Louisiana State University
Department of Medicine, Physical Medicine & Rehabilitation
Annual Resident Self-Evaluation
Name
Date
PGY ____________
PLEASE RATE YOURSELF ON THE FOLLOWING SCALE:
Never--------------------------------------------------------------------------------------------------------Always
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2
3
4
5
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2
3
4
5
Adaptability & Initiative
Adhere to time and attendance guidelines
Flexible in view of interruptions, emergencies and
schedule changes, including call
Anticipate needs of patients/visitors
Prepare for conference and rotations through both case
preparation and general reading
Appropriately utilize literature (primary and reference)
to work through difficult and puzzling cases, including
protocols and interpretation
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2
3
4
5
Communication and Relations with Others
Possess a collaborative, cooperative and hospitable
working relationship with all members of the PM&R
Department.
Demonstrate competence, professionalism, and respect
for patients including privacy and confidentiality.
Make suggestions for improvement in the residency
program.
Make suggestions for improvement in the PM&R
department
Act as mentor/teacher to students and rotating residents
while promoting a positive learning environment.
Communicate effectively with patients and family
members by educating and reassuring them.
Present a professional image in attire and demeanor.
Wear ID badge.
1
2
3
4
5
Quality of Work
Recognize normal and abnormal findings and generate a
differential diagnosis.
Understand and properly utilize equipment.
Appropriately recommend follow-up examinations,
understanding impact on costs and information gained
Dictations are clear and succinct
Record keeping completed in a timely manner
Please give specific details as to
why if you chose the rating of 5
Please give specific details as to
why if you chose the rating of 5
Please give specific details as to
why if you chose the rating of 5
Resident Self-Evaluation
Page 2
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2
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4
5
Productivity
Work efficiently with staff, therapists, nurses, and clerical
staff to minimize report turnaround time
Understand how to use various equipment
Familiar with routine protocols and understand when
they must be altered to answer specific questions
Utilize staff, therapists, and nurses to aid in planning for
difficult or puzzling cases
Ask for help when needed
Good steward of hospital resources
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2
3
4
5
Development of PM&R Knowledge
Regularly read reference textbooks in preparation for
rotations
Regularly read primary literature to expand knowledge
beyond texts and apply to individual cases
Identify areas of weakness and adjust study habits to
address those problem areas
Attend all conferences and maximize time spent in
conferences. Incorporate this knowledge into everyday
patient care
Please give specific details as to
why if you chose the rating of 5
Please give specific details as to
why if you chose the rating of 5
Please use additional space if necessary.
Provide an example where you felt you made a conscious ethical decision and/or handled a difficult patient situation:
What did you learn from the experience?
What would you like to do better the next time?
What plan do you have in place to accomplish this change?
Strengths:
Areas for improvement:
Plan to make these improvements:
Signature/Date