Download Critical Care Evaluation of Rotating Resident

Critical Care Evaluation of Rotating Resident
The University of Manitoba
Name of Resident: _____________________________________________________
Resident’s Program: _____________________________________________________
Rotating Service:
Rotation Dates:
_____________________________________________________
From: ____________________
to: ____________________
MEDICAL EXPERT
ECG
Knowledg e
Unsatisfactory
1
2
Lacks standardized approach to ECG
interpretation. Not able to reliably
diagnose common rhythm issues in
critically ill patients. Usually relies on
others for interpretation of ECG.
ABG
Interpretation
Mechanical
Ventilation
Unsatisfactory
1
2
Lacks standardized approach to ABG
interpretation. Not able to reliably diagnose
common acid-base issues in critically ill
patients. Usually relies on others for
interpretation of ABG.
Unsatisfactory
1
2
Unsatisfactory
1
2
Not able to recognize or classify shock. Not
able to utilize hemodynamic measurements
to manage patients.. Usually relies on others to
interpret the data and provide management advice.
Use of Inotropes
and vasopressors
Unsatisfactory
1
2
Limited knowledge of the pharmacology of
these agents. Does not make good decisions when
selecting agents. Inconsistent approach. Cannot
explain their rationale to others.
Management of
emergencies
Unsatisfactory
1
Fails to prioritize and/or hesitates in
providing appropriate, organized, life
saving interventions. Not an effective
leader.
4
Has good basic approach to
ECG interpretation. Can quickly
and reliably diagnose common
rhythm issues.
Limited knowledge of respiratory physiology.
Uncertain of the differences between modes of
ventilation. Limited clinical/physiology
Knowledge base results in inability to provide
appropriate ventilator orders for most patients.
Management of
Hemodynamics and
Shock
Satisfactory
3
2
Satisfactory
3
4
Has good basic approach to ABG
interpretation. Can quickly and
reliably diagnose common acid
base issues.
Satisfactory
3
4
Excels
5
Unable to
Evaluate
Expert at interpretation of ECG.
Can diagnose complex rhythm issues.
Is a resource to others.
Excels
5
Unable to
Evaluate
Expert at interpretation of ABG. Can
diagnose complex acid-base issues.
Can teach others.
Excels
5
Unable to
Evaluate
Reasonable knowledge of respiratory
physiology. Knows the difference
between ventilator modes. Able to
apply knowledge and provide
appropriate ventilator orders for most
patients.
Satisfactory
3
4
Strong knowledge of respiratory
physiology. Understands the modes of
ventilation including advanced modes.
Can provide ventilator orders for complex
patients where most residents require input
from attending or fellow.
Excels
Unable to
5
Evaluate
Can recognize and classify shock.
Utilizes hemodynamic measurements
in patient management decisions. Can
make most common hemodynamic
decisions independently.
Satisfactory
3
4
Superior knowledge of hemodynamics.
Advanced knowledge of measurement
techniques and interpretation of data.
Makes correct decisions in complex cases.
Able to teach others.
Excels
Unable to
5
Evaluate
Good knowledge of pharmacology.
Knows the differences between
commonly used medications.
Usually selects the correct agent for
most patients. Can explain their
Satisfactory
3
4
Superior knowledge of pharmacology.
Exhibits advanced skills in utilizing
these agents to manage patients. Able to
fully explain indications and rationale for
for clinical decisions. Can teach others.
Excels
Unable to
5
Evaluate
Appropriately intervenes in timing
and manner in most emergency
situations. Remains calm. Displays
leadership,utilizing resources in an
effective manner.
Excellent organization with definitive
responses. Recognizes/responds
appropriately to variations/uncommon
situations. Prioritizes correctly and
Delegates effectively.
Overall
Knowledge
Unsatisfactory
1
2
Lacks appropriate knowledge to define
priorities in diagnosis and management of
clinical problems. Does not apply knowledge.
Satisfactory
3
4
Fund of knowledge enables resolution
of common clinical situations on a
consistent basis.
Excels
5
Unable to
Evaluate
Has an exceptional fund of knowledge
consistently and appropriately applied
to patient care.
MEDICAL EXPERT- SKILLS
Airway
Management
Unsatisfactory
1
2
Despite teaching and supervision has difficulty
providing bag mask ventilation and/or intubation
in patients with uncomplicated airways. Misses
key features in airway evaluation.
