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

1 2 3 4 5

1 / 2 / 3 / 4 / 5 / Adaptability & Initiative / Please give specific details as to why if you chose the rating of 5
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
1 / 2 / 3 / 4 / 5 / Communication and Relations with Others / Please give specific details as to why if you chose the rating of 5
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 / Please give specific details as to why if you chose the rating of 5
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


Resident Self-Evaluation

Page 2

1 / 2 / 3 / 4 / 5 / Productivity / Please give specific details as to why if you chose the rating of 5
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
1 / 2 / 3 / 4 / 5 / Development of PM&R Knowledge / Please give specific details as to why if you chose the rating of 5
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 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