Room AE200
Harry Medovy House
Winnipeg, MB R3E 0Z2
Tel: (204) 787-8980
Fax: (204) 787-4291
FACULTY OF MEDICINE
Department of Anesthesia
Anesthesia Clinical Assistant Program
Professionalism & Humanism Evaluation
Clinical Assistant ___________________________
Evaluator__________________________
Print Name
Print Name
Date______/____/_____
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Evaluation at:
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2 months
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5 months
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8 months
10 months
Professionalism describes the skill, competence and character expected
of a member of a highly trained profession. In this instance, it refers to serving the interests of others above self-interest and
involves elements of altruism, accountability, excellence, duty, service, honor, integrity, adherence to ethical principles and
respect for others as communicated through attitudes, general behavior and body language.
Humanism fosters relationships that are compassionate and empathic. It
describes attitudes and behaviors that are sensitive to the values, autonomy, cultural and ethic backgrounds of others.
Categories:
EXCEEDS EXPECTATIONS
MEETS EXPECTATIONS
NEEDS IMPROVEMENT
UNSATISFACTORY
Far exceeds reasonable expectations
Always meets and occasionally exceeds reasonable expectations
Not consistent in meeting reasonable expectations
Consistently falls short of reasonable expectations
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Honesty & Integrity
Honesty implies being fair, being truthful and keeping one's word. Integrity is the congruence between expressed values and
behavior. It also entails being forthright in interactions with patients and peers, and in all professional work, whether through documentation,
personal communication, presentations, research, or other aspects of interaction and being aware of situations that may result in conflict of
interest or that result in personal gain at the expense of the best interest of the patient.
UNSATISFACTORY
NEEDS IMPROVEMENT
MEETS EXPECTATIONS
EXCEEDS EXPECTATIONS
Reliability & Responsibility
Means being responsible for and accountable to others at a number of levels: to one's patients and their families, to society
to ensure the public's needs are addressed, and to the profession to ensure that the ethical precepts of practice are upheld.
Inherent in responsibility is reliability in completing assigned duties or fulfilling commitments, and maintaining comprehensive,
legible, timely medical records. There must be a willingness to accept responsibility for errors.
UNSATISFACTORY
NEEDS IMPROVEMENT
MEETS EXPECTATIONS
EXCEEDS EXPECTATIONS
Respect for Others
Being respectful means treating all persons with regard for their individual worth and dignity, acting in a fair and
nondiscriminatory manner and inquiring about/expressing awareness of the emotional, personal, family, and cultural
influences on well-being. Respect considers the need for information and autonomy and acknowledges an individuals
rights and choices. It is an obligation to maintain confidentiality, consistently practice hand hygiene and adhere to
cleaning and disinfection practices.
December 16/08
UNSATISFACTORY
NEEDS IMPROVEMENT
MEETS EXPECTATIONS
EXCEEDS EXPECTATIONS
Compassion & Empathy
Comprises establishing rapport, listening attentively and responding humanely to the concerns of patients and family members.
Acknowledging the suffering (pain, discomfort and anxiety) of another and providing appropriate relief, is a part of daily practice.
UNSATISFACTORY
NEEDS IMPROVEMENT
MEETS EXPECTATIONS
EXCEEDS EXPECTATIONS
Self-Improvement
Is the pursuit of, and commitment to providing, the highest quality of health care through lifelong learning and education. It
involves seeking to learn from errors and aspiring to excellence through self-assessment and acceptance of the critiques of others.
UNSATISFACTORY
NEEDS IMPROVEMENT
MEETS EXPECTATIONS
EXCEEDS EXPECTATIONS
Self-Awareness Knowledge of Limits
Includes recognizing the need for guidance and supervision when faced with new or complex responsibilities. It also
includes the ability and willingness to recognize when fatigue/illness is likely to impair clinical competence. Being
insightful regarding the impact of one's behavior on others and cognizant of appropriate professional boundaries is
fundamental.
UNSATISFACTORY
NEEDS IMPROVEMENT
MEETS EXPECTATIONS
EXCEEDS EXPECTATIONS
Communication & Collaboration
Relates to working cooperatively and communicating effectively with a courteous and responsive demeanor. It includes the ability to earn
trust and engender confidence among patients, staff, and colleagues, the willingness to be available when needed and the desire to
share current, relevant professional information for the common good.
UNSATISFACTORY
NEEDS IMPROVEMENT
MEETS EXPECTATIONS
EXCEEDS EXPECTATIONS
Altruism & Advocacy
Refers to unselfish regard for and devotion to the welfare of others and the capacity to put the needs and interests of another
above self-interest. Advocacy involves acting or interceding on behalf of the patient, a peer or colleague.
UNSATISFACTORY
NEEDS IMPROVEMENT
MEETS EXPECTATIONS
EXCEEDS EXPECTATIONS
Service
The sharing of one's talent, time, and resources with those in need. It may involve community activities, such as volunteer service.
.
December 16/08
UNSATISFACTORY
NEEDS IMPROVEMENT
MEETS EXPECTATIONS
EXCEEDS EXPECTATIONS
Elaborate on specific issues, areas of concern or use this space for positive feedback:
An unsatisfactory or needs improvement assessment documented in any category will prompt a collaborative
review with “The Anesthesia Advisory Panel”.
_________________________________
Evaluator Signature
December 16/08
__________________________
Clinical Assistant Signature
December 16/08