Criteria for resident evaluations

A final written evaluation will be given and discussed with the resident at the end of the rotation. Residents will be notified during the course of the rotation if any significant problem areas are identified and given help to correct any deficiencies. Residents are encouraged to seek interim oral feedback from each attending staff at the end of each week.

The objectives will form the basis for the final evaluation. All Attending Staff, the ICU Fellow or Senior, and the Head Nurse will all be asked for their input for resident evaluation. The residents will be evaluated based on their performance on daily patient rounds and while on call. Academic performance will be assessed during the morning ICU teaching sessions. Technical skills will be evaluated at the bedside with the use of an objectively structured “procedure check sheet” by the ICU Attending, Fellow or Senior. It will be the resident's responsibility to ensure the check sheet is filled out.

A superior evaluation will be given to residents who far exceed reasonable expectations for their level of training. These residents will demonstrate a strong interest in critical care and exceptional problem solving ability. They will demonstrate imaginative, innovative, creative, independent thinking based on a strong base of knowledge. He or she will have the ability to generate relevant clinical questions at the bedside, search and critically appraise the recent medical literature for validity and usefulness, and be able to independently apply the literature to patient care.

Residents will be given borderline or unsatisfactory evaluations if it is felt that they do not possess the necessary knowledge, skills, or attitudes to safely and competently recognize, clinically assess, and stabilize critically ill patients.

I. Knowledge

The knowledge base of trainees will be evaluated during daily patient rounds and teaching sessions. A written exam will be given at the end of the rotation. The trainee will be assessed according to obtainment of the cognitive objectives of the rotation.

II. Skills

The skills of the trainee will be evaluated during daily patient rounds and throughout the day. Trainee performance during daily patient care, consults, and while on-call will be noted by ICU Attendings, Fellows, and Nurses. At the end of the rotation the resident should be able to:

1. Have acquired the necessary skills to perform an adequate initial assessment of critically ill patients and be able to start the appropriate resuscitative therapy. This includes patients with cardiac, respiratory, gastrointestinal, renal, hematological, or neurological failure;


2. Obtain an appropriate history from the patient, family, or other medical personnel;


3. Perform an appropriate problem-oriented physical examination;


4. Demonstrate the ability to collect and organize patient data, including history, physical examination, diagnostic tests and laboratory values. This information must be synthesized and presented in a clear, organized, and sequential manner. The resident should be able to discriminate between more important and less important information;


5. Generate a concise list of the patient's medical problems, a rational approach to a differential diagnosis, and to offer an initial investigational and management plan. Identify the problems in order of priority;


6. Provide accurate documentation in the progress notes of daily events, the therapeutic goals in each individual patient, and of decisions made on rounds with the attending staff. The therapeutic plan must be clearly documented. All notes should be complete, accurate, and satisfactorily organized;


7. Appropriately interpret the most commonly used tests and monitoring devices. Be able to order appropriate investigations and be aware of their limitations, advantages and risks. Discriminate and prioritize important from less important information that will allow appropriate identification of patient health problems. Demonstrate appropriate and cost effective use of laboratory and radiological investigations; and must be prepared to justify each requested test;


8. Correctly interpret the following: X-Ray of the Chest, arterial blood gases, hemodynamic parameters, mixed venous blood gases, and weaning parameters;


9. Effectively communicate with patients and their families, and with other members of the health care team;


10. Demonstrate effective work organization in such a way that priorities are established and that co-ordination occurs with other members of the team ensuring total, acute, and continuing care of patients;


11. Demonstrate proficiency in the management of cardiac arrest and the acute resuscitation of the acute resuscitation of the acutely ill patient.

The critical care resident is expected to have gained proficiency in procedures commonly carried out in the intensive care unit. It is expected that the resident will have an understanding of the indications, contraindications, limitations, and complications of each technique.

III. Attitudes

Trainee attitudes will be evaluated during daily patient rounds, throughout the day, and while on call. ICU Attendings, ICU Fellows, and ICU nurses will be asked to evaluate trainee attitudes. At the end of the rotation the resident should:

1. Be aware of the importance of clear, regular communication when caring for a patient with critical illness. Be capable of communicating easily and appropriately with consulting services, other ICU team members, nurses, pharmacists, respiratory technicians and especially the patient or the patient's family.


2. Be capable of working effectively with other members of the health care team in a considerate, tactful, respectful, and professional manner.


3. Be capable of assuming appropriate professional responsibilities, placing the needs of the patients before the trainee's own, ensuring that the trainee or his/her replacement are at all times available the patients.


4. Recognize the limits of their competence, and seek assistance when necessary.

The final evaluation will be based on the consensus opinion of all ICU Attendings, the ICU Fellow, and the Head Nurse. The resident will receive both written and oral feedback at the end of the rotation.