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Alberta Children’s Hospital Emergency Department PEM Rotation Daily Precepted Shift Evaluation

***Absent Shift*** Date:

Resident __________________________________________________ Training Level ______________ Medical School/Program _____________________________________ Rotation Block ______________ OFFICE USE ONLY Number/date of MISSED shifts: __________________________________________________________ Number/date of MISSED teaching sessions: _________________________________________________

Medical Expert In relation to expectations for level of training: Rarely Meets **

Inconsistently Meets **

Consistently Meets

Often Exceeds **

Consistently Exceeds **

No Data

Knowledge base (broad, relevant, current) History: performs independently in common cases – appropriate, thorough and directed Physical Exam: performs independently in common cases – appropriate, thorough and directed Differential Diagnosis: organized and appropriate Diagnostic Testing: appropriate choice and use of ancillary tests Presentations: organized, directed and pertinent Medical Record Keeping: legible, organized, pertinent Soundness of Judgement and Decision Making: provides effective treatment Clinical Procedures: safe and effective Organizes effective/efficient patient dispositions Supporting comments:

**any category given a mark OTHER than “Consistently Meets” MUST include supporting comments

Professional In relation to expectations for level of training: Rarely Meets **

Inconsistently Meets **

Consistently Meets

Often Exceeds **

Consistently Exceeds **

Consultancy Skills: Demonstrates timely consultation with staff ED physician and/or other services Communicator: physician-patient relationships Collaborator: team relationships (MDs, RNs, Unit Clerks) Is punctual for shifts and educational events; enthusiastic Follows through on assigned tasks, transfer of patient care, informs supervisor of errors or concerns Supporting comments:

**any category given a mark OTHER than “Consistently Meets” MUST include supporting comments

No Data


Procedures and Skills In relation to expectations for level of training: Procedure performed

Comments

On the basis of your assessments above, do you consider that this individual has reached a level of competence compatible with her/his level of training? ☐ No ☐ Yes Do you consider this candidate’s moral and ethical standing satisfactory? ☐ No ☐ Yes

Overall Evaluation In relation to expectations for level of training: Unable FAIL To Rarely Assess Meets Overall Evaluation ☐ ☐

FAIL Inconsistently Meets ☐

PASS Consistently Meets ☐

PASS Often Exceeds ☐

PASS Consistently Exceeds ☐

Comments: your comments are very important. They should summarize the candidate’s strengths and weaknesses. Applicant’s Strengths:

Applicant’s Weaknesses:

Recommendations for how improvement can occur:

Did you have an opportunity to meet with this trainee to discuss their performance? ☐ Yes ☐ No Completed by __________________________________________

Date _____________________

Daily evaluation form  
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