Surgery Evaluation Standards

 

 

 

 

Name:

 

 

 

 

 

 

 

 

 

 

Clerkship Student Formative Evaluation

 

RFUMS/The Chicago Medical School

 

Surgery Clerkship

Rotation Dates:

 

From:               To:

 

Circle the box which best describes your typical performance for appropriate meeting of curricular objectives and clinical competencies in each of the following categories.

 

The following are examples of behaviors/performance that guide you in assessing your performance. The list of examples is not comprehensive and only provides guidance.

 

I.  Medical and Scientific

Knowledge

Demonstrates knowledge about established and evolving biomedical, clinical, epidemiological, and social-behavioral sciences and applies this knowledge in caring for patients.

 

Does Not Meet Standards

Partially Meets Standards

Meets Standards

Exceeds Standards

 

 

Fund of knowledge of normal and altered structure and function and diagnostic methods is below that expected for a third year surgical student

 

Fund of knowledge adequate to address common presentations of surgical conditions

 

Good fund of surgical knowledge

 

Fund of knowledge includes information on less common core surgical conditions

 

Comments:


 

 

 

II.  Patient Care and

Prevention

Demonstrates patient centered care that is compassionate, appropriate, and effective for the promotion of health, quality of life, prevention of illness, treatment of disease, and the end of life.

 

Does Not Meet

Standards

Partially Meets Standards

Meets Standards

Exceeds Standards

 

 

 

Often unable to complete history due to insufficient or inaccurate information

 

 

 

 

 

Does not consistently demonstrate proper technique when performing the physical examination

 

 

 

Difficulty interpreting common diagnostic procedures and developing a differential diagnosis and treatment plan

 

 

 

 

Unable to demonstrate the ability to use preventive strategies in patient care

 

 

 

Unable to recognize life- threatening conditions or institute appropriate initial therapy

 

 

Able to perform complete histories on uncomplicated cases

 

Complicated cases at times disorganized

 

 

 

Consistently uses proper technique when performing the physical examination

 

 

 

 

 

Able to interpret basic diagnostic procedure and develop a differential diagnosis and treatment plan for common surgical problems

 

 

 

 

 

Able to use preventive strategies for common diseases

 

 

 

 

 

Able to recognize common life- threatening conditions and institute appropriate initial therapy

 

 

Consistently obtains complete histories, only missing less critical information

 

 

 

 

 

Consistently uses proper technique and identifies major abnormalities and pertinent normal findings

 

 

Consistently complete, well organized histories

 

 

 

 

Consistently performs a comprehensive physical examination using proper technique and appropriately focuses exams as needed

 

 

 

Able to interpret complex diagnostic procedures andevelop differential diagnosis and treatment plans for common and  at times less common surgical problems

 

 

 

 

Able to use preventive strategies for a wide variety of diseases

 

 

 

 

 

Able to recognize common and uncommon life-threatening conditions and institute appropriate initial therapy

 

Comments:


 

 

 

III.  Professionalism and Self- awareness

Demonstrates a commitment to professional service, adherence to ethical principles, sensitivity to diverse populations, and awareness of one’s own interests and vulnerabilities.

 

Does Not Meet

Standards

Partially Meets Standards

Meets Standards

Exceeds Standards

 

 

Has some difficulty recognizing limitations, tendency towards arrogance

 

Disrespectful to any member of healthcare team and/or patients

 

 

 

Sometimes has difficulty accepting constructive feedback

 

Recognizes limitations in knowledge/skill and asks for help

 

 

Never disrespectful toward patient or team members

 

 

 

 

Accepts feedback well but may not actively seek it

 

Good ability at self assessment

 

 

 

Makes an active effort to treat everyone with respect and courtesy

 

 

 

Actively seeks feedback

 

Very good ability to identify strengths and weaknesses

 

 

 

Professional demeanor(respect, courtesy, honesty, integrity) is very good

 

Actively seeks feed- back and adjusting behaviors accordingly

 

Comments:

 

 

 

 

 

IV.  Practice-based, Life-long

Learning

Demonstrates the ability to appraise and assimilate scientific evidence and methods to investigate, evaluate and improve one’s own patient care practices.

 

Does Not Meet Standards

Partially Meets Standards

Meets Standards

Exceeds Standards

 

Reading is inconsistent or too

superficial

 

 

Slow to learn from mistakes, tends to repeat them

Reads about patients’ problems

and tries to apply what is learned

 

Learns from mistakes but sometimes has trouble recognizing errors

Consistently reads and applies

it to patient care

 

 

Recognizes errors and rarely repeats mistakes

Reads extensively and often from

the most current sources

 

 

    
Actively seeks to anticipate
    potential errors and tries to
    prevent them

 

Comments:


 

 

 

V. Systems-based, Inter

Professional Practice

Demonstrates an awareness of and responsiveness to the larger context of health care and the ability to call on system resources and other health care

professionals to provide optimal care.

 

Does Not Meet Standards

*****

*****

Meets Standards

 

Insufficiently aware of the

roles of the members of the health care team

 

 

 

Insufficiently aware of how cost, insurance, and resource allocation practically affect patient care

 

 


Appreciates the different roles
of all members of the health care team and applies this to patient care

 

 

Understands general costs of care and commujnity resources

 

Comments:

 

 

 

 

VI.  Interpersonal and

Communication Skills

Demonstrates effective understanding, information exchange, and teamwork with patients, their families, and other health professionals.

 

Does Not Meet

Standards

Partially Meets Standards

Meets Standards

Exceeds Standards

 

 

 

Does not demonstrate at all times the ability to be respectful in relationships with patients, their

families, and colleagues

 

 

Notes sometimes illegible, incomplete, and/or contain inaccurate data

 

 

 

 

 

 

 

 

 

Notes legible, accurate and miss only minor details

 

 

 

 

 

 

 

 

 

Notes usually can stand on their own with little need for addendums

 

 

Students must always demonstrate the ability to sustain therapeutic, ethically sound, respectful professional relationships with patients, their families, and colleagues

 

Notes complete and organized

 

Comments:

 

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