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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