MDS Resident Team Management (ICS2) Assessment Pre-survey

Thank you for participating in today's simulation session. Your feedback for this activity is important to us as our goal is to create a worthwhile experience and simulation curriculum to help our staff build upon their abilities and skill sets in the emergency department. Thank you for taking the time to fill out this survey!

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* 1. What is your survey respondent number?

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* 2. What is your training level?

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* 3. Which resident will be leading your team during the "Springfield 2-Step" session (bolded in RED on your personal schedule)?

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* 4. How much experience have you had working with this resident?

No experience (never worked with or seen this resident)

Minimal experience (never worked with, however have seen them care for patients)

Some experience (worked with and have seen them care for patients during a few shifts)

Experience (worked and cared for patients with them during multiple shifts over many months)

A lot of experience (worked and cared for patients with them during multiple shifts over many years)

No experience (never worked with or seen this resident)

Minimal experience (never worked with, however have seen them care for patients)

Some experience (worked with and have seen them care for patients during a few shifts)

Experience (worked and cared for patients with them during multiple shifts over many months)

A lot of experience (worked and cared for patients with them during multiple shifts over many years)

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* 5. How would you rate your level of agreement with the following statements about this resident?

	Strongly disagree	Disagree	Slightly disagree	Slightly agree	Agree	Strongly Agree
I view this resident as a team leader	I view this resident as a team leader Strongly disagree	I view this resident as a team leader Disagree	I view this resident as a team leader Slightly disagree	I view this resident as a team leader Slightly agree	I view this resident as a team leader Agree	I view this resident as a team leader Strongly Agree
In high acuity patient scenarios this resident is the most vocal person in the patient care room	In high acuity patient scenarios this resident is the most vocal person in the patient care room Strongly disagree	In high acuity patient scenarios this resident is the most vocal person in the patient care room Disagree	In high acuity patient scenarios this resident is the most vocal person in the patient care room Slightly disagree	In high acuity patient scenarios this resident is the most vocal person in the patient care room Slightly agree	In high acuity patient scenarios this resident is the most vocal person in the patient care room Agree	In high acuity patient scenarios this resident is the most vocal person in the patient care room Strongly Agree
This resident is clear in communicating what patient care tasks need to be completed for patients	This resident is clear in communicating what patient care tasks need to be completed for patients Strongly disagree	This resident is clear in communicating what patient care tasks need to be completed for patients Disagree	This resident is clear in communicating what patient care tasks need to be completed for patients Slightly disagree	This resident is clear in communicating what patient care tasks need to be completed for patients Slightly agree	This resident is clear in communicating what patient care tasks need to be completed for patients Agree	This resident is clear in communicating what patient care tasks need to be completed for patients Strongly Agree
This resident is clear in communicating the order of priority of these patient care tasks	This resident is clear in communicating the order of priority of these patient care tasks Strongly disagree	This resident is clear in communicating the order of priority of these patient care tasks Disagree	This resident is clear in communicating the order of priority of these patient care tasks Slightly disagree	This resident is clear in communicating the order of priority of these patient care tasks Slightly agree	This resident is clear in communicating the order of priority of these patient care tasks Agree	This resident is clear in communicating the order of priority of these patient care tasks Strongly Agree
This resident asks me for input pertaining to the care of patients	This resident asks me for input pertaining to the care of patients Strongly disagree	This resident asks me for input pertaining to the care of patients Disagree	This resident asks me for input pertaining to the care of patients Slightly disagree	This resident asks me for input pertaining to the care of patients Slightly agree	This resident asks me for input pertaining to the care of patients Agree	This resident asks me for input pertaining to the care of patients Strongly Agree
