Ability to provide clear, accurate, and timely explanations, and to check for understanding. INTERVENTION DIRECTION GUIDANCE AUTONOMOUS EXPERT ☐ ☐ ☐ ☐ ☐ Narrative Comments ☐ Reaching Agreement / Closure Ability to synthesize and integrate different perspectives INTERVENTION DIRECTION GUIDANCE AUTONOMOUS EXPERT and to present a plan of care. ☐ ☐ ☐ ☐ ☐ Narrative Comments ☐ Conflict Management Ability to manage disagreements and emotionally charged conversations. INTERVENTION DIRECTION GUIDANCE AUTONOMOUS EXPERT ☐ ☐ ☐ ☐ ☐ Narrative Comments ☐ Professionalism Commitment to high standards of behavior and ethics. INTERVENTION DIRECTION GUIDANCE AUTONOMOUS EXPERT ☐ ☐ ☐ ☐ ☐ Narrative Comments ☐ Organization and Efficiency Ability to effectively gather information, to provide a clear structure, and to manage the INTERVENTION DIRECTION GUIDANCE AUTONOMOUS EXPERT flow of the meeting. ☐ ☐ ☐ ☐ ☐ OVERALL PERFORMANCE Choose a level of autonomy on the entrustment scale for the overall clinical activity being assessed. NEEDS DIRECTIONS NEEDS AUTONOMOUS EXPERT INTERVENTIONS Partially able to do with MINIMAL GUIDANCE Able to do without guidance; Able to do in complex Unable to do without others’ directions. Mostly able to do with refinement possible with situations; personal others’ actions. minimal guidance. feedback. insight on performance. ☐ ☐ ☐ ☐ ☐ CanMEDS Roles Choose the role(s) addressed during the feedback. Medical Expert Communicator Collaborator Leader Health Advocate Scholar Professional ☐ ☐ ☐ ☐ ☐ ☐ ☐ Trainees' Comments/Reflections: Signatures: Trainee Faculty
Ability to provide clear, accurate, and timely explanations, and to check for understanding. INTERVENTION ☐ DIRECTION ☐ GUIDANCE ☐ AUTONOMOUS ☐ EXPERT ☐ ☐ Reaching Agreement / Closure Ability to synthesize and integrate different perspectives and to present a plan of care. Narrative Comments INTERVENTION ☐ DIRECTION ☐ GUIDANCE ☐ AUTONOMOUS ☐ EXPERT ☐ ☐ Conflict Management Ability to manage disagreements and emotionally charged conversations. Narrative Comments INTERVENTION ☐ DIRECTION ☐ GUIDANCE ☐ AUTONOMOUS ☐ EXPERT ☐ ☐ Professionalism Commitment to high standards of behavior and ethics. Narrative Comments INTERVENTION ☐ DIRECTION ☐ GUIDANCE ☐ AUTONOMOUS ☐ EXPERT ☐ ☐ Organization and Efficiency Ability to effectively gather information, to provide a clear structure, and to manage the flow of the meeting. Narrative Comments INTERVENTION ☐ DIRECTION ☐ GUIDANCE ☐ AUTONOMOUS ☐ EXPERT ☐ OVERALL PERFORMANCE Choose a level of autonomy on the entrustment scale for the overall clinical activity being assessed. NEEDS INTERVENTIONS Unable to do without others’ actions. ☐ DIRECTIONS Partially able to do with others’ directions. ☐ NEEDS MINIMAL GUIDANCE Mostly able to do with minimal guidance. ☐ AUTONOMOUS Able to do without guidance; refinement possible with feedback. ☐ EXPERT Able to do in complex situations; personal insight on performance. ☐ CanMEDS Roles Choose the role(s) addressed during the feedback. Medical Expert ☐ Communicator ☐ Collaborator ☐ Leader ☐ Health Advocate ☐ Scholar ☐ Professional ☐ Trainees' Comments/Reflections: Signatures: Trainee Faculty