Communicating clearly and efficiently with patients, families, colleagues, healthcare team. INTERVENTION DIRECTION GUIDANCE AUTONOMOUS EXPERT ☐ ☐ ☐ ☐ ☐ Narrative Comments ☐ Organization / Efficiency Delivering care with optimal use of time and resources. INTERVENTION DIRECTION GUIDANCE AUTONOMOUS EXPERT ☐ ☐ ☐ ☐ ☐ Narrative Comments ☐ Documentation Comprehensive, concise and meaningful record keeping. INTERVENTION DIRECTION GUIDANCE AUTONOMOUS EXPERT ☐ ☐ ☐ ☐ ☐ Narrative Comments ☐ Professionalism Commitment to high standards of behavior and ethics. INTERVENTION DIRECTION GUIDANCE AUTONOMOUS EXPERT ☐ ☐ ☐ ☐ ☐ Narrative Comments ☐ Insight Recognition of the limits of one's experience and expertise. INTERVENTION DIRECTION GUIDANCE AUTONOMOUS EXPERT ☐ ☐ ☐ ☐ ☐ OVERALL PERFORMANCE Choose a level of autonomy on the entrustment scale for the overall clinical activity being assessed. NEEDS NEEDS NEEDS MINIMAL AUTONOMOUS EXPERT INTERVENTIONS DIRECTIONS GUIDANCE Able to do without Able to do in complex Unable to do without Partially able to do with Mostly able to do with guidance; refinement situations; personal others’ actions. others’ directions. minimal guidance. possible with 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
Communicating clearly and efficiently with patients, families, colleagues, healthcare team. INTERVENTION ☐ DIRECTION ☐ GUIDANCE ☐ AUTONOMOUS ☐ EXPERT ☐ ☐ Organization / Efficiency Delivering care with optimal use of time and resources. Narrative Comments INTERVENTION ☐ DIRECTION ☐ GUIDANCE ☐ AUTONOMOUS ☐ EXPERT ☐ ☐ Documentation Comprehensive, concise and meaningful record keeping. Narrative Comments INTERVENTION ☐ DIRECTION ☐ GUIDANCE ☐ AUTONOMOUS ☐ EXPERT ☐ ☐ Professionalism Commitment to high standards of behavior and ethics. Narrative Comments INTERVENTION ☐ DIRECTION ☐ GUIDANCE ☐ AUTONOMOUS ☐ EXPERT ☐ ☐ Insight Recognition of the limits of one's experience and expertise. 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. ☐ NEEDS 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
Assessment+Forms_GENERAL_July+2017.docx