Ortho PG Evaluation - End of Year 2010 - 2011

1. Resident A

Please evaluate Resident A's performance over the past 6 months!

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* 1. Clinical exam and diagnostic capabilities

1. Below Level

2. At Level

3. Above Level

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* 2. Establishing treatment objectives & treatment planning capabilities

1. Below Level

2. At Level

3. Above Level

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* 3. Clinical Skills (Arch wire changes, wire tie-in, recommendations for interarch mechanics and/or extraoral mechanics, recommendation for debond, and recommendation for retention)

1. Below Level

2. At Level

3. Above Level

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* 4. Professionalism (Patient/parent interaction, staff interaction, co-resident interaction, faculty interaction, and overall appearance)

1. Below Level

2. At Level

3. Above Level

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* 5. Attitude (Attention to details, attention given to assigned duties, and assignment follow through)

1. Below Level

2. At Level

3. Above Level

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* 6. Please grade Resident A's overall performance in the clinic.

A - consistently at level or above level in your opinion

B - consistently at level with occasional below level performance

F - consistently below level; significantly deficient in numerous areas and may need to extend his length of time in the residency. If your grade is an F, you must explain your reasoning!

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* 7. Please grade Resident A's overall performance in seminar.

A - consistently at level or above level in your opinion

B - consistently at level with occasional below level performance

F - consistently below level; significantly deficient in numerous areas and may need to extend his length of time in the residency. If your grade is an F, you must explain your reasoning!

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* 8. Please comment on Resident A's Strengths and any Deficiencies

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* 9. Do you feel Resident A is ready to graduate after having satisfied all requirements to the department, school, and university?

1. Yes

2. No. If you answer no, you must explain your reasoning!