Knowledge – Basic Medical Science



The importance of an accurate and honest

Observership Program evaluation

The program that your international medical graduate (IMG) observer has just completed will affect his/her career in many ways. Being able to function within the U.S. health care system and observing the delivery of care firsthand are invaluable experiences, but there are additional benefits tied to the quality of the evaluation you deliver.

A thoughtful and honest evaluation can provide valuable feedback to the observer with respect to how his or her performance has been perceived. This will allow the observer to work on any areas of weakness or deficiency in a focused manner. Ideally, the observer should have received a brief formative evaluation midway through the observership in order to address such issues before receiving this final summative evaluation. At that time, they also should have been given a copy of this evaluation form to understand how and in what areas they will be evaluated.

This evaluation can also provide program directors with critical information to help them narrow the large field of applicants they consider each year. For the Observership Program to have value and contribute meaningfully to the process of helping IMGs obtain positions in U.S. residency programs, however, evaluations must be accurate and not inflated. Therefore, it’s important to take a few moments after the weeks of hard work you and your assigned observer have completed, to provide an honest review that will serve these purposes.

The list of knowledge and skills to be evaluated may look overwhelming at first but by working through each one and using the examples of behavior, this evaluation should be completed in five to 10 minutes.

Thank you for taking the time to complete a fair and honest evaluation.

Completing the Observership Program evaluation form

1. Familiarize yourself with the descriptions of the Overall levels of performance (below):

2. When reviewing each item, first determine if it is relevant to the observer’s experience and/or if there was sufficient observation to evaluate. If not, check the “NA/NO” box (meaning “not applicable” or “not observed”) and move to the next item.

3. For each item that is determined applicable to your observer and for which there was adequate observation to evaluate, read the examples under the Needs improvement, Acceptable and Strong levels of performance. Determine which of those three levels best describes the IMG observer.

4. Within the level you’ve selected, check one of the three numbered boxes (the higher the number, the higher your evaluation). Check only one box for each area being evaluated.

5. Include written comments when possible, especially if the observer is rated very high or very low for an item.

6. Include any general comments or observations in the space provided at the end of the form.

7. You may choose to review the completed form with the IMG observer to provide more detailed feedback.

8. Return the form to: _______________________________________________________________________.

Overall levels of knowledge, skills or professional attributes

| | | |

|Needs improvement |Acceptable |Strong |

|May encounter problems in achieving required |Has or can be expected to achieve required |Already demonstrates performance at |

|performance levels |performance levels |or above required performance levels |

Observership evaluation

Observer name __________________________________________________________________________

Preceptor name __________________________________________________________________________

Nature of Observership (internal medicine, surgery, pediatrics, etc.)

________________________________________________________________________________________

Dates of Observership ____/_____/_____ to ____/_____/______ 

Institution(s) where Observership occurred

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

Evaluation based on:

______ Personal observations

______ Additional input from

________________________________________________________________________________________

________________________________________________________________________________________

Evaluation submitted (date) _____/_____/_______

Knowledge and skills

Page 1 of 4

| | | | |

| |Needs improvement |Acceptable |Strong |

|Knowledge – basic medical |Significant deficits in knowledge of relevant|Working knowledge of relevant anatomy and |Solid grasp of relevant anatomy and |

|science |anatomy and physiology; trouble recalling or |physiology; adequate recall of basic |physiology; demonstrates evidence of |

| |applying principles of basic sciences in |principles of clinically relevant basic |regular application of principles of all |

| |clinical settings. |sciences |basic sciences to clinically relevant |

| | | |situations |

|NA/NO | | | |

| |1 2 3|4 5 6 |7 8 9|

|Comments: |

| |

|Knowledge – clinical science |Lacks basic understanding of principles of |Good grasp of principles of clinical |Clear understanding of clinical medical |

| |clinical medicine including basic |medicine despite some gaps consistent with|principles, consistently able to articulate|

| |pathophysiology and therapeutics |limited experience or level of training |pathophysiology and relate to logical |

| | | |diagnostics and therapeutics |

|NA/NO | | | |

| |1 2 3|4 5 6 |7 8 9|

|Comments: |

| |

|Knowledge – medical education|Familiarity with standard textbook and |Is familiar with standard textbooks and |Well versed and familiar with all |

|resources |references is incomplete; difficulty |references, can access medical literature |components of medical literature including |

| |accessing medical literature and searching |both in library and electronically; can |standard texts, references and |

| |and retrieving relevant information; |search and retrieve relevant information; |peer-reviewed journals; searches are |

