MIME-Version: 1.0 Content-Location: file:///C:/F04BB24E/Orthopedic-Evaluation.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Sports Medicine Fellowship Evaluation

Sports Medicine Fellowship Evaluation

XYZ Sports Center

Fellow’s Name ______________________

Rotation Dates ______________________

Evaluator’s Name ____________________

Evaluator’s Location _________________

Please us the following grading scales by fill= ing in the appropriate square with the corresponding number.

  6 =3D= 60% -- Unacceptable Performance

  7 =3D= 70% -- Acceptable Performance

  8 =3D= 80% -- Meets Expectations

  9 =3D= 90% -- Exceeds Expectations

10 =3D 100% - Outstanding

N/A – Not Applicable

GENERAL OBJECTIVES

6

7

8

9

10

N/A

1.    Demonstrates profess= ional appearance

2.   &n= bsp; Communicates/relates to physicians and staff in a professional manner.

3.   &n= bsp; Appreciates the need for privacy, dignity and respect for the patient.

4.   &n= bsp; Shows evidence of being a self motivated learner.

5.   &n= bsp; Keeps accurate up-to date medical records.

6.   &n= bsp; Provided and discussed published objectives for this rotation.

CLINICAL SPORTS MEDICINE FELLOWSHIP EVALUATION

Orthopedics

6

7

8

9

10

N/A

1.     <= /span>Perform clinical orthopedic evaluation

On the following:

 

 

 

 

 

 

       &nbs= p;           a.  Upper Extremities=

       &nbs= p;           b.  Low Back

       &nbs= p;           c.  Hip

       &nbs= p;           d.  Knee

       &nbs= p;           e.  Leg

       &nbs= p;           f.  Ankle

       &nbs= p;           g.  Foot

2.     <= /span>Perform open and closed reduction of

Fractures/dislocations = under supervision.

3.    Perform or assist with large and small

        joint arthroscopic procedures.

4.     <= /span>Identify indications and limitations of

       rehabilitation programs associated with

       common orthopedic disorders.

5.    Recognize physiatrist role in evaluation

       and management of lower extremity

       disorders.

6.     <= /span>Identify principles associated with

Orthopedic concerns in = the following:

       &nbs= p;     a.  Sekeletally immature athlete 

       &nbs= p;     b.  Geriatric athlete=

       &nbs= p;     c.  Female athlete

 =

 =

 =

 =

 =

 =

Educational Quality Assurance

YES

NO

1.    = ; Were the rotation objectives clearly

       outlined ?

2.    = ; Was the Fellow adequ= ately prepared for

      this rotation ?

 

 

ŸPass     &= nbsp;     Ÿ<= /span>  Fail

 

 

COMMENTS:

 

___________________________= ___________________________________________________________________________= ___________________________________________________________________________= ___________________________________________________________________________= ___________________________________________________________________________= ___________________________________________________________________________= _______________________

___________________________= ___________________________________________________________________________= ___________________________________________________________________________= ___________________________________________________________________________= ___________________________________________________________________________= ___________________________________________________________________________= ___________________________________________________________________________= ___________________________________________________________________________= ___________________________________________________________________________= ___________________________________________________________________________= _______________________________________________________________

 

 

________________________________________________        &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;  _____________________

Evaluato= r’s Signature     &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;           &nbs= p;            &= nbsp;  Date

&nb= sp;