MCSO/OSU-CHS

Emergency Medicine

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 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 demonstrate adequate use of resource materials during this rotation? *

Did the Intern / Resident demonstrate punctuality? *

ROTATION SPECIFIC ITEMS

Understands the tenets of triage *

Understands the emergency medical response system *

Demonstrates the ability to rapidly and correctly assess the ER patient *

Understands appropriate use of the ER *

Intern/resident is competent to revise and repair several types of lacerations. *

Intern/resident is able to accurately diagnose and treat strains, sprains, and fractures seen in the ER setting *

Is able to rapidly identify and treat circulatory collapse *

Intern/Resident demonstrates competency in resuscitation of a patient and can successfully run a code *

Rapidly assesses and treats a multiple trauma victim *

Rapidly identifies and treats respiratory failure *

Demonstrates appropriate use of emergency diagnostic technology *

Disposition of patients to home, hospital or clinic is appropriate. Instructions to patients are appropriate and timely *

Comments * 🛈

Signature of Evaluator *

UPIN

SSN

MCSO ID MCSO ID

Date: *