| |interpretation of study results often flawed |can interpret results of studies |focused and efficient and consistently |

| | | |retrieve relevant information; critically |

| | | |appraises results of studies |

|NA/NO | | | |

| |1 2 |4 5 6 |7 8 9|

| |3 | | |

|Comments: |

| |

|Knowledge – health care |Often appears confused by elements of US |Demonstrates basic understanding of the US|Demonstrates clear understanding of the US |

|system |Healthcare system, has trouble integrating |Healthcare system, able to integrate new |Healthcare system, able to effectively |

| |new elements even with a appropriate |elements with appropriate explanation, |relate components including those less |

| |explanation, may be unaware of significant |comfortable with most commonly encountered|frequently encountered; demonstrates and |

| |components; oblivious to or confused by |elements; basic appreciation of |expresses awareness of implications of |

| |health care financing system |implications of health care financing |health care financing system |

| | |system | |

|NA/NO | | | |

| |1 2 3|4 5 6 |7 8 9|

|Comments: |

| |

Knowledge and skills

Page 2 of 4

|Knowledge – |Often appears confused by names, dosages and|Can apply basic knowledge of clinical |Demonstrates sound knowledge of names, |

|U.S. formulary |indications for commonly used drugs in U.S. |pharmacology to identifying appropriate |dosages and indications of all commonly |

| |formulary; frequently using names of drugs |drugs in U.S. formularies that may differ |used drugs in U.S. formulary with no |

| |from prior education or practice setting; |in name, dosages or indications from those |evidence of confusion with drugs used |

| |little or no familiarity with |in their prior country of training or |previously; facility with using |

| |pharmacological references. |practice; some familiarity with |pharmacological references |

| | |pharmacological references.. | |

|NA/NO | | | |

| |1 2 |4 5 6 |7 8 |

| |3 | |9 |

|Comments: |

| |

| | | | |

| |Needs improvement |Acceptable |Strong |

|Skills – clinical skills – | Beginning with specifics not related to CC | Starts with specifics but those identified| Initially broad inquiries followed by |

|medical history |or HPI; makes no effort to clarify |in CC or HPI; reposes questions to |specifics as indicated by CC and HPI; |

| |unintelligible or inadequate answers; |inadequate answers; broad pursuit of |rephrases patient responses or offers |

| |reasonable associations of symptoms not |potential related symptoms but not |similes to clarify inadequate answers; |

| |pursued; ignores obvious risk factors; |necessarily specific to case; generally |sequential questioning of associated |

| |pursues low yield information or fails to |explores common risk factors; follows up on|symptoms and pursuit of associations |

| |pursue critical information; random |most important information; questions in |which may not be intuitive; thoroughly |

| |questions in no logical order |some order and lead from general to |explores all risk factors; selective use |

| | |specific |of followup questions with deeper probing|

| | | |of critical information; clearly |

| | | |organized pattern of questions from |

| | | |general to specific |

|NA/NO | | | |

| |1 2 |4 5 6 | |

| |3 | |7 8 |

| | | |9 |

|Comments: |

| |

|Communication – patients and | May express impatience with difficulties in| Makes efforts to understand and be | Consistently confirms that understanding|

|families |understanding or being understood; may use |understood; rarely uses medical jargon; |is clear by repetition, soliciting |

| |medical jargon without explanation; may |generally respectful in addressing; is open|questions; explains any medical |

| |convey disdain toward some; critical of |to diverse beliefs and attitudes toward |terminology used; always respectful in |

| |beliefs or attitudes that do not conform to |health |addressing; genuine effort to understand |

| |own | |and respect diverse beliefs and attitudes|

|NA/NO | | | |

| |1 2 |4 5 6 | |

| |3 | |7 8 |

| | | |9 |

|Comments: |

| |

Knowledge and skills

Page 3 of 4

|Communication – colleagues | May be overly deferential toward superiors |Respectful of superiors and peers; |Treats all colleagues respectfully whether|

| |and/or dismissive of peers; conversations |conversations and discussions are generally|superiors or peers; actively participates |

| |and discussions may be minimal and often |relevant and appropriate, answers questions|in conversations and discussions without |

| |tangential or inappropriate; may be evasive |forthrightly, open to diverse ideas and |trying to dominate or show off; welcomes |

| |when questioned; resistant to new ideas and |approaches, |questions and challenges; actively |

| |approaches | |solicits different points of view and |

| | | |rationales |

|NA/NO | | | |

| |1 2 |4 5 6 |7 8 |

| |3 | |9 |

|Comments: |

|Communication – nursing and |Shows little interest in understanding role |Acknowledges role and expertise of staff |Makes efforts to learn the role and |