This resident is amenable to my suggestions as it pertains to the care of patients	This resident is amenable to my suggestions as it pertains to the care of patients Strongly disagree	This resident is amenable to my suggestions as it pertains to the care of patients Disagree	This resident is amenable to my suggestions as it pertains to the care of patients Slightly disagree	This resident is amenable to my suggestions as it pertains to the care of patients Slightly agree	This resident is amenable to my suggestions as it pertains to the care of patients Agree	This resident is amenable to my suggestions as it pertains to the care of patients Strongly Agree
This resident is respectful towards me and other staff	This resident is respectful towards me and other staff Strongly disagree	This resident is respectful towards me and other staff Disagree	This resident is respectful towards me and other staff Slightly disagree	This resident is respectful towards me and other staff Slightly agree	This resident is respectful towards me and other staff Agree	This resident is respectful towards me and other staff Strongly Agree
I feel confident in the decisions this resident makes	I feel confident in the decisions this resident makes Strongly disagree	I feel confident in the decisions this resident makes Disagree	I feel confident in the decisions this resident makes Slightly disagree	I feel confident in the decisions this resident makes Slightly agree	I feel confident in the decisions this resident makes Agree	I feel confident in the decisions this resident makes Strongly Agree
I feel attending, consulting, and other resident physicians have confidence in this resident's decisions	I feel attending, consulting, and other resident physicians have confidence in this resident's decisions Strongly disagree	I feel attending, consulting, and other resident physicians have confidence in this resident's decisions Disagree	I feel attending, consulting, and other resident physicians have confidence in this resident's decisions Slightly disagree	I feel attending, consulting, and other resident physicians have confidence in this resident's decisions Slightly agree	I feel attending, consulting, and other resident physicians have confidence in this resident's decisions Agree	I feel attending, consulting, and other resident physicians have confidence in this resident's decisions Strongly Agree
I feel nurses, techs, and ancillary staff have confidence in this resident's decisions	I feel nurses, techs, and ancillary staff have confidence in this resident's decisions Strongly disagree	I feel nurses, techs, and ancillary staff have confidence in this resident's decisions Disagree	I feel nurses, techs, and ancillary staff have confidence in this resident's decisions Slightly disagree	I feel nurses, techs, and ancillary staff have confidence in this resident's decisions Slightly agree	I feel nurses, techs, and ancillary staff have confidence in this resident's decisions Agree	I feel nurses, techs, and ancillary staff have confidence in this resident's decisions Strongly Agree
I feel comfortable approaching this resident with questions pertaining to patient care	I feel comfortable approaching this resident with questions pertaining to patient care Strongly disagree	I feel comfortable approaching this resident with questions pertaining to patient care Disagree	I feel comfortable approaching this resident with questions pertaining to patient care Slightly disagree	I feel comfortable approaching this resident with questions pertaining to patient care Slightly agree	I feel comfortable approaching this resident with questions pertaining to patient care Agree	I feel comfortable approaching this resident with questions pertaining to patient care Strongly Agree
I look forward to work when I see that this resident is working with me	I look forward to work when I see that this resident is working with me Strongly disagree	I look forward to work when I see that this resident is working with me Disagree	I look forward to work when I see that this resident is working with me Slightly disagree	I look forward to work when I see that this resident is working with me Slightly agree	I look forward to work when I see that this resident is working with me Agree	I look forward to work when I see that this resident is working with me Strongly Agree
I would want this resident to take care of me or my family	I would want this resident to take care of me or my family Strongly disagree	I would want this resident to take care of me or my family Disagree	I would want this resident to take care of me or my family Slightly disagree	I would want this resident to take care of me or my family Slightly agree	I would want this resident to take care of me or my family Agree	I would want this resident to take care of me or my family Strongly Agree

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* 6. What feedback would you like to give to this resident regarding his/her leadership and team management skills?

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* 7. Which resident will be leading your team during the "Traditional Simulation" session (bolded in GREEN on your personal schedule)?

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* 8. How much experience have you had working with this resident?

