MCSO/OSU-CHS
Orthopedics
NAME OF RESIDENT
Monica Woodall, DO
Michael Roach, DO
Mike Boger, DO
Robert Gispanski, DO
Thomas Jarvis, DO
Andrew Hamill, DO
Alex Roby DO
Clay Garrett DO
Robert Moody DO
Tim Newton DO
Rotation Dates
Month
Jan
Feb
March
April
May
June
July
August
Sept
Oct
Nov
Dec
Year
2010
2011
2012
2013
2014
2015
Name of evaluator
Dr. Grider
Dr. Malone
other
Lichert Scale 1=poor 3=average 5=excellent
CORE COMPETENCY EVALUATION
Did the intern / resident demonstrate Osteopathic Skills during this rotation?
1
2
3
4
5
UE
Did the Intern demonstrate adequate medical knowledge during this rotation?
1
2
3
4
5
UE
Did the intern / resident demonstrated professionalism during this rotation?
1
2
3
4
5
UE
Did the Intern / Resident demonstrate adequate interpersonal and communication skills during this rotation?
1
2
3
4
5
UE
Did the Intern / Resident demonstrate adequate patient care skills for their level of training?
1
2
3
4
5
EU
Did the Intern demonstrate adequate use of resource materials during this rotation?
1
2
3
4
5
UE
Did the Intern / Resident demonstrate punctuality
1
2
3
4
5
UE
ROTATION SPECIFIC QUESTIONS
1
2
3
4
5
UE
Can the Intern/Resident recognize and manage common fractures, sprains, dislocations?
Does the Intern/Resident describe orthopedic injuries accurately to you?
Does the Intern/Resident understand orthopedic pathology that is emergent?
Does the Intern/Resident recognize those emergent disorders that require intervention by an orthopedic surgeon?
Has the Intern/Resident utilized your services appropriately?
Is the Intern/Resident competent to evaluate, work-up the shoulder, knee and ankle?
Does the Intern/Resident diagnose and treat various arthridites correctly?
Does the Intern/Resident have a basic understanding of congenital bony disorders?
Is the Intern/Resident competent to workup and treat low back disorders?
Can the Intern/Resident inject various joint competently?
ROTATION SPECIFIC COMMENTS
Comments
Signature of Evaluator
UPIN
SSN
MCSO ID
Date:
Indicates Response Required