|ancillary staff |and expertise of staff; rarely if ever |and accepts suggestions; may occasionally |expertise of staff; actively solicits |

| |approaches staff for help or information and|approach staff for help or information; |staff information and help and takes |

| |may ignore or dismiss suggestions when made;|treats staff with respect; rarely |suggestions gracefully; treats staff |

| |may be disrespectful or make disparaging |criticizes or blames staff for lack of |respectfully as colleagues; often |

| |remarks about staff; quick to blame staff |knowledge or performance |compliments staff on knowledge and skills |

| |for lack of knowledge or performance | | |

|NA/NO | | | |

| |1 2 |4 5 6 |7 8 |

| |3 | |9 |

|Comments: |

| |

|Clinical skills – | Frequent problems with comprehension and | Generally comprehensible, accent may be |Virtually no difficulty in comprehension |

|communication - spoken |understanding due to rate of speech, extreme|obvious but not problematic, makes effort |even if accent is present, confirms |

|English proficiency |accent or errors in syntax, little or no |to adapt rate of speech and pronunciation |understanding of listener by repetition or|

| |effort to adapt to listeners or clarify, may|to listener, may attempt to incorporate |clarification as necessary, reasonable |

| |become annoyed or upset when misunderstood |idioms although not always successful |facility with incorporation of idioms |

|NA/NO | | | |

| |1 2 |4 5 6 |7 8 |

| |3 | |9 |

|Comments: |

| |

|Clinical skills – |Handwritten entries frequently illegible, |Handwritten entries are legible, occasional|Handwriting consistently legible with |

|communication – written |spelling and syntax errors hamper |spelling and syntax errors; entry by |accurate spelling and syntax; proficient |

| |comprehensibility; |keyboard may be slow and error prone but |at typing with few errors and final proof |

| |essentially unable to enter material via |final drafts are reasonably proofed |near perfect |

| |keyboard or does so with multiple unproofed | | |

| |errors | | |

|NA/NO | | | |

| |1 2 |4 5 6 |7 8 |

| |3 | |9 |

|Comments: |

| |

|Skills – information | Has recurrent difficulty accessing |Is able to access electronic medical | Easily and efficiently accesses and moves|

|technology skills – |electronic medical records; often unable to |records and locate relevant information; is|about within electronic medical records to|

|electronic medical records |locate relevant information; unable to enter|able to appropriately enter basic clinical |locate and retrieve information and to |

| |clinical information or does so with |information into electronic medical records|enter information in appropriate |

| |frequent errors of format or location. | |locations and formats |

|NA/NO | | | |

| |1 2 |4 5 6 |7 8 |

| |3 | |9 |

|Comments: |

| |

Knowledge and skills

Page 4 of 4

| | | | |

| |Needs improvement |Acceptable |Strong |

|Skills – IT skills | Frequently unable to retrieve current | Can generally retrieve current laboratory | Facility with retrieving not only current|

|–information retrieval – |laboratory results or radiology reports or |results and radiology reports |laboratory results and radiology reports |

|clinical data |retrieves erroneous information, e.g., wrong| |but also with accessing older and archived|

| |patient | |materials |

|NA/NO | | | |

| |1 2 |4 5 6 |7 8 |

| |3 | |9 |

|Comments: |

| |

| |

|Skills – IT skills – | Has difficulty accessing electronic and | Can retrieve necessary information from | Facility with retrieving key information |

|information retrieval – |web-based resources, frequently unable to |electronic and web-based resources; can |from electronic and web-based resources, |

|reference material |retrieve necessary information; unfamiliar |construct and carry out reasonable searches|frequently in real-time and at point of |

| |with or unable to effectively use search |using PubMed or other search engines |service; uses PubMed or other search |

| |engines | |engines to conduct efficient, |

| | | |comprehensive searches |

|NA/NO | | | |

| |1 2 |4 5 6 |7 8 |

| |3 | |9 |

|Comments: |

| |

|Skills – presentation skills| Presentation of patients is disorganized |Presents patients following traditional | Presents patients following clear and |

|– patient presentations |with significant relevant information |format, includes relevant information and |logical format, relevant information |

| |lacking; results of diagnostics not |results of diagnostics; responds |includes pertinent positives and |

| |presented or presented in confusing or |appropriately to questions |negatives; results of diagnostic tests |

