Entering Resident Goal-Based Evaluation for Dr Sandy Resident (Self-evaluation)
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<strong>Entering</strong> <strong>Resident</strong> <strong>Goal</strong>-<strong>Based</strong> <strong>Evaluation</strong> <strong>for</strong> <strong>Dr</strong>. <strong>Sandy</strong> <strong>Resident</strong> (<strong>Self</strong>-<strong>evaluation</strong>)<br />
<strong>Resident</strong>:<br />
Evaluator:<br />
<strong>Dr</strong>. <strong>Sandy</strong> <strong>Resident</strong><br />
<strong>Dr</strong>. <strong>Sandy</strong> <strong>Resident</strong><br />
Date Evaluated: 7/30/2011 21:25<br />
Outcome/<strong>Goal</strong> Narrative Commentary Score<br />
Outcome R1: Manage and improve the medication-use process.<br />
<strong>Goal</strong> R1.1: Identify opportunities <strong>for</strong> improvement of the organization’s medication-use system.<br />
Made some improvements as a lead tech.<br />
<strong>Goal</strong> R1.2: Design and implement quality improvement changes to the organization’s medication-use system.<br />
<strong>Goal</strong> R1.3: Prepare and dispense medications following existing standards of practice and the organization’s policies<br />
and procedures.<br />
<strong>Goal</strong> R1.4: Demonstrate ownership of and responsibility <strong>for</strong> the welfare of the patient by per<strong>for</strong>ming all necessary<br />
aspects of the medication-use system.<br />
<strong>Goal</strong> R1.5: Provide concise, applicable, comprehensive, and timely responses to requests <strong>for</strong> drug in<strong>for</strong>mation from<br />
patients and health care providers.<br />
Outcome R2: Provide evidence-based, patient-centered medication therapy management with interdisciplinary teams.<br />
<strong>Goal</strong> R2.1: As appropriate, establish collaborative professional relationships with members of the health care team.<br />
<strong>Goal</strong> R2.2: Place practice priority on the delivery of patient-centered care to patients.<br />
SlA (Slightly<br />
Agree)<br />
SlA (Slightly<br />
Agree)<br />
MA (Moderately<br />
Agree)<br />
MA (Moderately<br />
Agree)<br />
SlA (Slightly<br />
Agree)<br />
SlA (Slightly<br />
Agree)<br />
SlA (Slightly<br />
Agree)<br />
<strong>Entering</strong> <strong>Resident</strong> <strong>Goal</strong>-<strong>Based</strong> <strong>Evaluation</strong> <strong>for</strong> <strong>Dr</strong>. <strong>Sandy</strong> <strong>Resident</strong> (<strong>Self</strong>-<strong>evaluation</strong>)<br />
7/31/2011 21:59<br />
ASHP's Demo Site #1<br />
Page 1 of 4
<strong>Goal</strong> R2.3: As appropriate, establish collaborative professional pharmacist-patient relationships.<br />
<strong>Goal</strong> R2.4: Collect and analyze patient in<strong>for</strong>mation.<br />
<strong>Goal</strong> R2.5: When necessary, make and follow up on patient referrals.<br />
<strong>Goal</strong> R2.6: Design evidence-based therapeutic regimens.<br />
<strong>Goal</strong> R2.7: Design evidence-based monitoring plans.<br />
<strong>Goal</strong> R2.8: Recommend or communicate regimens and monitoring plans.<br />
<strong>Goal</strong> R2.9: Implement regimens and monitoring plans.<br />
<strong>Goal</strong> R2.10: Evaluate patients’ progress and redesign regimens and monitoring plans.<br />
<strong>Goal</strong> R2.11: Communicate ongoing patient in<strong>for</strong>mation.<br />
<strong>Goal</strong> R2.12: Document direct patient care activities appropriately.<br />
SlD (Slightly<br />
Disagree)<br />
MD (Moderately<br />
Disagree)<br />
SlD (Slightly<br />
Disagree)<br />
MD (Moderately<br />
Disagree)<br />
MD (Moderately<br />
Disagree)<br />
SlD (Slightly<br />
