360 Evaluation Medical Staff printable pdf download

360 Evaluation Medical Staff

TEMPLE UNIVERSITY HOSPITAL

360

EVALUATION

Please return to Jean by FAX

(215) 707-9168

RESIDENT:

PGY:

EVALUATORS:

Date:

For each criteria, please rate [ x ] the resident named above

and make a short comment about each performance area.

Unsatisfactory Marginal Satisfactory

Good Excellent

Unknown

FUND OF KNOWLEDGE

[ ]

Considerations: Is basic medical knowledge appropriate to PGY level of training? Is knowledge sound, current, well applied and

logical? Is knowledge of disease, pathophysiology, diagnosis and therapy limited or extensive? Is resident self motivated to

acquire knowledge?

Comments:

Unsatisfactory Marginal Satisfactory

Good Excellent

Unknown

CLINICAL JUDGMENT

[ ]

Considerations: Exhibits ability to discern relationship of medical facts, clinical data, to evaluate risks and benefits and alternatives?

Uses diagnostic procedures appropriately? Indecisive or reasons well in difficult patient management or ambiguous situations?

Treats the patient, not just the problem? Manages time well given the complexity of the case? Is aware or unaware of his/her

own limitations of knowledge and skill?

Comments:

Unsatisfactory Marginal Satisfactory

Good Excellent

Unknown

PROFESSIONALISM & HUMANISTIC

[ ]

PATIENT CARE

Considerations: Exhibits ability to place patient's interests and well being first? Displays sensitive, caring, respectful attitude

toward patient, family, team members and students? Establishes trust and maintains credibility with patient care team and patient?

Establishes good rapport with all care givers, patient and family? Is reliable and demonstrates integrity?

Comments:

360 Evaluation Medical Staff