| |unclear manner | |presented with proposed interpretations; |

| | | |highly receptive to questions and comments|

|NA/NO | | | |

| |1 2 |4 5 6 |7 8 |

| |3 | |9 |

|Comments: |

| |

|Skills – presentation skills| Assigned topic may be misconstrued or | Presents topics as assigned, includes | Focuses assigned topics for maximal |

|– educational presentations |unfocused, only rudimentary material |basic required information, presentation is|relevance, materials beyond basics as |

| |presented, no or ineffective AV materials; |logical, AV materials are appropriate; able|appropriate, AV materials significantly |

| |unable to respond to many questions |to respond to most questions |contribute to presentation; confidently |

| | | |takes questions and responds appropriately|

|NA/NO | | | |

| |1 2 |4 5 6 |7 8 |

| |3 | |9 |

|Comments: |

| |

Professional qualities

Page 1 of 4

| | | | |

| |Needs improvement |Acceptable |Strong |

|Professional qualities – |May be evasive when lacking information, may |Consistently honest, does not fabricate |Unswervingly honest, readily admits and may |

|integrity |fabricate answers to avoid embarrassment, may|answers if does not know, does not takes |even volunteer when lacking information or |

| |attempt to take credit for accomplishments of|credit for things done by others |answers, acknowledges accomplishments of |

| |others | |others, may minimize credit for own |

| | | |accomplishments |

|NA/NO | | | |

| |1 2 3|4 5 6 |7 8 9 |

|Comments: |

| |

| | | | |

| |Needs improvement |Acceptable |Strong |

|Professional qualities – |Frequently has or expresses negative |Accepts people of diverse backgrounds, does|Actively attempts to understand |

|tolerance |judgments regarding groups or types of |not express negative judgments or use |perspectives and values of diverse groups, |

| |people, may use derogatory terms, rejects |derogatory terms, acknowledges validity of |makes efforts to maintain sensitivity to |

| |validity of different perspectives even |differing perspectives when explained |cultural and other interpersonal issues |

| |when explained | | |

|NA/NO | | | |

| | |4 5 6 |7 8 9|

| |1 2 | | |

| |3 | | |

|Comments: |

| |

| | | | |

| |Needs improvement |Acceptable |Strong |

|Professional qualities – |Expresses resistance to or dismissiveness |Understands and accepts principles of |Values and respects principles of |

|confidentiality |regarding principles of confidentiality, may|confidentiality, generally careful with |confidentiality, consistently conscientious|

| |be careless with patient related documents, |patient related documents, may occasionally|regarding patient related documents, never |

| |frequently discusses patient information in |reference patient information in unsecured |discusses patient information in unsecured |

| |unsecured areas |areas |areas |

|NA/NO | | | |

| |1 2 |4 5 6 |7 8 9|

| |3 | | |

|Comments: |

| |

Professional qualities

Page 2 of 4

| | | | |

| |Needs improvement |Acceptable |Strong |

|Professional qualities – |Frequently or persistently late for |Generally on time for scheduled activities,|Always on time for scheduled activities, |

|punctuality |scheduled activities, considers tardiness |understands and accepts the importance of |may even make a point of arriving a few |

| |not a significant issue |punctuality |minutes early, may articulate respect for |

| | | |others which punctuality bespeaks |

|NA/NO | | | |

| |1 2 |4 5 6 |7 8 |

| |3 | |9 |

|Comments: |

| |

| | | | |

| |Needs improvement |Acceptable |Strong |

|Professional qualities – |Fails to complete tasks assigned or requires|Generally completes tasks assigned, rarely|Consistently completes tasks assigned on or |

|reliability |repeated reminders and prodding, materials |needs to be reminded or prodded, produces |before due dates with no need for reminders,|

| |delivered may be inappropriate to requests |materials consistent with requests and of |materials produced consistently meet and |

| |and/or of unacceptable quality |acceptable quality |often exceed specifications, all work is of |

| | | |highest quality |

|NA/NO | | | |

| |1 2 |4 5 6 |7 8 9 |

| |3 | | |

|Comments: |

| |

| | | | |

| |Needs improvement |Acceptable |Strong |

|Professional qualities – |Has difficulty gathering information or |After adequate directions subsequently is |Can gather information and complete tasks |

|initiative |completing tasks even after extensive |able to gather information or complete |after only minimal initial direction, |

| |directions, rarely or never initiates |tasks with minimal additional guidance, |consistently initiates proposals and offers|

| |proposals or offers suggestions |sometimes initiate proposals or offers |suggestions, seeks creative solutions to |

