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IMPORTANT!---When you have completed this survey, don't forget to click on the "Submit" button at the very bottom. If you need to complete a survey on an additional faculty member, please do not go "back" through the screens, instead, go "forward" and log in again. Although you are not required to fill in narrative comments at the end of each section, it is helpful if you do so. Almost all of the other types of questions must be answered in order to submit the survey, so do your best to provide an answer, but don't skip questions. Thank you very much! * * * * * * This survey is for Interns and Residents on the Inpatient General Internal Medicine Service to confidentially and anonymously evaluate their teaching attendings. If you have had more than one significant teaching attending during the rotation, please fill out a survey for each attending. We know that you already fill out an incredible number of forms (and we are very appreciative). This is one of our main ways of providing feedback to teaching faculty and encouraging "quality improvement". [When the survey asks about "reading" assignments, this can refer to any assigned "homework", such as review of articles, online video, etc.] Thank you again for your help!
1.
Current Year (choose one)
2.
Name of Inpatient General Internal Medicine Teaching attending:
3.
Medical Knowledge: The teaching attending discussed with me the written SBH OnLine Curriculum at the beginning of this rotation, including suggested "homework" or other "reading" assignments.
a. yes     b. no
4.
Medical Knowledge: Encouraged me to use evidence-based resources such as Up-To-Date, Harrisons, The Medical Letter before discussing some of the cases at teaching rounds.
a. yes     b. no
5.
Medical Knowledge: Reviewed my Clinical Reasoning and Clinical Judgment, not only on rounds, but also by some formal chart reviews that focused on My Assessment and Plan (i.e. from Admission and/or Progress Notes).
a. yes     b. no
6.
Medical Knowledge: Comments or suggestions.
7.
Communication: Had me or others discuss some of the Communication Skills assignments.
a. yes     b. no
8.
Communication: Included in the discussion of Communication Skills, which of the following themes (only indicate topics reviewed - it is not expected that all themes would be discussed during a single rotation).
a. None of Communication Skills listed below
b. Open-ended interviewing
c. Empathy
d. End-of-Life/Palliative Care
e. Social History and its relation to System Resources
f. Cultural Competency
g. Informed Consent
h. Counselling for behavior change (e.g. smoking)
i. Screening for Domestic Violence
j. Eliciting a history of alcohol or other subtance abuse
k. Geriatric interviewing
l. Adolescent interviewing
m. Challening situations
9.
Communication: Encouraged me to communicate with patient's family, primary care physician, consultants.
a. yes     b. no
10.
Communication: Demonstrated communication skills by verifying some of history at the bedside.
a. yes     b. no
11.
Communication: Directly observed my history taking as part of rounds or a mini-CEX, or recorded and interview with a "standardized patient".
a. yes     b. no
12.
Communication: Performed a Formal Chart Review to observe my notes for legibility and useful communication with consultants and other providers. [Notes dated, timed, signed, consultant and attending notes acknowledged....]
a. yes     b. no
13.
Communication: Comments or suggestions.
14.
Patient Care: Had me or others discuss some of the Physical Diagnosis, Procedural Skills, EKG/Radiographic and other Test Interpretation assigned "reading".
a. yes     b. no
15.
Patient Care: Directly observed my physical examination skills as part of rounds or a mini-CEX.
a. yes     b. no
16.
Patient Care: On occasion, demonstrated by verifying some of the physical examination at the bedside.
a. yes     b. no
17.
Patient Care: Reviewed test interpretation (including EKGs and radiographic studies) of patients who were discussed.
a. yes     b. no
18.
Patient Care: Comments or suggestions.
19.
Professionalism: At the beginning of the rotation, discussed physician wellness, stress-reduction, fatigue, impairment, and physician support resources available at SBH.
a. yes     b. no
20.
Professionalism: Had me or others discuss some of the assigned reading on Physician Stress and/or Professionalism (e.g., accountability, community service, compassion, respect, integrity, undue pharmaceutical influence....)
a. yes     b. no
21.
Professionalism: Teaching Attending demonstrated Professionalism by:
a. None of the following
b. Showing up on time for teaching rounds
c. Arranging for a covering teaching attending if necessary
d. Treating residents with respect
e. Providing written mid-rotation "formative" feedback
f. Providing end-of-rotation "summative" feedback
22.
Professionalism: Average length of teaching rounds (in minutes):
a. 15
b. 30
c. 45
d. 60
e. 75
f. 90
g. 120
23.
Professionalism: Average number of teaching sessions a week (your best estimate)
a. 0
b. 1
c. 2
d. 3
e. 4
f. 5
g. 6
24.
Professionalism: Approximate TOTAL number of teaching sessions with this teaching attending during the 4 week block (your best estimate, but don't pick a number greater than 20 sessions).
25.
Professionalism: Comments or suggestions.
26.
Pract-based learn/improve: Had me or others discuss some of the assigned reading on PBLI (e.g., EBM, error reduction/patient safety, quality improvement/PDSA, research, other PBLI)
a. yes     b. no
27.
Pract-based learn/improve: Directly observed the quality of my care by reviewing my charts and providing me feedback on which of the following:
a. None of the following
b. Orders that are appropriate and accurate
c. Medex reviewed by resident at least weekly
d. Discharge Note that is accurate and useful (patient-centered)
e. Prescriptions that are accurate and appropriate
28.
Pract-based learn/improve: Comments or suggestions
29.
Systems-based pract: Had me or others discuss some of the assigned "reading on SBP (e.g., utility of the SHx in predicting need for system resources, practice guidelines [including 'ours'], different forms of healthcare delivery and managed care.)
a. yes     b. no
30.
Systems-based pract: Directly observed my ability to orchestrate utilization of system resources by reviewing my charts for some of the following: a social history that was useful for predicting need for system resources; completion of our 'indicator' guideline documents for CHF, MI, smoking, etc; Discharge Notes that were useful to the patient in accessing the next arena of the system (e.g., NH, clinic, VNS,....)
a. yes     b. no
31.
Systems-based pract: To strive for continuity, encouraged me to do some or all of the following: contact the PCP at the time of discharge; if appropriate, to facilitate follow up appointments to see me as out patient; to call the patient and/or family after discharge to ensure a smooth transition of care
a. yes     b. no
32.
Systems-based pract: Comments or suggestions.
33.
Summary of rotation - Performance Evaluation: On a scale of 1 -> 9 where 4="marginal", 5-6="expected performance", and 9="superior", please give a global evaluation of this teaching attending
a. 1
b. 2
c. 3
d. 4
e. 5
f. 6
g. 7
h. 8
i. 9
34.
Would you want this physician to be your teaching attending again?
a. yes     b. no
35.
Summary Comments or Suggestions on Teaching Attending Performance (optional but appreciated) [This is the last question! Thank you for your help; don't forget to click "submit" when you are done.]