Disagree)<br />
MD (Moderately<br />
Disagree)<br />
SlD (Slightly<br />
Disagree)<br />
SlA (Slightly<br />
Agree)<br />
SlA (Slightly<br />
Agree)<br />
7/31/2011 21:59<br />
<strong>Entering</strong> <strong>Resident</strong> <strong>Goal</strong>-<strong>Based</strong> <strong>Evaluation</strong> <strong>for</strong> <strong>Dr</strong>. <strong>Sandy</strong> <strong>Resident</strong> (<strong>Self</strong>-<strong>evaluation</strong>)<br />
ASHP's Demo Site #1<br />
Page 2 of 4
Outcome R3: Exercise leadership and practice management skills.<br />
<strong>Goal</strong> R3.1: Exhibit essential personal skills of a practice leader.<br />
<strong>Goal</strong> R3.2: Contribute to departmental leadership and management activities.<br />
<strong>Goal</strong> R3.3: Exercise practice leadership.<br />
Outcome R4: Demonstrate project management skills.<br />
<strong>Goal</strong> R4.1: Conduct a practice-related project using effective project management skills.<br />
Outcome R5: Provide medication and practice-related education/training.<br />
<strong>Goal</strong> R5.1: Provide effective medication and practice-related education, training, or counseling to patients, caregivers,<br />
health care professionals, and the public.<br />
Was a math tutor <strong>for</strong> high school algebra so have some teaching experience, but would like to get more.<br />
Outcome R6: Utilize medical in<strong>for</strong>matics.<br />
<strong>Goal</strong> R6.1: Use in<strong>for</strong>mation technology to make decisions and reduce error.<br />
Experience with Word and Power Point is good and have experience with the hospital computer system. Don't have<br />
a good grasp of Excel. Have no experience with Access or statistical programs.<br />
MA (Moderately<br />
Agree)<br />
SlA (Slightly<br />
Agree)<br />
SlA (Slightly<br />
Agree)<br />
StD (Strongly<br />
Disagree)<br />
SlA (Slightly<br />
Agree)<br />
SlA (Slightly<br />
Agree)<br />
Additional Questions<br />
Question<br />
Individual goals related to increasing your patient care<br />
abilities:<br />
Patient care interest areas:<br />
Leadership positions held – past or present:<br />
Previous leadership training:<br />
Comments<br />
Learn to analyze the drugs that the patient is on to see what needs to be changed.<br />
Family medicine, ID, cardiology, critical care<br />
Secretary and Treasurer of SSHP.<br />
No <strong>for</strong>mal training, but work experience as lead pharmacy tech.<br />
7/31/2011 21:59<br />
<strong>Entering</strong> <strong>Resident</strong> <strong>Goal</strong>-<strong>Based</strong> <strong>Evaluation</strong> <strong>for</strong> <strong>Dr</strong>. <strong>Sandy</strong> <strong>Resident</strong> (<strong>Self</strong>-<strong>evaluation</strong>)<br />
ASHP's Demo Site #1<br />
Page 3 of 4
Personal leadership and communication skill goals:<br />
Describe previous experience with design and<br />
implementation of patient care programs or projects:<br />
Project ideas:<br />
Previous teaching experience:<br />
Personal goals related to teaching:<br />
Desired teaching activities to complete during the<br />
year:<br />
Would like to be an officer in local chapter after completing my residency training.<br />
Continue to improve my presentation skills.<br />
None.<br />
None.<br />
Algebra tutor.<br />
Oriented pharmacy technicians.<br />
Would like to be a preceptor once I have a little experience as a clinical pharmacist. Would<br />
eventually like to be a residency program director.<br />
Precept a student.<br />
Present a lecture to pharmacy students.<br />
RPD Comments: <br />
RPD Cosign: <br />
Page 4 of 4
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