Critical Care Medicine Programme
The University of Toronto
Evaluation of Rotation by CCM Trainee
Dates of
Rotation: From:
To:
Hospital: Unit:
Medical Director: Programme Director: Dr.
Thomas Stewart
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Criteria |
Inadequate (1) |
Marginal (2) |
Good (3) |
Very Good (4) |
Excellent (5) |
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1. Morale of Resident |
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Comments on Morale: |
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2. General responsibility for level of
training |
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3. Clinical bedside instruction |
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4. In-patient workload |
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5. Overall educational experience |
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6. In-house call schedule |
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7. Time for study, review and preparation |
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8. Responsibility for patient care |
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9.
Teaching Rounds: |
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Combined Adult/Paediatric |
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10. City Wide Rounds (opportunity to attend) |
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Criteria |
Inadequate (1) |
Marginal (2) |
Good (3) |
Very Good (4) |
Excellent (5) |
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11. Critical constructive review of trainee |
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12. Attending supervision (in general) |
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13. Attending interest (in general) |
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14. Basic science instruction |
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15. Exposure to ongoing research |
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16. Application of research concepts &
methods to clinical problems |
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17. Opportunity to improve technical skills |
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General Comments on Rotation: |
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Would
you recommend this rotation to other trainees with similar goals: Yes
No Comments: |
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Please
return completed evaluation in the envelope provided to:
Dr. Thomas Stewart
Programme Director
Mount Sinai Hospital
600 University Avenue,
Suite 1818
Toronto, Ontario, M5G 1X5
Tel: 586-8774 Fax: 586-5981
~ Evaluations are Private
& Confidential ~
Please
rate individual Intensivists on the following pages.
Evaluation
of Attending Staff by CCM Trainee
Name of
Attending Staff:
|
Criteria |
Inadequate (1) |
Marginal (2) |
Good (3) |
Very Good (4) |
Excellent (5) |
|
1. How extensive was your exposure to this
Intensivist |
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The Intensivist |
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a)
provided quality formal teaching |
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b)
provided quality informal day-to-day
teaching |
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c)
questioned and challenged housestaff |
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d)
stimulated enthusiasm for learning |
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e)
was approachable for assistance &
discussion |
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f)
provided appropriate independence in
patient care |
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g)
contributed to improvement in
technical skills |
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h)
established a good rapport with
housestaff |
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i)
provided direction and feedback |
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j)
provided a good role model |
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k)
overall assessment of this
Intensivist’s teaching |
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General Comments regarding this Intensivist:
(Please
use additional pages if necessary).
Evaluation
of Attending Staff by CCM Trainee
Name of
Attending Staff:
|
Criteria |
Inadequate (1) |
Marginal (2) |
Good (3) |
Very Good (4) |
Excellent (5) |
|
1. How extensive was your exposure to this
Intensivist |
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The Intensivist |
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a)
provided quality formal teaching |
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b)
provided quality informal day-to-day
teaching |
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c)
questioned and challenged housestaff |
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d)
stimulated enthusiasm for learning |
|
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e)
was approachable for assistance &
discussion |
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f)
provided appropriate independence in
patient care |
|
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g)
contributed to improvement in
technical skills |
|
|
h)
established a good rapport with
housestaff |
|
|
i)
provided direction and feedback |
|
|
j)
provided a good role model |
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k)
overall assessment of this
Intensivist’s teaching |
|
General Comments regarding this Intensivist:
(Please
use additional pages if necessary).
Evaluation
of Attending Staff by CCM Trainee
Name of
Attending Staff:
|
Criteria |
Inadequate (1) |
Marginal (2) |
Good (3) |
Very Good (4) |
Excellent (5) |
|
1. How extensive was your exposure to this
Intensivist |
|
|
|
|
|
The Intensivist |
|
|
a)
provided quality formal teaching |
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|
b)
provided quality informal day-to-day
teaching |
|
|
c)
questioned and challenged housestaff |
|
|
d)
stimulated enthusiasm for learning |
|
|
e)
was approachable for assistance &
discussion |
|
|
f)
provided appropriate independence in
patient care |
|
|
g)
contributed to improvement in
technical skills |
|
|
h)
established a good rapport with
housestaff |
|
|
i)
provided direction and feedback |
|
|
j)
provided a good role model |
|
|
k)
overall assessment of this
Intensivist’s teaching |
|
General Comments regarding this Intensivist:
(Please
use additional pages if necessary).
Evaluation
of Attending Staff by CCM Trainee
Name of
Attending Staff:
|
Criteria |
Inadequate (1) |
Marginal (2) |
Good (3) |
Very Good (4) |
Excellent (5) |
|
1. How extensive was your exposure to this
Intensivist |
|
|
|
|
|
The Intensivist |
|
|
a)
provided quality formal teaching |
|
|
b)
provided quality informal day-to-day
teaching |
|
|
c)
questioned and challenged housestaff |
|
|
d)
stimulated enthusiasm for learning |
|
|
e)
was approachable for assistance &
discussion |
|
|
f)
provided appropriate independence in
patient care |
|
|
g)
contributed to improvement in
technical skills |
|
|
h)
established a good rapport with
housestaff |
|
|
i)
provided direction and feedback |
|
|
j)
provided a good role model |
|
|
k)
overall assessment of this
Intensivist’s teaching |
|
General Comments regarding this Intensivist:
(Please
use additional pages if necessary).
Evaluation
of Attending Staff by CCM Trainee
Name of
Attending Staff:
|
Criteria |
Inadequate (1) |
Marginal (2) |
Good (3) |
Very Good (4) |
Excellent (5) |
|
1. How extensive was your exposure to this
Intensivist |
|
|
|
|
|
The Intensivist |
|
|
a)
provided quality formal teaching |
|
|
b)
provided quality informal day-to-day
teaching |
|
|
c)
questioned and challenged housestaff |
|
|
d)
stimulated enthusiasm for learning |
|
|
e)
was approachable for assistance &
discussion |
|
|
f)
provided appropriate independence in
patient care |
|
|
g)
contributed to improvement in
technical skills |
|
|
h)
established a good rapport with
housestaff |
|
|
i)
provided direction and feedback |
|
|
j)
provided a good role model |
|
|
k)
overall assessment of this Intensivist’s
teaching |
|
General Comments regarding this Intensivist:
(Please use additional pages if necessary).