subject_line
MCSO/OSU-CHS
Radiology
NAME OF RESIDENT
*
Justin Mitchell, DO
Lauren Mitchell, DO
Jacinda (Jaci) Nuttle, DO
Sara Oldham, DO
Ana Crew, DO
Brian Lee, DO
Ashely Lomax-Walker, DO
Luke Records, DO
Justin Walker, DO
Kasey Welch, DO
Rotation Dates
Month
*
Jan
Feb
March
April
May
June
July
August
Sept
Oct
Nov
Dec
Year
*
2015
2016
Name of evaluator
*
Alvin Davis, III, MD
Ian Fischer, MD
William Frey, MD
Bradley Hammett, MD
Thomas McGee, MD
Peter McGowen, MD
Joe Niehus, MD
Charles Phelps, II, MD
Paul Wheeler, MD
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 the indications and limitations of various imaging techniques
1
2
3
4
5
UE
Intern/Resident has a good grasp on preparation of the patient for various imaging studies
1
2
3
4
5
UE
Intern/Resident shows the ability to read basic xrays and scans and can recognize basic pathology
1
2
3
4
5
UE
Intern/Resident shows the ability to choose between CT, MRI, US and Nuclear scans for workup of a patient
1
2
3
4
5
UE
ROTATION SPECIFIC COMMENTS
Comments
*
🛈
Signature of Evaluator
*
UPIN
SSN
MCSO ID
MCSO ID
Date:
*
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