 Medical Knowledge
Inadequate
Adequate
Outstanding
2
1
0
Resident had an appropriate knowledge base for level of training and is able to apply knowledge to the clinical setting.
Comment on rating of inadequate or outstanding:
Patient Care
2
1
0
H&P and differential diagnoses are complete and accurate. Medical decisions are typically accurate and safe. The resident triages patients and problems by level of acuity. The resident recognizes life-threatening conditions and is able to sequence critical actions.
2
1
0
Procedural skills are acceptable for level of training. The resident uses proper technique, organizes equipment and puts the patient at ease.
2
1
0
Diagnositic tests are ordered and interpreted appropriately. Consultations are timely and coordinated with plan of care.
Comment on ratings of inadequate or outstanding:
Practice-based learning & Improvement
2
1
0
The resident demonstrates self-education and applies principles of evidence based medicine in the clinical setting. The resident supplements patient care with current literature, up-to-date textbooks and online readings. Applies knowledge of study design and methodology when appraising the literature.
2
1
0
The resident actively participates in teaching opportunities with other residents, students and other healthcare professionals.
Comment on ratings of inadequate or outstanding:
System-based practice
2
1
0
The resident practices cost-effective health care and resource allocation without compromising quality of care. The resident advocates for quality patient care and assist patients in dealing with the complexity of the healthcare system.
2
1
0
Resource utilization is acceptable. Management and discharge plan is appropriate for patient with consideration given to patient and hospital resources.
Comment on ratings of inadequate or outstanding:
Professionalism
2
1
0
Work habits are acceptable. Actively participates in all required activities, accepts responsiblity, and is punctual and appropriately dressed.
2
1
0
Insight & Self assessment is acceptable. Accepts constructive criticism & appropriately asks for assistance and feedback.
Comment on ratings of inadequate or outstanding:
Interpersonal & Communication skills
2
1
0
The resident is a repected member of the health care team, and maintains a good working relationship with nurses, peers and consultants. Creates and sustains therapeutic and ethical relationships with patients and families.
2
1
0
Demonstrates effective and appropriate verbal, nonverbal and documentation skills.
2
1
0
Ethical and cultural sensitivity is acceptable. Resident is responsive to patient's age, culture, disablity & gender, and demonstrates compassion, respect and integrity.
Comment on ratings of inadequate or outstanding:
Self-reflection:
List three of your strenghts:
List three of your weaknesses and how you plan to improve:
How much stress have you been experiencing this year?:
NO
YES
Is your personal support system adequate?
NO
YES
Have you been experiencing the symptoms of excessive fatigue: irritablity, moody, memory lapses, poor concentration?
Plans and goals
What was your National inservice score this year? What is your goal for next year and how do you plan to achieve it?
What is your scholarly activity or research project? Completed?
What are your plans for your 4th subspecialty track?
NO
YES
Do you plan on doing a fellowship?
What type of fellowshipt?
Where do you plan to practice after you graduate? (Geography and type of hospital)
The residency
What do you like best about our residency?
What would you like to see changed about our residency?
Yearly residency requirements
NO
YES
Have you met with your advisor this year?
NO
YES
Are all ACGME required procedures logged into Residency Partner?
NO
YES
Have all your monthly evaluations been completed?
NO
YES
Have you submitted all scholarly activities and lectures to be filed in your portfolio?
NO
YES
Does your conference attendance (including home study modules and journal club) exceed 70%?
NO
YES
Have you completed the Core Competencies?
NO
YES
Have you submitted your 20 patient follow-ups?
NO
YES
Are you in compliance with the ACGME mandated duty-hour maximum of an average of 60 hours per week (in ED), and 1 day off in 7, and minimum 10 hours off between shifts?
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