No experience (never worked with or seen this resident)

Minimal experience (never worked with, however have seen them care for patients)

Some experience (worked with and have seen them care for patients during a few shifts)

Experience (worked and cared for patients with them during multiple shifts over many months)

A lot of experience (worked and cared for patients with them during multiple shifts over many years)

No experience (never worked with or seen this resident)

Minimal experience (never worked with, however have seen them care for patients)

Some experience (worked with and have seen them care for patients during a few shifts)

Experience (worked and cared for patients with them during multiple shifts over many months)

A lot of experience (worked and cared for patients with them during multiple shifts over many years)

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* 9. How would you rate your level of agreement with the following statements about this resident?

	Strongly disagree	Disagree	Slightly disagree	Slightly agree	Agree	Strongly Agree
I view this resident as a team leader	I view this resident as a team leader Strongly disagree	I view this resident as a team leader Disagree	I view this resident as a team leader Slightly disagree	I view this resident as a team leader Slightly agree	I view this resident as a team leader Agree	I view this resident as a team leader Strongly Agree
In high acuity patient scenarios this resident is the most vocal person in the patient care room	In high acuity patient scenarios this resident is the most vocal person in the patient care room Strongly disagree	In high acuity patient scenarios this resident is the most vocal person in the patient care room Disagree	In high acuity patient scenarios this resident is the most vocal person in the patient care room Slightly disagree	In high acuity patient scenarios this resident is the most vocal person in the patient care room Slightly agree	In high acuity patient scenarios this resident is the most vocal person in the patient care room Agree	In high acuity patient scenarios this resident is the most vocal person in the patient care room Strongly Agree
This resident is clear in communicating what patient care tasks need to be completed for patients	This resident is clear in communicating what patient care tasks need to be completed for patients Strongly disagree	This resident is clear in communicating what patient care tasks need to be completed for patients Disagree	This resident is clear in communicating what patient care tasks need to be completed for patients Slightly disagree	This resident is clear in communicating what patient care tasks need to be completed for patients Slightly agree	This resident is clear in communicating what patient care tasks need to be completed for patients Agree	This resident is clear in communicating what patient care tasks need to be completed for patients Strongly Agree
This resident is clear in communicating the order of priority of these patient care tasks	This resident is clear in communicating the order of priority of these patient care tasks Strongly disagree	This resident is clear in communicating the order of priority of these patient care tasks Disagree	This resident is clear in communicating the order of priority of these patient care tasks Slightly disagree	This resident is clear in communicating the order of priority of these patient care tasks Slightly agree	This resident is clear in communicating the order of priority of these patient care tasks Agree	This resident is clear in communicating the order of priority of these patient care tasks Strongly Agree
This resident asks me for input pertaining to the care of patients	This resident asks me for input pertaining to the care of patients Strongly disagree	This resident asks me for input pertaining to the care of patients Disagree	This resident asks me for input pertaining to the care of patients Slightly disagree	This resident asks me for input pertaining to the care of patients Slightly agree	This resident asks me for input pertaining to the care of patients Agree	This resident asks me for input pertaining to the care of patients Strongly Agree
