Cardiology Fellows Evaluation - Nuclear Imaging
Fellow:
[First Name] [Last Name]
Evaluation Period: [99/99/9999] to [99/99/9999]
Evaluator:
[First Name] [Last Name]
Rotation Name: [Rotation Name]
Interpersonal and Communication Skills
Does the fellow establish a highly effective therapeutic relationship with patients
and families; demonstrate excellent relationship building through listening and
narrative and nonverbal skills; provide excellent education and counseling of
patients, families, and colleagues; and is always "interpersonally" engaged?
,7541884_1
,7560403_1
(Select one)
System-Based Practices
Does the fellow effectively access/utilize outside resources; effectively use
systematic approaches to reduce errors and improve patient care; and
enthusiastically assist in developing systems' improvement?
,7560402_1
(Select one)
Professionalism
Does the fellow always demonstrate respect, compassion, integrity, honesty;
teach/role model responsible behavior; total commitment to self-assessment;
willingly acknowledge errors; and always consider needs of patients, families,
colleagues?
,7560401_1
(Select one)
Practice-Based Learning and Improvement
Does the fellow constantly evaluate own performance, incorporate feedback into
improvement activities; an effectively use technology to manage information for
patient care and self-improvement?
Evaluation of Fellow
(Select one)
Medical Knowledge
Does the fellow have exceptional knowledge of basic and clinical sciences; highly
resourceful development of knowledge; and comprehensive understanding of
complex relationships, mechanisms of disease?
(Select one)
Does the fellow have good understanding about the different isotopes and stress
MPI? (Tl, Tc, PET?)
(Select one)
Does the fellow have basic understanding on how to image the patient and
process the raw images?
(Select one)
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Patient Care and Procedural Skills
Does the fellow conduct superb, accurate, comprehensive medical interviews,
physical exams, review of other data; and always make diagnostic and therapeutic
decisions based on available evidence, sound judgment, and patient preferences?
(Select one)
Does the fellow demonstrate competence in performance of essential procedures
and minimizes patient's discomfort?
(Select one)
Can the fellow adequately interpret nuclear SPECT MPI scan?
(Select one)
Can the fellow recognize important extracardiac abnormalities from the raw
images?
(Select one)
Does the fellow know how to perform nuclear stress MPI?
(Select one)
Does the fellow know how to handle the radioactive tracer, act if there is a spill,
and avoid contamination?
(Select one)
Does the fellow recognize the different types of image artifacts and know how to
resolve them?
(Select one)
Does the fellow adequately interpret stress ECG?
(Select one)
,7560482_1
Overall/Summary
How would you rate the fellow's overall clinical competence as a sub-specialist?
,7560388_1
(Select one)
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Comments (Please write about Strengths, Weaknesses and Areas for Improvement)
Optional Comments Section:
* * Confidential Comments (The following comments will only be seen by the Program Director) * *
Feedback Confirmation
The following message is displayed to the attending and trainee to confirm verbal feedback to the trainee.
Evaluator Question:
Did you provide direct feedback on this evaluation?
Trainee Question:
Did the evaluator provide you with direct feedback on this evaluation?