MCSO/OSU-CHS

Orthopedics

NAME OF RESIDENT *

Rotation Dates

Month *

Year *

Name of evaluator *

Lichert Scale 1=poor 3=average 5=excellent

CORE COMPETENCY EVALUATION

Did the intern / resident demonstrate Osteopathic Skills during this rotation? *

Did the Intern demonstrate adequate medical knowledge during this rotation? *

Did the intern / resident demonstrated 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 demonstrate adequate use of resource materials during this rotation? *

Did the Intern / Resident demonstrate punctuality *

ROTATION SPECIFIC QUESTIONS *

	1	2	3	4	5	UE
Can the Intern/Resident recognize and manage common fractures, sprains, dislocations?	1	2	3	4	5	UE
Does the Intern/Resident describe orthopedic injuries accurately to you?	1	2	3	4	5	UE
Does the Intern/Resident understand orthopedic pathology that is emergent?	1	2	3	4	5	UE
Does the Intern/Resident recognize those emergent disorders that require intervention by an orthopedic surgeon?	1	2	3	4	5	UE
Has the Intern/Resident utilized your services appropriately?	1	2	3	4	5	UE
Is the Intern/Resident competent to evaluate, work-up the shoulder, knee and ankle?	1	2	3	4	5	UE
Does the Intern/Resident diagnose and treat various arthridites correctly?	1	2	3	4	5	UE
Does the Intern/Resident have a basic understanding of congenital bony disorders?	1	2	3	4	5	UE
Is the Intern/Resident competent to workup and treat low back disorders?	1	2	3	4	5	UE
Can the Intern/Resident inject various joint competently?	1	2	3	4	5	UE

ROTATION SPECIFIC COMMENTS

Comments * 🛈

Signature of Evaluator *

UPIN

SSN

MCSO ID MCSO ID

Date: *