MCSO/OSU-CHS
Pediatrics
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. Akin
Dr. Karina
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 demonstrate 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
Intern/Resident understands and provides adequate care to the newborn
Intern/Resident is competent to perform a newborn circumcision
Intern/Resident understands the differential and treatment for jaundice in the newborn
Intern/Resident understands the presentation, workup and basic treatment for neonatal infections
Intern/Resident has a basic understanding of various infant feeding problems, newborn formulas and their use
Intern/Resident understands and can treat GERD and colic in the neonatal period
Intern/Resident has a basic understanding of various congenital anomalies
Intern/Resident understands basic immunizations and their administration
Intern/Resident understands basic pediatric drugs and their dosages
Intern/Resident differentiates between functional and organic heart murmurs
Intern/Resident recognizes and treats common skin conditions in pediatrics
Intern/Resident recognizes developmental milestones and abnormalities in growth and development
Intern/Resident recognizes and can deal with psych/social issues in kids
Intern/Resident recognizes and can work up and treat a basic seizure disorder
Intern/Resident recognizes and can treat asthma in children
Intern/Resident has an understanding and can recognize various genitourinary pediatric conditions
ROTATION SPECIFIC COMMENTS
Comments
Signature of Evaluator
UPIN
SSN
MCSO ID
Date:
Indicates Response Required