This resident is amenable to my suggestions as it pertains to the care of patients	This resident is amenable to my suggestions as it pertains to the care of patients Strongly disagree	This resident is amenable to my suggestions as it pertains to the care of patients Disagree	This resident is amenable to my suggestions as it pertains to the care of patients Slightly disagree	This resident is amenable to my suggestions as it pertains to the care of patients Slightly agree	This resident is amenable to my suggestions as it pertains to the care of patients Agree	This resident is amenable to my suggestions as it pertains to the care of patients Strongly Agree
This resident is respectful towards me and other staff	This resident is respectful towards me and other staff Strongly disagree	This resident is respectful towards me and other staff Disagree	This resident is respectful towards me and other staff Slightly disagree	This resident is respectful towards me and other staff Slightly agree	This resident is respectful towards me and other staff Agree	This resident is respectful towards me and other staff Strongly Agree
I feel confident in the decisions this resident makes	I feel confident in the decisions this resident makes Strongly disagree	I feel confident in the decisions this resident makes Disagree	I feel confident in the decisions this resident makes Slightly disagree	I feel confident in the decisions this resident makes Slightly agree	I feel confident in the decisions this resident makes Agree	I feel confident in the decisions this resident makes Strongly Agree
I feel attending, consulting, and other resident physicians have confidence in this resident's decisions	I feel attending, consulting, and other resident physicians have confidence in this resident's decisions Strongly disagree	I feel attending, consulting, and other resident physicians have confidence in this resident's decisions Disagree	I feel attending, consulting, and other resident physicians have confidence in this resident's decisions Slightly disagree	I feel attending, consulting, and other resident physicians have confidence in this resident's decisions Slightly agree	I feel attending, consulting, and other resident physicians have confidence in this resident's decisions Agree	I feel attending, consulting, and other resident physicians have confidence in this resident's decisions Strongly Agree
I feel nurses, techs, and ancillary staff have confidence in this resident's decisions	I feel nurses, techs, and ancillary staff have confidence in this resident's decisions Strongly disagree	I feel nurses, techs, and ancillary staff have confidence in this resident's decisions Disagree	I feel nurses, techs, and ancillary staff have confidence in this resident's decisions Slightly disagree	I feel nurses, techs, and ancillary staff have confidence in this resident's decisions Slightly agree	I feel nurses, techs, and ancillary staff have confidence in this resident's decisions Agree	I feel nurses, techs, and ancillary staff have confidence in this resident's decisions Strongly Agree
I feel comfortable approaching this resident with questions pertaining to patient care	I feel comfortable approaching this resident with questions pertaining to patient care Strongly disagree	I feel comfortable approaching this resident with questions pertaining to patient care Disagree	I feel comfortable approaching this resident with questions pertaining to patient care Slightly disagree	I feel comfortable approaching this resident with questions pertaining to patient care Slightly agree	I feel comfortable approaching this resident with questions pertaining to patient care Agree	I feel comfortable approaching this resident with questions pertaining to patient care Strongly Agree
I look forward to work when I see that this resident is working with me	I look forward to work when I see that this resident is working with me Strongly disagree	I look forward to work when I see that this resident is working with me Disagree	I look forward to work when I see that this resident is working with me Slightly disagree	I look forward to work when I see that this resident is working with me Slightly agree	I look forward to work when I see that this resident is working with me Agree	I look forward to work when I see that this resident is working with me Strongly Agree
I would want this resident to take care of me or my family	I would want this resident to take care of me or my family Strongly disagree	I would want this resident to take care of me or my family Disagree	I would want this resident to take care of me or my family Slightly disagree	I would want this resident to take care of me or my family Slightly agree	I would want this resident to take care of me or my family Agree	I would want this resident to take care of me or my family Strongly Agree

