Faculty Evaluation of Resident

Emergency Medicine Elective — End of Shift Feedback

Instructions: E&M = Evaluation and Management. A score of 1 is not a deficiency; early interns will generally score 1-2. Please complete this form at the end of the shift.
Please enter the resident's name.
1 Data Gathering / Interpretation *
Conducts a patient interview; performs a pertinent physical exam; appropriately prioritizes and interprets essential tests; synthesizes all information in a timely manner to generate a differential diagnosis; modifies differential diagnosis in response to new information.
This field is required.
2 Management Plans *
With progressive independence, initiates, manages and modifies patient care plans for common through complex medical diseases (e.g. abnormal vital signs, sick vs not sick, cardiac vs noncardiac chest pain, arrhythmia, injury, altered mental status, decompensated liver disease) using appropriate resources and evidence-based medicine.
This field is required.
3 Consult Interactions *
Asks the appropriate questions of consultants; weighs and implements recommendations.
This field is required.
4 Acute Care *
Recognizes and manages acute clinical decompensations/emergencies (e.g. shock, ACS, respiratory failure, CVA); stabilizes the patient and escalates care when appropriate.
This field is required.
5 Strengths & Focused Feedback *
Please document the resident's strengths, and provide focused feedback for development of knowledge, skills and attitude. This is the most meaningful portion of the evaluation.
This field is required.