Trauma. Level 2. This resident can lead a to recognize common. This resident can. accurately diagnose. team that cares for traumatic conditions and

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1 Page 1 of 7 Trauma Subject Name Status Employer Program Rotation Evaluation Dates Evaluated by: Evaluator Name Status Employer Program 1 (Trauma) Patient Care: Ward Care This resident is not able lead a to recognize common perform a focused, accurately diagnose accurately diagnose team that cares for traumatic conditions and efficient, and accurate some broad diseases most common injuries patients with multiple disorders (e.g., aortic history and physical for a and conditions related to (such as those and complex injuries injury, colon and rectal stable injured patient. critically injured patients mentioned in ), (e.g., a patient with an injury, hemothorax, (tension pneumothorax, and some focused or aortic transection and a pelvic fracture). problems in recognizing or managing common problems in injured manage common postoperative problems in the injured patient with direct supervision (senior residents or staff shock, open fracture, vascular injury). manage common postinjury problems on the less common injuries (smoke inhalation and carbon monoxide poisoning, tracheal and bronchial injury, and urethral injury). closed head injury, or a patient with a splenic laceration and a pelvic fracture). provide patients (such as physically present). trauma service with supervision in the pneumothorax, wound indirect supervision evaluation of patients infection or dehiscence, (consultation by phone). independently manage with multiple injuries, alcohol withdrawal complex post-traumatic including supervising syndrome, bleeding). problems and their stabilization and independently stabilize transfer within the and transfer the injured hospital. patient to a higher level of care within the hospital. recognize atypical presentations in injured patients and exhibits good judgment in when to proceed to the OR in complex situations.

2 Page 2 of 7 (Trauma) Patient Care: Operative 2 This resident is not able to perform basic surgical skills such as instrument identification and handling, laceration closure and dressing changes. basic surgical skills such as instrument handling, knot -tying, and simple suturing. perform basic (but not all) steps with direct supervision in some common procedures such as endotracheal intubation, chest tube insertion, and establishment of central venous access. show respect for tissue and can move independently through some portions of common operations such as exploratory laparotomy, splenectomy and repair of injured stomach or intestine. Still requires coaching to complete those common operations. demonstrate proficiency in the handling of all instruments from common trauma related procedures and operations. move through the steps of most common trauma related procedures and operations (e.g., FAST exam, repair GI tract injury, splenectomy, temporary closure of the abdomen, debridement and suturing of major wounds) without much coaching. make straightforward operative decisions. This resident demonstrates proficiency in use of instruments and equipment required for essential common and uncommon injuries and operations,such as those in and such repair of aortic and vena cava injury, fasciotomy, hepatic injury?packing and repair, neck exploration for injury, and repair of ureteral injury. perform all essential operations (such as those above) and has some experience in complex operations such as burn debridement, hepatic resection for trauma.

3 Page 3 of 7 (Trauma) Medical Knowledge 3 have medical student clerkship basic knowledge about the diagnosis and management common injury patterns seen after blunt and penetrating trauma. Or about common essential operations and procedures in the injured patient including ATLS primary and secondary survey, chest tube and central venous line insertion, repair of simple lacerations and wound dressings. medical student clerkship basic understanding of the symptoms, signs and treatments of: - the broad diseases /conditions of injured patients (such as aortic injury, colon and rectal injury, GI tract trauma, hemothorax). - essential-common surgical operations and procedures in injured patients (such as resuscitation of the injured patient, care of major wounds fractures and dislocations, care of blunt head injury). basic knowledge about many of the "broad" diseases and conditions seen in injured patients (such as cardiac tamponade, diaphragmatic injury, hepatic injury, pelvic fractures), and "essential" operations (such as exploratory laparotomy and repair of GI tract injury). and can complete an initial assessment of the critically injured patient, developing an appropriate plan of care. This resident meets level 2 and also has also basic knowledge of the focused diseases and conditions in injured patients (such as animal and insect bites and stings, fractures, head injury, spine fractures, tracheal and bronchial injury), and can complete an initial assessment, and resuscitation of the critically injured patient. comprehensive knowledge about varying patterns of presentation in injured patients including children and the elderly, can make diagnoses and provide the initial treatment for complex patients with multiple trauma.

