Quarterly Compentency Based Assessment for Family Medicine

Instructions

A number of specific physician competencies are provided below, grouped by general AOA Core Cometencies. Rate how well the intern/resident currently meets each specific competency using the scale 0=deficient to 5=exceptional

RESIDENT NAME *

Quarter

*

Osteopathic Philosophy and Osteopathic Manipulative Medicine 1=poor 3=average 5=excellent

Recognizes clinical situations where OMT is appropriate *

Shows understanding of somato-visceral relationships and the role of the musculoskeletal system in disease *

Provides accurate structural diagnosis *

Performs appropriate OMT as a procedural skill *

Takes each patient's illness into account when dealing with that individual *

Provides osteopathic health care services using behavioral medicine *

Advocate for patient's welfare, autonomy and quality of care *

Comments *

Medical Knowledge

1=poor 3=average 5=excellent

Gathers essential information for physical examinations *

Gathers essential information for medical records *

Gathers essential information for diagnostic or therapeutic plans *

Gathers essential information for treatments *

Treats patients with the most up-to-date and evidenced based information on therapeutic effectiveness *

Comments *

Patient Care 1=poor 3=average 5=excellent

Demonstrates up-to-date biomedical knowledge and applies that knowledge to patient care *

Demonstrates up-to-date clinical knowledge and pllies that knowledge effectively to patient care *

Shows good clinical judgement; reaches valid decisions *

Treats patients with up-to-date and evidence-based information on diagnostic effectiveness *

Performs procedures properly *

Comments *

Professionalism 1=poor 3=average 5=excellent

Maintains patient confidentiality *

Shows respect for patients and families *

Shows respect for co-workers and hospital and clinic personel *

Demonstrates integrity *

Acts responsibly. Is available when needed. Carries a fair share of the workload *

Communicates well in discussions with health professionals *

Works respectfully and effectively with others as a member of a healthcare team *

Understands the resident's role as a health care team member *

Comments *

Practice-based learning and improvement 1=poor 3=average 5=excellent

Understands research methods *

Understands medical informatics *

Understands and uses technoligy as aplied to medicine *

Comments *

Interpersonal and Communication Skills 1=poor 3=average 5=excellent

Develops and maintains appropriate doctor-patient relationships *

Writes clearly and legibly in communication with patients and health care workers *

Writes clearly and legibly when making records *

Listens well when meeting and treating patients *

Listens well in encounters with health care professionals *

Exhibits effective oral communication skills when interviewing patients and their families *

Comments *

Systems-based Practice

1=poor 3=average 5=excellent

Understands the business side of medical practice *

Shows operational knowledge of health care organizations, state and federal programs *

Knows and uses local medical resources available to patients for treatment and referral *

Practices cost-effective medicine *

Comments *

Logs and Evaluations are current *

Yes

No

Intern/Resident is progressing satisfactorily in relation to OGME level(check as appropriate) *

yes

no

Reviewed with Intern/Resident on: *

Program Director's signature *