Residency Manual

APPENDIX I: Sample Evaluation of Residency Program & Residency Program Supervisor

Evaluation of Residency Program and Residency Program Supervisor PART I Using the following scale, respond to the questions below. 1 =Strongly Disagree 2 =Disagree 3 =No Opinion 4 =Agree 5 =Strongly Agree NA =Not Applicable Please rate your Residency Program Supervisor on the following residency program administrative duties . Score Criteria Your Residency Program Supervisor: 1 2 3 4 5 NA 1. Reviews the program’s mission statement, goals and objectives and your progress in meeting these. 1 2 3 4 5 NA 2. Arranges for didactic activities, such as lectures, meetings, grand-round, etc. 1 2 3 4 5 NA 3. Provides an academic environment with appropriate learning opportunities 1 2 3 4 5 NA 4. Provides you, the resident, opportunities appropriate for the program 1 2 3 4 5 NA 5. Allows enough flexibility in the schedule to pursue scholarly activity 1 2 3 4 5 NA 6. Demonstrates interest in didactic activities (including research and/or publication activities, etc.) 1 2 3 4 5 NA 7. Encourages you, the resident, in scholarly activities such as academic posters, research papers, etc. 1 2 3 4 5 NA 8. Meets the needs and concerns of you, the resident 1 2 3 4 5 NA 9. Works to insure you, the resident, achieve your goals and objective for the residency 1 2 3 4 5 NA 10. Provides appropriate assistance, review and feedback for: 1 2 3 4 5 NA a. Minor Presentation 1 2 3 4 5 NA b. Major Presentation 1 2 3 4 5 NA c. Final Paper 1 2 3 4 5 NA 11. Provides adequate feedback overall on performance in residency program 1 2 3 4 5 NA Overall how would you rate your Supervisor’s performance of his or her administrative responsibilities to the resident and residency program? 1=lowest 5=highest PART II Using the following scale, respond to the questions below. 1 =Strongly Disagree 2 =Disagree 3 =No Opinion 4 =Agree 5 =Strongly Agree NA =Not Applicable If your Residency Program Supervisor also acts as a Clinical Attending please rate your Supervisor on the following clinical related duties while you are in clinic with him or her. Score Criteria While working with you in Clinic your Residency Program Supervisor: 1 2 3 4 5 NA 1. Is knowledgeable in the area of clinical care (s)he is rendering 1 2 3 4 5 NA 2. Provides a good learning experience 1 2 3 4 5 NA 3. Demonstrates and shares diagnostic skills and strategies in managing clinical problems 1 2 3 4 5 NA 4. Demonstrates and shares advanced diagnostic techniques 1 2 3 4 5 NA 5. Allows resident enough flexibility in developing diagnostic/management skills 1 2 3 4 5 NA 6. Is available for second opinions and consultations 1 2 3 4 5 NA 7. Frequently suggest references, texts and journals for relevant cases 1 2 3 4 5 NA Overall how would you rate your Supervisor’s performance as a Clinical Attending? 1=lowest 5=highest

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