Central Venous access
Arterial access
Literature Search/
Use of Learning
resources
Unsatisfactory
1
2
Despite teaching and supervision has difficulty
cannulating central veins.. May not follow
standard procedures. Knowledge of
anatomy below average.
Unsatisfactory
1
2
Despite teaching and supervision has
Difficulty cannulating arteries. May not
follow standard procedures. Knowledge of
anatomy poor.
Unsatisfactory
1
2
Seldom looked anything up. May not have
been reading around the patient problems that were
encountered on the rotation.
Satisfactory
3
4
Excels
5
Unable to
Evaluate
Can provide bag mask ventilation and
intubation in most patients with
uncomplicated airways. Evaluates
the airway correctly and can predict
patients who might be difficult.
Seeks help appropriately.
Satisfactory
3
4
Can teach others about airway management.
Able to manage patients with known
difficult airways. Can predict circumstances
where problems might occur and develops
plans to prevent foreseeable problems.
Can successfully cannulate central
veins in most patients and follow
standard procedures. Good basic
lnowledge of relevant anatomy.
Satisfactory
3
4
Expert with this skill who can teach others.
Excellent anatomic knowledge. Able to
succeed where others have failed.
Can successfully cannulate arteries
in most patients and follows
standard procedures.
Satisfactory
3
4
Actively sought information from
the medical literature around patient
issues that arose during the rotation.
Able to find articles/resources to help
patient care.
Excels
5
Excels
5
Unable to
Evaluate
Unable to
Evaluate
Expert with this skills who can teach
others. Able to succeed where others
have failed.
Excels
5
Unable to
Evaluate
Consistently provided the team with
information from the medical literature.
Relevant issues always identified and
appropriate literature provided. Exhibited
superior abilities to critically analyze the
information.
PROFESSIONAL
Independence
Receptiveness to
feedback
Reliability and/or
conscientiousness
Unsatisfactory
1
2
Satisfactory
3
4
Excels
5
Unable to
Evaluate
Relies heavily on superiors. Not equipped
to deal with routine problems independently.
OR, alternatively, not aware of own
limitations, thereby putting patients at risk.
Unsatisfactory
1
2
Handles most problems independently, but uses superiors
appropriately in more complex
cases. Aware of limitations.
Satisfactory
3
4
Can operate safely and independently.
even in complex cases, but will ask for
help when appropriate.
Cannot or will not respond constructively
to feedback/suggestions. Evasive/unable
to take advice gracefully. Unaware of
own limitations and repeats inappropriate
behaviors/actions despite feedback.
Seeks assistance and/or feedback
to overcome/compensate for
limitations. Accepts advice
graciously. Subsequent performance
indicates that feedback was used
to overcome deficiencies. Aware
of own limitations.
Satisfactory
3
4
Always accepts criticism positively.
Consistently displays professional
behavior and recognizes own limitations.
Raises constructive questions/seeks feedback
to further excel.
Unsatisfactory
1
Not dependable and/or reliable. Does
less than the prescribed work. Needs
repeated reminders to complete duties.
Frequently absent from non-clinical
duties (e.g. teaching sessions) or clinical.
duties/
2
Dependable, reliable and forthright
in information and facts. Provides
prompt appropriate follow-up of
patients. Deals with clinical and
non-clinical duties well.
Excels
5
Excels
5
Demonstrates reliability and
conscientiousness. Meets deadlines and
is punctual. Consistently
displays exceptional attention in
clinical and non-clinical duties.
Always prepared to give effort willingly.
Unable to
Evaluate
Unable to
Evaluate
COMMUNICATOR
Case presentations
Unsatisfactory
1
2
Disorganized and incomplete when presenting
patients during rounds. Key features consistently
missed. Unable to prioritize issues. Incorrect
information frequently provided.
Records/Reports
Unsatisfactory
1
2
Records/reports are incomplete,
Inaccurate and/or lack important information
and structure.
Satisfactory
3
4
Organized, relevant presentations for
most patients. Key features generally
provided. Resident understands what
findings are important and communicates
them to the team.
Satisfactory
3
4
Records/reports are usually
accurate, complete and orderly.
Excels
5
Unable to
Evaluate
Organized presentations for all patients –
even the ones with complex issues and
histories. Seldom misses key features and
provides team with all relevant information
the first time.
Excels
Unable to
5
Evaluate
Consistently produces comprehensive
and accurate reports reflecting not merely
the facts but clearly communicating plans
and directions.
