MCSO/OSU-CHS

Family Medicine Evaluation for Critical Care/ICU

Name of Resident 
Rotation Dates
Name of Evaluator

Lichert Scale 1=poor 3=average 5=excellent

Did the Intern/Resident demonstrate Osteopathic skills during this rotation?
Did the Intern/Resident demonstrate adequate knowledge during this rotation?
Did the Intern/Resident demonstrate professionalism during this rotation?
Did the Intern/Resident demonstrate adequate interpersonal and communication skills during this rotation
Did the Intern/Resident demonstrate adequate patient care skills for their level of training?
Did the Intern/Resident demonstrate adequate use of resource materials during this rotation?
Did the Intern/Resident demonstrate punctuality?

Demonstrates and adequate understanding of CV physiology?

Demonstrates an understanding of pulmonary physiology?

Recognizes the criteria for admission to the critical care unit?

Recognizes multiple organ failure


* Indicates Response Required