resident shift card Survey

1. Name

	PGY 1	PGY 2	PGY 3
Resident's name	Name Resident's name PGY 1	PGY 2	PGY 3

2. Date of shift

	MM		DD		YYYY
Date	Date of shift Date Month	/	Day	/	Year

3. Area

	Area
Area of ED in which resident worked	Area Area of ED in which resident worked Area

4. Please describe 1-2 things that the resident did well on shift (the more specific the description, the better)

Please describe 1-2 things that the resident did well on shift (the more specific the description, the better)

5. Please describe 1-2 things the resident could do to improve his/her performance on shift (the more specific the description, the better)

Please describe 1-2 things the resident could do to improve his/her performance on shift (the more specific the description, the better)

resident shift card
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