4 Page 4 of 7 (Trauma) Systems-Based Practice 4 have a basic understanding of resources available for coordinating patient care and how hospital and healthcare systems impact the patient who presents to the trauma service. a basic understanding of the team members coordinating care for the injured patient. They are aware that variations in care occur. This resident knows the resources available to coordinate care and how to access them to help aid transitions in care for the injured patient. This resident follows protocols for the trauma service when they are presented. arrange disposition planning and prepare necessary materials for discharge of the trauma patient. This resident sometimes makes suggestions for changes that might improve the process. This resident coordinates the activities of all health care team members (including nursing, PT/OT, social work, etc.) to provide optimal care for the trauma patient for discharge or transfer. This resident participates in hospital work groups designed to reduce errors. This resident participates in creating protocols for the trauma service.

5 Page 5 of 7 (Trauma) Practice-Based Learning and Improvement 5 communicate effectively. demonstrate interest or ability in learning from the results of his or her practice. This resident participates in trauma rounds or conference with appropriate comments and questions. This resident changes behaviors in response to feedback from supervisors. teach learners at an appropriate level. This resident presents patient cases at trauma rounds or conference accurately and succinctly. This resident uses external sources to answer questions about patient care. develop learning plans based on feedback and can modify his or her own practice to avoid errors. demonstrate effective teaching in trauma conference or rounds. look for trends and patterns in the care of injured patients and use sources to understand these patterns. This resident independently practices his or her skills and actively looks for opportunities to reduce errors. This resident recognizes teachable moments and engages the learner. This resident initiates learning assignments for others on the team. facilitate trauma conference or rounds and discuss the patients in respect to current literature.

6 Page 6 of 7 (Trauma) Professionalism 6 exhibited undesirable behaviors on this service such as being impolite, disrespectful, not respecting confidentiality, flagrantly violating duty hour requirements, or failing to timely perform duties. This resident is polite and respectful, takes personal responsibility for patient care outcomes. This resident responds promptly to pages and consultations while on the trauma service. This resident maintains composure even in stressful situations. This resident asks for help when needed. This resident is prompt in attendance at trauma conference, rounds and other conferences. This resident ensures that patient care responsibilities are performed. This resident accepts responsibility for errors in patient care. This resident assures that team members under his or her supervision respond appropriately to responsibilities. This resident serves as a role model for others in terms of ethical behavior especially towards the consulting services and encourages prompt and polite responses to all consultations. This resident places the patient's needs above him or herself when appropriate. This resident leads a team that promotes wellness of others by modifying schedules or intervening when necessary without compromising patient wellbeing. This resident sets an example for attendance at trauma conference, rounds or procedures.

7 Page 7 of 7 7 (Trauma) Interpersonal and Communication Skills not effectively communicate with patients and their families, hospital staff members, and/or the senior surgeon on the trauma team. This resident uses a variety of communication techniques with patients when necessary. This resident responds professionally to requests for consultation services of the trauma service. This resident performs face-to-face handoffs. perform a basic consent for procedures in trauma patients such as chest tube, central line placement. This resident takes the initiative to provide timely updates to patients and their families on the trauma service. This resident exhibits respect, approachability and active listening when speaking with consulting services and team members. perform a clear consent for common traumarelated procedures such as chest tube insertion, central venous access. This resident is capable of delivering difficult news to family members on the trauma service. This resident keeps members of the health care team up to date on patient statuses and care plan changes. This resident effectively communicates back to consulting services that use the trauma service in a timely manner. effectively consent a patient for a complex operation. This resident is capable of leading end-of-life discussions. This resident is capable of negotiating and managing conflict among patients and their families, as well as among health care providers. This resident is able to effectively communicate unexpected events to patients and family members. 8* What are this resident's strengths (using the categories above a guides) 9* Please elaborate on at least one area where this resident should strive to improve (using the categories above a guides) Overall I want to add a Confidential (to Program Director only)

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