Responsibilities of Residents Toward Third Year Medical Students by zly32307


									 Responsibilities of Residents Toward Third Year Medical Students
              at Ronald Reagan UCLA Medical Center
Site Director: Neveen El-Farra, MD (preferred contact method), UCLA phone (310) 267-9643, pager21714

Course Coordinator: Jonathan David, (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.

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

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