EPA: Other Procedure

Name of Other Procedure

Evaluatee Name (Last, First)

Enter resident starting with last name. Once a form has been submitted, the resident will receive a copy of the evaluation.

Evaluator Name

Last Name, First Initial

Rotation

Date of Assessment

mm/dd/yyyy

Case Difficulty

Straightforward

Moderate

Complex

Anatomy(Other)

Able to describe normal anatomy

Able to identify normal anatomy during the operation

Describe abnormal anatomy

Identify abnormal anatomy (setting of inflammation or scarring)

Step(Other)

Unable to accurately mark or describe the optimal skin incision or port placement

Describe the basic steps of the operation, but requires supervision and coaching for most intraoperative decisions

Make straightforward intraoperative decisions, requires coaching

Make intraoperative decisions, independently. Requires assistance for complex decisions. Modifies operative plan as needed in the face of intraop findings.

Compl(Other)

Does not work to preserve essential structures.

Describe most potential errors, but not able to demonstrate how to avoid them.

Describe and takes steps to avoid potential errors, but not always successful.

Describe and successfully take steps to avoid potential errors.

Tech(Other)

Uncertain, jerky, and may demonstrate discoordination between two hands

Increasing coordination between two hands. Dissection is inefficient and can cause tissue trauma.

Developing skill with instrument handling, coordination with two hands, and respect for tissue (minimal tissue trauma). Dissection may be inefficient and result in excess maneuvers.

Facile with instrument handling, coordination with two hands, and respect for tissue (minimal tissue trauma). Dissection techniques mirror those of practicing surgeon with few extra maneuvers.

Overall Performance

Based on your observation, what level of autonomy would you trust the resident to manage this surgical condition at the next encounter?

Limited Participation: Learner has basic knowledge and skills, attending does show and tell

Direct Supervision: Attending provides active help

Indirect Supervision: Attending provides passive help

Practice Ready: Attending is available but is not needed for routine cases/presentations, but input may be needed for complex cases

Comment

Please add comment on why you selected the answer above. Specifically note what steps the resident can take to achieve the next level of autonomy.

Report Abuse