely.
Example:
|
□ Adequate: Orders & interprets diagnostic tests, consults appropriately.
|
□ Outstanding. Has planned alternative strategies based on pending diagnostic test results. Consultations are timely and well-coordinated with plan of care.
Example:
|
PATIENT CARE: Decision-making
|
□ na
|
□ Inadequate: Decisions are risky, unsafe or inappropriate.
Example:
|
□ Adequate: Decisions typically accurate and safe, uses common sense. Able to triage patients and problems by level of acuity.
|
□ Outstanding. Mature, safe, decisions based on sound integration of data & reason. Prioritizing and critical actions are consistently appropriate.
Example:
|
PRACTICE-BASED LEARNING: Evidence Based Medicine And Self-Education
|
□ na
|
□ Inadequate: Doesn’t know patients, no reading or online learning evident.
Example:
|
□ Adequate: Supplements patient care with current literature, textbooks or online readings.
|
□ Outstanding. Extensive supplemental reading, knows disease process of own and other patients.
Example:
|
PRACTICE-BASED LEARNING: Teaching
|
□ na
|
□ Inadequate: Does not participate in teaching students or other residents.
Example:
|
□ Adequate: Participates in teaching opportunities. Actively teaches students & junior residents, motivates learning.
|
□ Outstanding. Develops teaching opportunities, motivates, and teaches with enthusiasm and dedication.
Example:
|
SYSTEMS-BASED PRACTICE: Resource Utilization
|
□ na
|
□ Inadequate: Unable to formulate an appropriate, resource- or cost-effective management plan.
Example:
|
□ Adequate: Management and discharge plan is appropriate for patient, with consideration given to patient and hospital resources.
|
□ Outstanding. Management plan is typically comprehensive, precise, and resource- & cost-effective.
Example:
|
PROFESSIONALISM: Work Habits
|
□ na
|
□ Inadequate: Poor attendance, shirks responsibility, frequently late, prolonged absence on shifts. Prevaricates.
Example:
|
□ Adequate: Attends required activities, accepts responsibility, usually punctual and organized. Occasionally performs extra functions, showing some independent initiative.
|
□ Outstanding. Consistently attends extra functions, displays leadership role, highly efficient. Stays late to help.
Example:
|
PROFESSIONALISM: Insight And Self-Assessment
|
□ na
|
□ Inadequate: Doesn’t accept criticism, displays little insight.
Example:
|
□ Adequate: Accepts constructive criticism, appropriately asks for assistance and feedback.
|
□ Outstanding. Assesses own limitations & responds constructively to feedback.
Example:
|
PROFESSIONALISM: Ethical and cultural sensitivity
|
□ na
|
□ Inadequate: Not responsive to patient’s age, culture, disability or gender issues. Unaware of patient as a person.
Example:
|
□ Adequate: Responsive to patient’s age, culture or gender issues. Demonstrates respect, compassion and integrity.
|
□ Outstanding. Consistently acts as an outstanding role model, demonstrating compassion and integrity in response to cultural, gender, age or disability issues.
Example:
|
INTERPERSONAL & COMMUNICATION SKILLS: Team Member
|
□ na
|
□ Inadequate: Doesn’t work well with others. Alienating, disrespectful to nurses, peers, consultants.
Example:
|
□ Adequate: Maintains good working relationship with team. Respected by nurses, peers, consultants.
|
□ Outstanding. Highly regarded by team. Consensus-builder. Role model.
Example:
|
INTERPERSONAL & COMMUNICATION SKILLS: Verbal, nonverbal and documentation skills
|
□ na
|
□ Inadequate: Unable to create or sustain a therapeutic or ethical relationship with patients. Ineffective listener. Unacceptable documentation.
Example:
|
□ Adequate: Creates and sustains therapeutic and ethical relationships with patients and families. Effective listening, verbal, nonverbal and writing skills.
|
□ Outstanding. Excellent verbal, nonverbal and writing skills. A role model
Example:
|
SUMMARY RATING:
|
□ na
|
□ Inadequate
|
□ Adequate
|
□ Outstanding
|
Annual Self-Evaluation
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