COLLABORATOR
Development of problem
Unsatisfactory
lists and daily
1
2
plans
Unable to generate a relevant problem list in most
patients. Plans often rudimentary and do not
address many relevant issues. Plans require
input from attending most of the time.
Team relations
Unsatisfactory
1
2
Unable to be effective in interdisciplinary
team discussions/meetings. Inappropriate
behavior interferes with
team function/performance. Lacks ability
to get along with other members of team.
Undermines team operation and creates
undue tension.
Satisfactory
3
4
Good problem lists developed for most
patients, and this list is used to generate
an appropriate plan. Plans frequently do
not require much input from the
attending.
Satisfactory
3
4
Effective in interdisciplinary team
discussions/meetings. An active
member of the team who works well
with others. Appropriate instructions/
rapport with nurses/allied staff.
resulting in a constructive
environment.
Excels
5
Unable to
Evaluate
Outstanding development of problem lists
and plans. Complete and comprehensive
in an approach to both. Plans usually do not
require input from the attending.
Excels
5
Unable to
Evaluate
Very effective in interdisciplinary team
discussions. An active member
of the team whose leadership qualities
are recognized by others. Is always able
to achieve best results, even in difficult
situations. Deals effectively with issues
interfering with optimal team functions.
SCHOLAR
Critical appraisal skills
Unsatisfactory
1
2
Is seldom aware of/does not utilize
literature-based evidence in clinical
practice. Is unable to critically access
the literature.
Self Education Skills
Unsatisfactory
1
Satisfactory
3
4
Demonstrates an ability to seek out,
locate and judge the strength of the
evidence in the literature.
2
Makes an inadequate effort to ensure
continuing competence. Is unable to
critically assess the literature.
Satisfactory
3
4
Up-to-date in major clinically
applicable developments. Displays
effective skills in continuing education.
Can identify gaps in knowledge
and develop a strategy to fill the
gaps.
Excels
5
Unable to
Evaluate
Skilled in critical appraisal of the
literature. Integrates information
from a variety of sources into
practice.
Excels
5
Unable to
Evaluate
Constantly upgrading knowledge and skills.
Always up to date and skilled in critical
appraisal of the literature. Stimulated by
new challenges. A role model for others in
professional maintenance of competence.
MANAGER
Personal manager
Unsatisfactory
1
2
Ineffective time management to achieve
balance between patient care, learning needs,
and outside responsibilities.
Satisfactory
3
4
Usually demonstrates effective time
management to achieve balance between
patient care, learning needs, and outside
responsibilities.
Excels
5
Consistently demonstrates effective time
management to achieve balance between
patient care, learning needs, and outside
responsibilities.
Unable to
Evaluate
Provision of ICU care
Unsatisfactory
1
2
Ineffectively administers the provision of
care and implementation of decisions.
regarding patient care and use of health care
resources. Unable to predict and thereby
prevent potential problems.
Satisfactory
3
Excels
5
4
Usually administers provision of care
and implementation of decisions
regarding patient care/health care
resources effectively. Able to
anticipate and prevent potential
problems.
Unable to
Evaluate
Effectively administers the provision of
care/implementation of decisions regarding
patient care. Utilizes health care resources in
scientifically, ethically and economically
defensible manner. Predicts and prevents
foreseeable problems.
ADVOCATE
Advocacy
Unsatisfactory
1
2
Fails to recognize and/or respond to
those issues, settings, circumstances, or
situations in which advocacy on behalf of
patients, profession, or society is
appropriate.
Satisfactory
3
Excels
5
4
Usually recognizes/responds to those
issues, settings, circumstances, or
situations in where advocacy on behalf
of patients, profession, or society is
appropriate.
Consistently recognizes/responds to
those issues, settings, circumstances or
situations where advocacy on behalf of
patients, profession, or society is
appropriate.
Overall Evaluation
Unsatisfactory
1
2
Did the Resident ….
Satisfactory
3
PASS
Excels
5
4
FAIL
Comments-required for assessments of 1, 2 or 5!
Names of Participants in group evaluation: _________________________
__________________________
_________________________
_________________________
Evaluator’s Signature: ______________________________
Resident Comments:
Date:
Resident’s Signature: __________________________________
Date: ____________________________________
(To attest that evaluation has been seen by resident)
_________________________
Unable to
Evaluate