Evaluation Program and Attending Staff

Evaluation by Attending

Resident Physician:________________ Evaluator ___________________
First Name Last Name First Name Last Name

Evaluation Period: ________________

Core Competencies

Interpersonal and Communication Skills

Does not establish even minimally effective therapeutic relationships with patients and families, does not demonstrate ability to build relationships through listening, narrative or nonverbal skills; does not provide education or counseling to patients, families or colleagues. Establishes a highly effective therapeutic relationship with patients and families, demonstrates excellent relationship building through listening, narrative and nonverbal skills, excellent education and counseling of patients, families and colleague, always “interpersonally” engaged.
Unsatisfactory Satisfactory Superior

1 2 3 4 5 6 7 8 9

No Interaction Marginal

Medical Knowledge

Limited knowledge of basic and clinical sciences, minimal interest in learning, does not understand complex relations, mechanisms of disease. Exceptional knowledge of basic and clinical sciences, highly resourceful development of knowledge, comprehensive understanding of complex relationships, mechanisms of disease. .
Unsatisfactory Satisfactory Superior

1 2 3 4 5 6 7 8 9

No Interaction Marginal

Patient Care

Incomplete, inaccurate medical interviews, physical examinations and review of other data; incompetent performance of essential procedures, fails to analyze clinical data and consider patient preferences when making medical decisions. Superb, accurate, comprehensive medical interviews, physical examinations, review of other data, and procedural skills; always makes diagnostic and therapeutic decisions based on available evidence, sound judgment, and patient preferences..
Unsatisfactory Satisfactory Superior

1 2 3 4 5 6 7 8 9

No Interaction Marginal

Practiced Based Learning

Fails to perform self-evaluation; lacks insight, initiative, resists or ignores feedback; fails to use information technology to enhance patient care or pursue self-improvement.. Constantly evaluates own performance, incorporates feedback into improvement activities; effectively uses technology to manage information for patient care and self-improvement.
Unsatisfactory Satisfactory Superior

1 2 3 4 5 6 7 8 9

No Interaction Marginal

Professionalism

Lacks respect, compassion, integrity, honestly; disregards need for self-assessment, fails to acknowledge errors, does not consider needs of patients, families, colleagues, does not display responsible behavior. Always demonstrates respect, compassion, integrity, honesty; teaches/role modes responsible behavior, total commitment to self-assessment, willingly acknowledges errors; always considers needs of patient, families, colleagues
Unsatisfactory Satisfactory Superior

1 2 3 4 5 6 7 8 9

No Interaction Marginal
System-Based Learning

Unable to access/mobilize outside resources; actively resists efforts to improve systems of care; does not use systematic approaches to reduce error and improve patient care. Effectively accesses/utilizes outside resources; effectively uses systematic approaches to reduce errors and improve patient care; enthusiastically assists in developing systems improvement.
Unsatisfactory Satisfactory Superior

1 2 3 4 5 6 7 8 9

No Interaction Marginal
Secondary Competencies

Resident’s overall clinical competence in rotation. Resident’s overall clinical competence in rotation

Unsatisfactory Satisfactory Superior

1 2 3 4 5 6 7 8 9

No Interaction Marginal