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* 10. What feedback would you like to give to this resident regarding his/her leadership and team management skills?

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* 11. Which resident will be supervising the "Springfield 2-Step" session (bolded in BLUE on your personal schedule)?

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* 12. How much experience have you had working with this resident?

No experience (never worked with or seen this resident)

Minimal experience (never worked with, however have seen them care for patients)

Some experience (worked with and have seen them care for patients during a few shifts)

Experience (worked and cared for patients with them during multiple shifts over many months)

A lot of experience (worked and cared for patients with them during multiple shifts over many years)

No experience (never worked with or seen this resident)

Minimal experience (never worked with, however have seen them care for patients)

Some experience (worked with and have seen them care for patients during a few shifts)

Experience (worked and cared for patients with them during multiple shifts over many months)

A lot of experience (worked and cared for patients with them during multiple shifts over many years)

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* 13. How would you rate your level of agreement with the following statements about this resident?

	Strongly disagree	Disagree	Slightly disagree	Slightly agree	Agree	Strongly Agree
I view this resident as a team leader	I view this resident as a team leader Strongly disagree	I view this resident as a team leader Disagree	I view this resident as a team leader Slightly disagree	I view this resident as a team leader Slightly agree	I view this resident as a team leader Agree	I view this resident as a team leader Strongly Agree
This resident communicates clearly and effectively to me and other staff in the emergency department	This resident communicates clearly and effectively to me and other staff in the emergency department Strongly disagree	This resident communicates clearly and effectively to me and other staff in the emergency department Disagree	This resident communicates clearly and effectively to me and other staff in the emergency department Slightly disagree	This resident communicates clearly and effectively to me and other staff in the emergency department Slightly agree	This resident communicates clearly and effectively to me and other staff in the emergency department Agree	This resident communicates clearly and effectively to me and other staff in the emergency department Strongly Agree
This resident is respectful towards me and other staff	This resident is respectful towards me and other staff Strongly disagree	This resident is respectful towards me and other staff Disagree	This resident is respectful towards me and other staff Slightly disagree	This resident is respectful towards me and other staff Slightly agree	This resident is respectful towards me and other staff Agree	This resident is respectful towards me and other staff Strongly Agree
I feel confident in the decisions this resident makes	I feel confident in the decisions this resident makes Strongly disagree	I feel confident in the decisions this resident makes Disagree	I feel confident in the decisions this resident makes Slightly disagree	I feel confident in the decisions this resident makes Slightly agree	I feel confident in the decisions this resident makes Agree	I feel confident in the decisions this resident makes Strongly Agree
I feel comfortable approaching this resident with questions pertaining to patient care	I feel comfortable approaching this resident with questions pertaining to patient care Strongly disagree	I feel comfortable approaching this resident with questions pertaining to patient care Disagree	I feel comfortable approaching this resident with questions pertaining to patient care Slightly disagree	I feel comfortable approaching this resident with questions pertaining to patient care Slightly agree	I feel comfortable approaching this resident with questions pertaining to patient care Agree	I feel comfortable approaching this resident with questions pertaining to patient care Strongly Agree
I look forward to work when I see that this resident is working with me	I look forward to work when I see that this resident is working with me Strongly disagree	I look forward to work when I see that this resident is working with me Disagree	I look forward to work when I see that this resident is working with me Slightly disagree	I look forward to work when I see that this resident is working with me Slightly agree	I look forward to work when I see that this resident is working with me Agree	I look forward to work when I see that this resident is working with me Strongly Agree
I would want this resident to take care of me or my family	I would want this resident to take care of me or my family Strongly disagree	I would want this resident to take care of me or my family Disagree	I would want this resident to take care of me or my family Slightly disagree	I would want this resident to take care of me or my family Slightly agree	I would want this resident to take care of me or my family Agree	I would want this resident to take care of me or my family Strongly Agree

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* 14. What feedback would you like to give to this resident regarding his/her leadership and team management skills?

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* 15. Which resident will be supervising the "Traditional Simulation" session (bolded in PURPLE on your personal schedule)?

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* 16. How much experience have you had working with this resident?

No experience (never worked with or seen this resident)

Minimal experience (never worked with, however have seen them care for patients)

Some experience (worked with and have seen them care for patients during a few shifts)

Experience (worked and cared for patients with them during multiple shifts over many months)

A lot of experience (worked and cared for patients with them during multiple shifts over many years)

No experience (never worked with or seen this resident)

Minimal experience (never worked with, however have seen them care for patients)

Some experience (worked with and have seen them care for patients during a few shifts)

Experience (worked and cared for patients with them during multiple shifts over many months)

A lot of experience (worked and cared for patients with them during multiple shifts over many years)

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* 17. How would you rate your level of agreement with the following statements about this resident?

