DEPARTMENT OF PEDIATRICS
DEPARTMENT OF PEDIATRICS | |
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|Mission |
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|Improving the lives of children through excellence in advocacy, education, research and clinical care |
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|FACULTY PERFORMANCE AND GOALS |
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|The purpose of the faculty performance appraisal system is to link the appraisal process to your goals and to the goals and missions of the University, |
|Department, and Division, and to facilitate communication between the Division Chief and the faculty member. This form will provide a framework for your dialogue|
|with your Division Chief. This document is not intended to be used beyond these meetings. |
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|For the period of |
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|Today's Date: | |
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|Faculty General Information |
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|Name: | |
|Division: | |
|% FTE in Division: | |
|Rank and Track: | |
|Employment Date: | |
|Years in Rank: | |
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|Please enter the percentage of time spent in the following activities: |
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|Education | % |
|Scholarship | % |
|Clinical Care | % |
|Administration | % |
|Other | % |
|Total | 100 % |
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|Clinical Care |
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|Describe your clinical activities and indicate an overall rating of Exceeds Expectation, Meets Expectation, or Opportunity for Improvement. Consider the |
|following activities: inpatient and outpatient service, efforts to enhance clinical care, patient/parent comments, and clinical honors and awards. |
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|Overall Rating |
|Self-Evaluation |Division Chief Evaluation |
|Exceeds Expectation |Meets Expectation |Opportunity |Exceeds Expectation |Meets Expectation |Opportunity |
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| | |Improvement | | |Improvement |
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|Clinical responsibilities in the previous year: (Attach additional sheet, if necessary) |
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|Clinical goals for this year: |
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|Division Chief comments: |
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|Education |
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|Describe your education activities and indicate an overall rating of Exceeds Expectation, Meets Expectation, or Opportunity for Improvement. Consider the |
|following activities: medical lectures per clerkship, resident lecture series per resident year, Grand Rounds presentations, teaching honors and awards, small |
|group leadership, post-graduate education (CME lectures, etc.), curriculum development, graduate student training, laboratory training for post-doctoral fellows |
|and visiting scientists, and invited lecturer or visiting professor. |
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|Overall Rating |
|Self-Evaluation |Division Chief Evaluation |
|Exceeds Expectation |Meets Expectation |Opportunity |Exceeds Expectation |Meets Expectation |Opportunity |
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| | |Improvement | | |Improvement |
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|Education contributions in the previous year: (Attach additional sheet, if necessary) |
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|Education goals for this year: |
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|Division Chief comments: |
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|Scholarship |
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|Describe your scholarship activities and indicate an overall rating of Exceeds Expectation, Meets Expectation, or Opportunity for Improvement. Consider the |
|following activities: |
|A. Publications (list and attach copies): |C. Grants and Contracts (list) |
| Journal articles published during the last academic year | In development (what is planned, what is planned submission date) |
| Abstracts accepted for presentation | Submitted |
| Medical books and chapters | Unfunded (include score) |
|B. Presentations (list topic, what meeting, when, and where) | Funded (include score and budget) |
| Oral and poster presentations at national/ international meetings |D. Research honors and awards |
| Oral and poster presentations at regional meetings | |
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|Overall Rating |
|Self-Evaluation |Division Chief Evaluation |
|Exceeds Expectation |Meets Expectation |Opportunity |Exceeds Expectation |Meets Expectation |Opportunity |
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| | |Improvement | | |Improvement |
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|Scholarship accomplishments in the previous year: (Attach additional sheet, if necessary) |
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|Scholarship goals for this year: |
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|Division Chief comments: |
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|Administration |
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|Describe your administrative activities and indicate an overall rating of Exceeds Expectation, Meets Expectation, or Opportunity for Improvement. Consider |
|activities in the following arenas: medical school, hospital, department, other university service, community, service honors and awards, and professional |
|societies. |
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|Overall Rating |
|Self-Evaluation |Division Chief Evaluation |
|Exceeds Expectation |Meets Expectation |Opportunity |Exceeds Expectation |Meets Expectation |Opportunity |
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| | |Improvement | | |Improvement |
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|Administrative responsibilities in the previous year: (Attach additional sheet, if necessary) |
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|Administrative goals for this year: |
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|Division Chief comments: |
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|General Effectiveness as a Faculty Member |
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|Indicate rating of Exceeds Expectation, Meets Expectation, or Opportunity for Improvement for each category. |
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| |Self-Evaluation |Division Chief Evaluation |
| |Exceeds |Meets |Opportunity for |Exceeds |Meets |Opportunity for |
| |Expectation |Expectation |Improvement |Expectation |Expectation |Improvement |
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|Adaptability |
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|How well do you adjust to change? Consider your ability to | | |
|learn quickly, adapt to changes in job assignments, methods/ | | |
|processes, personnel, or surroundings. | | |
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|Dependability |
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|How reliable are you? Consider your willingness to take on | | |
|responsibilities and to be accountable for them. | | |
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|Initiative and Resourcefulness |
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|Do you see things to be done and then take action? Consider | | |
|your ability to contribute, develop, and/or carry out new | | |
|ideas or methods/processes. Consider also your ability to be a| | |
|self-starter, to offer suggestions, to anticipate needs, and | | |
|to seek additional tasks as time permits. | | |
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|Interpersonal Relationships |
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|Do you work effectively with others (superiors, peers, | | |
|subordinates)? Consider respect and courtesy shown to others, | | |
|the willingness to provide and accept guidance in a | | |
|constructive manner, how your attitude affects the work area, | | |
|and how it reflects on the division as well as your own | | |
|position. Are apparel, manners, and sociability appropriate to| | |
|the job responsibilities? | | |
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|General Effectiveness as a Faculty Member |
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|Indicate rating of Exceeds Expectation, Meets Expectation, or Opportunity for Improvement for each category. |
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| |Self-Evaluation |Division Chief Evaluation |
| |Exceeds |Meets |Opportunity for |Exceeds |Meets |Opportunity for |
| |Expectation |Expectation |Improvement |Expectation |Expectation |Improvement |
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|Judgment |
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|Do you exhibit good judgment? Consider the ability to evaluate| | |
|facts and make sound decisions and use of reasoning to | | |
|identify, solve, and prevent problems. (Not just related to | | |
|clinical activities.) | | |
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|Quality of Work |
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|How accurate, complete, and timely is your work. | | |
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|Originality/Creativity |
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|Do you see alternative solutions to problems? Do you pose new| | |
|ideas or novel concepts for consideration? | | |
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|Overall |
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|Are you an effective faculty member? Do you consider yourself | | |
|a role model for other faculty and trainees? | | |
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|Professional activities in which you wish to spend…. |
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|More time: |
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|Less time: |
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|Your plans for faculty development: |
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|Division Chief summary: |
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|Signatures |
|Faculty |Date: |
|Division Chief |Date: |
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