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ALBERTA CHILDREN’S HOSPITAL PAEDIATRIC EMERGENCY MEDICINE ROTATION INTERIM EVALUATION Resident Name _________________________ Rotation Dates _________ Home Program _________________________ Level ________ Preceptors: Please review evaluations to date and provide a summary evaluation of first half of rotation. Evaluation Codes: 1 – Below expectations for level of training 2 – Meeting expectations for level of training 3 – Outstanding resident (functioning in top 10% of peers) Medical Expert: History and physical exam Recognition of seriously ill child Ability to formulate differential Investigation & management plans

_____ _____ _____ _____

Communicator: Communication with families and pts Written reports

_____ _____

Collaborator: Team relationships (MDs RNs unit clerks)

_____

Manager: Follows up on own patients

_____

Scholar: Knowledge of the literature

_____

Professionalism: Sense of responsibility Recognition of own limitations Ability to receive feedback Ethical behavior

_____ _____ _____ _____

Overall Competency:

_____

Completed by: _____________________________ Please have preceptor complete at end of shift.

Comments:

Date: __________________

Resident Interim Evaluation Form  

PEM Resident Interim Evaluation Form - PDF

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