| | |suggestions |problems |

|NA/NO | | | |

| |1 2 |4 5 6 |7 8 9|

| |3 | | |

|Comments: |

| |

Professional qualities

Page 3 of 4

| | | | |

| |Needs improvement |Acceptable |Strong |

|Professional qualities – |Makes minimal or no contribution to |Makes effort to participate in discussions |Consistently contributes meaningfully to |

|participation |discussions even when invited or makes |and activities although may sometimes |discussions while evidencing respect for |

| |inappropriate or overly aggressive attempts|require some drawing out or may occasionally|input of others, can appropriately gear |

| |to dominate discussions |tend to be overly or inappropriately verbose|level of participation to nature of |

| | | |discussion |

|NA/NO | | | |

| | |4 5 6 |7 8 9|

| |1 2 | | |

| |3 | | |

|Comments: |

| |

| | | | |

| |Needs improvement |Acceptable |Strong |

|Professional qualities – |Has great difficulty functioning in a team |After adequate introduction, can function |A natural team player, evidences mutual |

|teamwork |framework, may express significant |appropriately within a team framework, |respect and support of all team members, |

| |skepticism of the team concept or resistance|although may have some confusion regarding|able to defer or lead as appropriate, |

| |to its implementation, recurring problem |team concept or resistance to deferring to|actively acknowledges contributions of |

| |with deferring to other team |other team members |other team |

|NA/NO | | | |

| |1 2 |4 5 6 |7 8 9|

| |3 | | |

|Comments: |

| |

| | | | |

| |Needs improvement |Acceptable |Strong |

|Professional qualities – |May become overly defensive receive |Can accept and respond to both negative and |Consistently solicits feedback both |

|receptivity to feedback |negative feedback, tends to make excuses |positive feedback although may evidence |negative and positive, never defensive or |

| |and blame others, rarely if ever actively |minimal defensiveness, generally only seeks |blaming of others for shortcomings, |

| |seeks feedback |feedback following errors or difficulties |actively attempts to correct problems and |

| | | |initiates follow-up feedback |

|NA/NO | | | |

| | |4 5 6 |7 8 9|

| |1 2 | | |

| |3 | | |

|Comments: |

| |

Professional qualities

Page 4 of 4

| | | | |

| |Needs improvement |Acceptable |Strong |

|Professional qualities – |Fails to recognize limits of knowledge and |Can generally recognize limits of |Accurate and realistic recognition of limits|

|mindfulness |skills even when clearly exceeded, unaware |knowledge and skills when challenged, |of knowledge and skills, modestly |

| |of strengths or weaknesses, oblivious to |evidences awareness of strengths and |acknowledges strengths while actively |

| |prejudices, and not capable of self |weaknesses and prejudices, capable of self|working on weaknesses, identifies and |

| |reflection |reflection but generally only when asked |resists personal prejudices, regularly |

| | |to do so |engages in self reflection |

|NA/NO | | | |

| |1 2 |4 5 6 |7 8 9 |

| |3 | | |

|Comments: |

| |

| | | | |

| |Needs improvement |Acceptable |Strong |

|Professional qualities – |Pursuit of knowledge and skills in medicine|Conscientiously pursues acquisition of |Enthusiastically seeks out opportunities to |

|dedication |is often secondary to personal issues, |knowledge and skills in medicine, evidences |increase knowledge and skills in medicine, |

| |tends to minimize time and effort devoted |willingness to accept personal challenges of|evidences willingness to devote necessary |

| |to training, long-term goals primarily |training and practice, evidences genuine |time and effort to training and practice but|

| |self-centered, rarely evidences genuine |concern for patient's welfare |also maintains healthy balance in lifestyle,|

| |concern for patients | |active and compassionate patient advocate |

|NA/NO | | | |

| | |4 5 6 |7 8 9 |

| |1 2 | | |

| |3 | | |

|Comments: |

| |

| | | | |

| |Needs improvement |Acceptable |Strong |

|Teachability / Learnability |Requires frequent repetition of most basic |Retains new information well, can usually |Actively pursues knowledge and explores |

| |information, fails to apply general |apply principles to specific cases, takes |topics on own initiative, effectively |

| |principles to specific cases; resistant to |correction and negative feedback well; asks|applies principles to specific cases, seeks|

| |correction, defensive to negative feedback; |good questions and participates in |and responds to correction and feedback; |

| |rarely asks questions, little or no |discussions |questions are incisive and participates |

| |participation in discussions | |actively and appropriately in discussions |

|NA/NO | | | |

| |1 2 |4 5 6 |7 8 9|

| |3 | | |

|Comments: |

| |

Overall Comments

Include any comments, observations or information that you believe would be of value to those who may be assessing this observer as a potential program applicant.

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