* 1. Fellow Name - Date

* 2. Review evaluations in New Innovations
(Path) Start Menu/Partners Applications/New Innovations/Main/Evaluations

* 3. For ACGME Fellows: Review patient log in New Innovations (Path) Start Menu/Partners Applications/New Innovations/Main/Logbook)
Fellows should be on track to see:
100 new patients
25 home visits
2-4 families for bereavement
3-4 continuity patients
25 patients in more than one setting (setting include ED, IPCU, inpatient hospice at MGH/DFCI/Kaplan House, home hospice, outpatient clinic or rehab facility).

* 4. Suggested topics for discussion. Please document any comments or concerns in the text box below.

- Check in about current rotation (any problems, suggestions for improvement, goals for the experience).
- Discuss ongoing approach towards coping and self-care.
- Review elective planning.
- Check in about upcoming educational projects (QI, Small Group Teaching, Grand Rounds)
- Identify Learning Goals
- Problems or concerns about hand-over/sign out process.