	Strongly disagree	Disagree	Slightly disagree	Slightly agree	Agree	Strongly Agree
I view this resident as a team leader	I view this resident as a team leader Strongly disagree	I view this resident as a team leader Disagree	I view this resident as a team leader Slightly disagree	I view this resident as a team leader Slightly agree	I view this resident as a team leader Agree	I view this resident as a team leader Strongly Agree
This resident communicates clearly and effectively to me and other staff in the emergency department	This resident communicates clearly and effectively to me and other staff in the emergency department Strongly disagree	This resident communicates clearly and effectively to me and other staff in the emergency department Disagree	This resident communicates clearly and effectively to me and other staff in the emergency department Slightly disagree	This resident communicates clearly and effectively to me and other staff in the emergency department Slightly agree	This resident communicates clearly and effectively to me and other staff in the emergency department Agree	This resident communicates clearly and effectively to me and other staff in the emergency department Strongly Agree
This resident is respectful towards me and other staff	This resident is respectful towards me and other staff Strongly disagree	This resident is respectful towards me and other staff Disagree	This resident is respectful towards me and other staff Slightly disagree	This resident is respectful towards me and other staff Slightly agree	This resident is respectful towards me and other staff Agree	This resident is respectful towards me and other staff Strongly Agree
I feel confident in the decisions this resident makes	I feel confident in the decisions this resident makes Strongly disagree	I feel confident in the decisions this resident makes Disagree	I feel confident in the decisions this resident makes Slightly disagree	I feel confident in the decisions this resident makes Slightly agree	I feel confident in the decisions this resident makes Agree	I feel confident in the decisions this resident makes Strongly Agree
I feel comfortable approaching this resident with questions pertaining to patient care	I feel comfortable approaching this resident with questions pertaining to patient care Strongly disagree	I feel comfortable approaching this resident with questions pertaining to patient care Disagree	I feel comfortable approaching this resident with questions pertaining to patient care Slightly disagree	I feel comfortable approaching this resident with questions pertaining to patient care Slightly agree	I feel comfortable approaching this resident with questions pertaining to patient care Agree	I feel comfortable approaching this resident with questions pertaining to patient care Strongly Agree
I look forward to work when I see that this resident is working with me	I look forward to work when I see that this resident is working with me Strongly disagree	I look forward to work when I see that this resident is working with me Disagree	I look forward to work when I see that this resident is working with me Slightly disagree	I look forward to work when I see that this resident is working with me Slightly agree	I look forward to work when I see that this resident is working with me Agree	I look forward to work when I see that this resident is working with me Strongly Agree
I would want this resident to take care of me or my family	I would want this resident to take care of me or my family Strongly disagree	I would want this resident to take care of me or my family Disagree	I would want this resident to take care of me or my family Slightly disagree	I would want this resident to take care of me or my family Slightly agree	I would want this resident to take care of me or my family Agree	I would want this resident to take care of me or my family Strongly Agree

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* 1. What is your survey respondent number?

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* 2. What is your training level?

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* 3. Which resident will be leading your team during the "Springfield 2-Step" session (bolded in RED on your personal schedule)?

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* 4. How much experience have you had working with this resident?

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* 5. How would you rate your level of agreement with the following statements about this resident?

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* 6. What feedback would you like to give to this resident regarding his/her leadership and team management skills?

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* 7. Which resident will be leading your team during the "Traditional Simulation" session (bolded in GREEN on your personal schedule)?

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* 8. How much experience have you had working with this resident?

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* 9. How would you rate your level of agreement with the following statements about this resident?

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* 10. What feedback would you like to give to this resident regarding his/her leadership and team management skills?

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* 11. Which resident will be supervising the "Springfield 2-Step" session (bolded in BLUE on your personal schedule)?

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* 12. How much experience have you had working with this resident?

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* 13. How would you rate your level of agreement with the following statements about this resident?

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* 14. What feedback would you like to give to this resident regarding his/her leadership and team management skills?

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* 15. Which resident will be supervising the "Traditional Simulation" session (bolded in PURPLE on your personal schedule)?

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* 16. How much experience have you had working with this resident?

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* 17. How would you rate your level of agreement with the following statements about this resident?

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* 18. What feedback would you like to give to this resident regarding his/her leadership and team management skills?