System of Evaluation

Residents are evaluated on core competencies by their supervising attendings, and nurse practitioners while on clinical rotations in the hospital and the clinics.

The following elements will be used for the evaluation of resident’s achieving core competencies:

1. Faculty/Attending Evaluation of Resident Performance
   1. During clinical rotations, the attending will provide verbal evaluation and feedback during clinical case presentations, patient examination, discussion of differential diagnosis and management, and review of neuroradiology studies.
   2. During clinical rotations, the attending will review residents’ notes – both admission history and physicals as well as daily progress notes.  He/She will evaluate notes for appropriate structure, thoughtful differential diagnosis, and formation of appropriate management plan.
   3. At the completion of clinical rotations, the attending will complete written evaluations using the Medhub system.  These evaluations include measures of the six core competencies as identified by the ACGME and will focus on achieving the Neurocritical Care Milestones.
   4. After completion of rotations, residents will present at monthly morbidity and mortality conference, where they receive verbal and written feedback on difficult clinical scenarios.
2. Program Director Evaluations Quarterly
   Every three months, every resident will have a meeting with either the program director or the division head, over the course of the year to review progress and improvement in the Neurocritical Care Milestones.  During this meeting, the program director or division head will review written feedback, review attainment of training milestones, give direct verbal feedback and discuss residency and career planning.
3. Final Summative Evaluation
   At completion of residency training, the program director will complete a summary evaluation that confirms competence to begin practice without direct supervision.
4. Program Evaluation
   Faculty and residents participate with written evaluations via MedHub and are used in the process of mutual evaluations. These take the form not only of check-lists for levels of performance and satisfaction with the experience as well as opportunities to write longhand or in typed form the strengths and weaknesses of the experience during each of the months on service.
5. Nurse and Physician Assistant Evaluation of Fellow Performance
   The nurses and advanced practice providers who work with the fellows for the care of the inpatient neurology services evaluate competency in a number of domains, including but not limited to: interpersonal skills and communication, including signing out patient information; practice-based learning and improvement, including time management skills; professionalism; and systems-based practice, including the ability to work with other members of the health care team and share information with other providers at interdisciplinary rounds.
6. Self-Assessment
   Fellows will evaluate themselves, and use these self-assessments of their own knowledge and skills as a way to address practice-based learning and improvement and foster thoughtful reflection on their own career progress and plans.
7. Attendance at Conferences
   • Attendance at conferences will be used as one way of assessing medical knowledge, professionalism, and practice-based learning and improvement.
   • Residents are expected to attend all conferences unless exempted because of urgent patient care responsibilities, Bell Commission requirements, or permission from the Chief of Service.  Conferences include:
     1. Tuesday Columbia Case Conference
     2. Wednesday Cornell Case Conference
     3. Thursday Columbia Critical Care Conference
     4. Vascular Neurology Journal Club
     5. Neurology and Critical Care Grand Rounds (Cornell and Columbia campuses)
8. Praise and Concern Notifications
   Evaluations may also be filled out ad-hoc by any faculty member or peer group. 
9. Resident Evaluation of Teaching Attendings and Program
   All fellows will have the opportunity to evaluate the program and teaching Attendings confidentially and in writing at least annually, and the program will use this feedback to make improvements to the training experience.
   • The following mechanisms will be used to evaluate the program and teaching Attendings:
     1. Online feedback of the program in a written format through the Medhub system.
     2. Annual meeting of all fellows to discuss weaknesses and items of deficiency in the program.
     3. Annual written feedback and evaluation of the fellowship program
        • Items identified through the annual fellow meetings and written evaluations will be used to develop an action plan in conjunction with the program director and Department Chairman.
     4. Individual in-person meetings between each fellow and the program director to give verbal evaluation and feedback on the fellowship program strengths and weaknesses.
     5. Each attending physician will be asked to review attainment of clinical milestones with the program director every quarter before the meeting between the fellow and program director.
10. Fellow Academic Project
    Fellowship academic projects are mandatory for ACGME neurocritical care fellowship graduation. Fellows are mentored by the program director, department chairman, and faculty body, with the goal of the program is to help fellows achieve their academic project goals during their training.