8
EM2-4 Milestone End of Shift Evaluation
Instructions- Yes means the item is consistently done. No means that it is not consistently done, that it can
occasionally occur. NA should be used when you do not have enough information.
These questions are Milestone markers, with varying levels of proficiency. It is not expected that EM residents
will have Yes for all of these questions.
The resident:
1.
Revises a differential diagnosis in response to changes in a patient’s
course over time?
Resident is able to add/subtract differential diagnoses based on
changes in the patient’s vital signs, lab values, mental status, etc.
observed during the ED visit.
Yes
No
2.
Synthesizes essential data necessary for the correct management of
patients using all potential sources of data?
Resident calls family members, nursing homes, pharmacies, old
records to obtain information on an obtunded or demented
patient.
Yes
No
NA
3.
Consistently recognizes limits of knowledge in common and
frequent clinical situations and asks for assistance?
Resident knows when to ask for help. Does not give orders or
perform procedures that he or she is not comfortable with.
Yes
No
NA
4.
Prioritizes essential components of a physical examination given a
limited or dynamic circumstance?
Resident addresses the cardiopulmonary system first in their
physical exam in a patient presenting with dyspnea and chest
pain. Prioritizes a neuro exam in a patient presenting with
stroke-like symptoms.
Yes
No
NA
Yes
No
NA
Yes
No
NA
Yes
No
NA
5.
6.
7.
8.
Correctly assigns admitted patients to an appropriate level of care
(ICU/Telemetry/Floor/ Observation Unit)?
Resident consistently does not need guidance on the correct
destination for their admitted patient.
Consistently recognizes limits of knowledge in uncommon and
complicated clinical situations; develops and implements plans for
the best possible patient care?
Resident recognizes when he or she may be seeing a “zebra” and
uses available text books, colleagues, and consultants to ensure
best patient care and follow-up.
Participates in patient satisfaction initiatives?
Resident is involved in QI/QA process or patient follow-up
program.
Reviews risks, benefits, contraindications, and alternatives to a
diagnostic study or procedure?
NA
8
EM2-4 Milestone End of Shift Evaluation
Resident is able to teach patients and family members risks and
benefits of LP, conscious sedation, risk of contrast-induced
nephropathy in a patient with symptoms concerning for AAA or
mesenteric ischemia and borderline GFR.
9.
10.
Monitors that necessary therapeutic interventions are performed
during a patient’s ED stay?
Resident is diligent in making sure their patients have been
given pain medication/IVF/antibiotics.
Uses flexible communication strategies to resolve specific ED
challenges such as difficulties with consultants and other health care
providers?
Resident is able to effectively communicate with consultants,
giving pertient information. Knows how to problem-solve or
call another physician for admission when dealing with a
difficult consultant.
Please provide feedback/goals you would like this resident to work on:
Yes
No
NA
Yes
No
NA
Yes
No
NA