CHCO Clinic Dermatology Resident/Fellow STAFF ELECTRONIC Survey
Resident/Fellow Name:
*
Please Select
Sofia Guelfand Warnken
Juan Acosta
Kelsey Baab
Sue Choi
Neha Deo
Lauren Gendrew
Jesse Hinshaw
Jon Kibbie
William Kim
Sam Logan
Desiree Morris
Ani Oganesyan
Caterina Prizio
Hope Rietcheck
Ramiro Rodriguez
Torunn Sivesind
Molly Weinberg
Jacqueline Zayas
Sophia Zita
Professionalism:
1=Never 2=Sometimes 3=Often 4=Always
Accepts inconvenience when necessary to meet the needs of the patient.
Never
1
2
3
Always
4
1 is Never, 4 is Always
Respects patient privacy when conducting examinations.
Never
1
2
3
Always
4
1 is Never, 4 is Always
Respects patient's right to make choices regarding their care.
Never
1
2
3
Always
4
1 is Never, 4 is Always
Uses respectful language when discussing patients with nursing and support staff.
Never
1
2
3
Always
4
1 is Never, 4 is Always
Is courteous and receptive to nursing and support staff.
Never
1
2
3
Always
4
1 is Never, 4 is Always
Seeks consultation/supervision when appropriate.
Never
1
2
3
Always
4
1 is Never, 4 is Always
Maintains confidentiality when handling patients' medical materials.
Never
1
2
3
Always
4
1 is Never, 4 is Always
Attempts to maintain punctuality.
Never
1
2
3
Always
4
1 is Never, 4 is Always
Interpersonal Communication Skills:
1=Never 2=Sometimes 3=Often 4=Always
Demonstrates willingness to listen to patients and families.
Never
1
2
3
Always
4
1 is Never, 4 is Always
Explains information to patients and families using clear, understandable terms.
Never
1
2
3
Always
4
1 is Never, 4 is Always
Keeps patients, families, nursing, and support staff informed of changes in the care plan.
Never
1
2
3
Always
4
1 is Never, 4 is Always
Handles demanding interpersonal situations in a respectful and effective manner.
Never
1
2
3
Always
4
1 is Never, 4 is Always
Handles messages appropriately in a timely fashion and responds in timely manner when contacted by health care staff.
Never
1
2
3
Always
4
1 is Never, 4 is Always
Please provide specific comments where you have concerns regarding this resident's performance in the above areas.
Please provide information where this resident has consistently performed in an outstanding manner.
Thank you!
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