Responsibilities of Residents Toward Third Year Medical Students at Ronald Reagan UCLA Medical Center Site Director: Neveen El-Farra, MD email@example.com (preferred contact method), UCLA phone (310) 267-9643, pager21714 Course Coordinator: Jonathan David firstname.lastname@example.org, (310) 825-5846 1. Orient each student to your expectations on the first or second day you work together Residents and faculty vary in their expectations of students, for example, in preferred case presentation style, giving presentations on educational topics, use of particular resources for reading about patients (e.g., being for or against using Up To Date), dress, etc. Please be sure to give the student an overview of what is expected. 2. Provide regular feedback, including both things done right and tips for improving a. General feedback: All students, regardless of their skill level, need specific, face-to- face feedback. At a minimum, feedback should be provided at the end of your contact with a student. Even better is to notice and comment on the things students did well as often as possible, and to provide very concrete and specific tips for improvement on a periodic basis. b. Feedback on case presentations and H&Ps: Please go over one of each of these in detail with each student. Feedback is also needed on physical examinations. 3. Observe and demonstrate physical examinations. 4. Complete an evaluation at the end of the course Please complete an evaluation if you worked with a student for four or more days. You can still opt out of evaluating specific areas when contact was insufficient. Intern and resident perceptions of students’ performance are critical to have an accurate evaluation of the student. a. Narrative evaluation: 1. The text should discuss the things the student did (or didn’t) do well and provide examples, if at all possible. This is more useful than subjective statements about the student. For example, it is more convincing to state that the student demonstrated considerable knowledge about their patients by asking insightful questions during rounds, than to state that the student was very knowledgeable. 2. Also, there are certain types of comments we tend to exclude from the summary evaluation statement. For example, since the degree of experience in evaluating students varies greatly, we don’t include statements like, “the best student I have worked with [ever, this year, etc.].” Because the course, not individual evaluators, determines when students receive a Letter of Distinction (LOD), we don’t include statements like, and “I strongly recommend this student for an LOD.” The reason that including such statements confuses the reader – was a letter awarded or not? We tend not to include predictions about future performance because they are less convincing than concrete statements about past performance. Lastly, “excellent” actually has somewhat mediocre connotations on the Dean’s Letter circuit so we try to avoid sentences with that word, particularly when the intended meaning actually seemed more positive. b. Ratings: The typical ratings for UCLA students are: 7 = “High Outstanding”: truly exceptional; only this is sufficient for an LOD. Few students rotating at Ronald Reagan-UCLA medical center get scores in this range. Use 7 if you think a student deserves an LOD. (see descriptors below for what criteria you can use to assess an outstanding clinical performance) 6 = “Low Outstanding”: terrific but not exceptional; NOT sufficient for an LOD. Most very strong students receive grades in this range, and it is probably the mode grade at UCLA. 5 = “High Satisfactory”: (very good) the second most common grade at UCLA 4 = “Mid Satisfactory”: reflects a somewhat weaker performance than is often seen. 3 = “Low Satisfactory”: although this grade includes the term “satisfactory,” it is very rarely used, which means it actually represents a performance far below other students. Please notify the clerkship director if you feel a student is performing at this level. 2 = “Marginal”: Very rarely used. Please notify the clerkship director if you feel a student is performing at this level. 1 = “Unsatisfactory”: Almost never used. Please notify the clerkship director if you feel a student is performing at this level. LETTERS OF DISTINCTION: To better understand what demonstrates an outstanding clinical performance please see the descriptors listed below. History taking: Precise, logical, thorough, reliable, purposeful, and focused. Includes all pertinent positives and negatives. Physical examinations: Very complete, accurately done, directed toward patient's problem(s), and elicits subtle findings. Case Presentations: Extremely clear, organized, complete, accurate, and polished presentation appropriate in length to the situation. Uses precise, accurate terminology. Write ups: Outstanding, conscientious and accurate in recording patients' histories and physical exams. Differential diagnoses are extensive. Outstanding analysis of patient's problems. Therapeutic plans are thorough. Medical Knowledge: Extensive, well-applied knowledge of disease, pathophysiology, diagnosis, and therapy. Consistently up to date. Familiar with relevant current journal articles. Clinical Judgement: Regularly integrates medical facts and clinical data, weighs alternatives, costs, risks and benefits. Understands limitations of knowledge. Wise use of diagnostic and therapeutic procedures. Regularly applies evidence-based medicine. Physician Patient Interactions: Does not use jargon. Communication with patients and families reflects clarity and empathy. Effective communicator with teams, staff et al. Professional Attitude and Behavior: Enthusiastic, responsive, reliable. Committed, cooperative and respectful. Establishes trust. Displays initiative. Please contact the site director with any questions regarding the evaluation and grading of students.
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