Satisfactory 3 3 Adequate interviewing skills; usually complete exams, including review of systems
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1 Any score of a or must be accompanied by an explanation. Please either fax completed evaluation to Julie Englert at , send to Julie Englert at Suite 9 Eye Ear Institute or englertjm@upmc.edu I. Patient Care History Physical Examination Skills Clinical Judgment Diagnostic Acumen Usually incomplete, superficial, unreliable. Exams are cursory or awkward Unable to analyze data; poor selection of tests/studies; incomplete Patient Management Skills Unable to initiate proper therapy, modify when needed, /or make critical decisions under pressure Technical (Procedural) Skills Inconsistent performance; all thumbs; disregards Usually incomplete, superficial, unreliable. Exams are cursory or awkward Unable to analyze data; poor selection of tests/studies; incomplete Unable to initiate proper therapy, modify when needed, /or make critical decisions under pressure Inconsistent performance; all thumbs; disregards Adequate interviewing skills; usually complete exams, including review of systems Able to analyze & data; differential diagnosis is acceptable; test selection appropriate, includes risk analysis Initiates maintains patient care in an orderly & appropriate manner most of the time ; sometimes has a difficult hling pressure Adequate use of instruments; minimizes patient discomfort risk Always precise, accurate thorough; systematic, efficient, focused exams; consistently thorough, elicits subtle findings integrates data, including risks & benefits; excellent selection of diagnostic studies; comprehensive initiates patient care in an orderly appropriate manner; hles pressure exceptionally well Extremely capable; rarely makes ; very attentive to Always precise, accurate thorough; systematic, efficient, focused exams; consistently thorough, elicits subtle findings integrates data, including risks & benefits; excellent selection of diagnostic studies; comprehensive initiates patient care in an orderly appropriate manner; hles pressure exceptionally well Extremely capable; rarely makes ; very attentive to
2 Any score of a or must be accompanied by an explanation. Please either fax completed evaluation to Julie Englert at , send to Julie Englert at Suite 9 Eye Ear Institute or englertjm@upmc.edu II. Medical Knowledge General knowledge Specialty Medical knowledge Good understing of essential information Good understing of essential information Extensive knowledge; well integrated; impressive Understs complex pathophysiology in specialty Extensive knowledge; well integrated; impressive Understs complex pathophysiology in specialty III. Practice-Based Learning & Improvement Record Documentation Incomplete, lacks critical contain inaccurate hwriting illegible Dictation of Operative notes/discharge Summaries Late, incomplete /or delinquent notes; fails to heed warnings; many Self-Directed Learning Shows no evidence of reading; ignores selfassessment & feedback; avoids Incomplete, lacks critical contain inaccurate hwriting illegible Late, incomplete /or delinquent notes; fails to heed warnings; many Shows no evidence of reading; ignores selfassessment & feedback; avoids Patient records are complete accurate; hwriting readable; needs occasional reminder Operative notes, discharge summaries completed in a timely Shows evidence of reading; intermittent selfassessment; incorporates Comprehensive, concise accurate records; hwriting readable; never needs a reminder Dictations are wellorganized thorough; always on time; rarely needs a reminder Voracious reader, shows articles, performs selfassessment accepts feedback; leader in use of Comprehensive, concise accurate records; hwriting readable; never needs a reminder Dictations are wellorganized thorough; always on time; rarely needs a reminder Voracious reader, shows articles, performs selfassessment accepts feedback; leader in use of
3 Any score of a or must be accompanied by an explanation. Please either fax completed evaluation to Julie Englert at , send to Julie Englert at Suite 9 Eye Ear Institute or englertjm@upmc.edu IV. Professionalism Respect Disrespectful; lacks compassion Integrity Dishonest; avoids responsibility for Appearance Fails to follow dress code: ignores feedback V. Interpersonal & Communication Skills Case Presentations Disorganized incomplete; difficult to comprehend; sloppy Sign-out/Cross Coverage In appropriate signouts; lacks understing during cross coverage Effectiveness with Patient Families Avoids contact with patients; insensitive, disrespectful; does not listen; tactless Disrespectful; lacks compassion Dishonest; avoids responsibility for Fails to follow dress code: ignores feedback Disorganized incomplete; difficult to comprehend; sloppy In appropriate signouts; lacks understing during cross coverage Avoids contact with patients; insensitive, disrespectful; does not listen; tactless Usually respectful, compassionate & Honest; recognizes & takes responsibility Follows dress code; responds to feedback Organized; contains the most important lacks details occasionally Sign out contains most important appropriate follow up of patients Good contact with patients; deals with their emotional personal needs when necessary respectful, compassionate Unquestionable honesty; takes initiative to address Exemplary appearance; always adheres to dress code Exceptionally wellorganized concise; very polished presentation Thorough, detailed sign-outs; hles cross coverage well Very skillful; shows sensitivity, respect insight; patients express confidence make compliments respectful, compassionate Unquestionable honesty; takes initiative to address Exemplary appearance; always adheres to dress code Exceptionally wellorganized concise; very polished presentation Thorough, detailed sign-outs; hles cross coverage well Very skillful; shows sensitivity, respect insight; patients express confidence make compliments
4 Any score of a or must be accompanied by an explanation. Please either fax completed evaluation to Julie Englert at , send to Julie Englert at Suite 9 Eye Ear Institute or englertjm@upmc.edu Effectiveness with Faculty, Staff Other Health Professionals Does not cooperate well, interact amicably /or work productively Clinical didactic teaching skills Displays a general lack of interest in teaching; poor ; many VI. System Based Practice Resource Utilization Poor utilization; resists improvement Billing/Compliance/Insurance Antagonizes billing compliance staff; does not attend meetings; ignores regulations Does not cooperate well, interact amicably /or work productively Displays a general lack of interest in teaching; poor ; many Poor utilization; resists improvement Antagonizes billing compliance staff; does not attend meetings; ignores regulations Works well with others, cooperative productive most of the time Teaches students, interns colleagues when asked; no ; adequate Adequate utilization; strives to improve Listens to billing compliance staff; attends necessary meetings; complies with regulations Cooperates extremely well, a real team player; works productively with others; others express confidence Demonstrates a strong interest in teaching others; many positive comments; excellent Effective utilization; reduces ; remarkable improvements Incorporates information from billing compliance staff into practice; complies with regulations promotes compliance among peers Cooperates extremely well, a real team player; works productively with others; others express confidence Demonstrates a strong interest in teaching others; many positive comments; excellent Effective utilization; reduces ; remarkable improvements Incorporates information from billing compliance staff into practice; complies with regulations promotes compliance among peers
5 Any score of a or must be accompanied by an explanation. Please either fax completed evaluation to Julie Englert at , send to Julie Englert at Suite 9 Eye Ear Institute or englertjm@upmc.edu SUMMARY: A. Please use this space to explain any ratings of or : B. Areas of Strength: C. Areas to Improve: D. Overall rating of resident performance during this clinical experience/rotation: (Circle One) UNSATISFACTORY MARGINAL SATISFACTORY VERY GOOD EXCELLENT Signature of Evaluator: Date:
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