ࡱ> a bjbj 7hGbhGb$$$8\4$<0"^<`<`<`<`<`<`<$>@<<<R^<^<:\#,#/F2]F# J<<0<#RkA!PkA##FkA*$ <<q<kAB : Instructions: Table is pre-populated with major headings for each table (department, local, regional/nation, and professional activities). Table is pre-populated examples; faculty should review examples, remove examples, and type directly into the table. Add extra rows as needed. Remove rows that are empty. There should be data entered into the table for every set of evaluations providedin the dossier (set=single collated report for a given activity in given academic year). DatesDepartment of [department name]Evaluation Scores [Average]SD, if available# of studentsScale used2018-19Annual Evaluation by Residents2.78 (1-3 scale)2017-18Annual Evaluation by Residents 2.7 (1-3 scale)2016-17Annual Evaluation by Residents 2.45 (1-3 scale)2015-16Annual Evaluation by Residents 4.14 (1-5 scale)2016-17Annual Evaluation by Medical Students 3.5 (1-5 scale)2018-19Evaluation of Resident/Fellow Didactics 4.5 (1-5 scale) Dates̽̽/̽̽MC CoursesSession TitleEvaluation Scores [Average]SD, if available# of studentsScale usedLarner College of Medicine Teaching Academy2018Teaching Academy Snow Season Education RetreatAdvancing Medical Education Through Technology4.57 (1-5 scale)2016Teaching Academy Snow Season Education RetreatMentoring the Challenging Learner4.14(1-5 scale)2017Teaching Academy Essentials of Teaching and Assessment CourseFeedback Essentials4.38 (1-5 scale)̽̽MC Quality Improvement & Patient Safety Essentials Course2018Quality Improvement & Safety Essentials for Residents/Fellows Course Director (Overall course evaluation)4.5 (1-5 Scale)2018Quality Improvement & Safety Essentials for Residents/FellowsThe Root Cause Analysis (Workshop Presenter/Facilitator)4.52 (1-5 Scale)2017Quality Improvement & Safety Essentials for Advanced Practice Providers Course Director (Overall course evaluation)4.61 (1-5 Scale)[Insert Additional Course Name] DatesRegional & NationalSession TitleEvaluation Score [Average]SD, if available# of studentsScale used2018Northern New England Chapter of the American College of Cardiology Annual MeetingCourse Co-Director (Overall course evaluation)4.63 (1-5 scale)2018Northern New England Chapter of the American College of Cardiology Annual MeetingHeart Failure in Sepsis: A Reappraisal4.9 (1-5 scale)2017American College of Surgeons Annual MeetingManagement of High Impact Trauma in Pediatrics4.4 (1-5 scale)2/2/18Visiting Professor, Tulane University Department of Medicine Heart Failure in Sepsis: A Reappraisal4.8 (1-5 scale) Professional ActivitiesDatesAmerican Board of Pediatrics (In-Training Exam Question Writer)FeedbackItem Quality [based on Excellent/Good/Fair/Poor]2017Question Author Feedback Very Responsive A few items required reworking due to failing the cover-up test, but responses to my suggestions were immediate. Used novel ways to ask blueprint areas. That creativity was quite welcome.Excellent Item content was appropriate for the assigned content area. References were current, complete, and appropriate2016Question Author FeedbackVery Responsive Actively participated in dialogue about the questions and demonstrated understanding of how suggested edits would improve the items. Good Items demonstrated adherence to formatting guidelines. DatesJournal of General Internal Medicine (peer reviewer)FeedbackAverage Score20183 reviewsOutstanding critique that is comprehensive, insightful, and well-written, addresses both content and pedagogy, and serves as an exemplar for other reviews.7.9 (scale 1-9)[Insert additional activity][Qualitative data][Quantitative data]     Name Department of Summary Table of Evaluation Results (see documents for full details)  PAGE   PAGE 2  & 6 7 D E O P Q X [ w z |    , - C q r v w y hOJQJh=bhOJQJh=bh5OJQJh5OJQJhbOJQJ#hB*CJOJQJ^JaJph)hhOB*CJOJQJ^JaJph hhOCJOJQJ^JaJ<  8 & 7 E P Q Y x ~  $(P$Ifa$gdQY (P$IfgdQYFfZ$(P$Ifa$gdgdQ & FgdOgdO kd$$Iflֈ$")- 3BX t0644 l` apyt $(P$Ifa$gd=b$(P$Ifa$gd (P$Ifgd (P$Ifgd=b kdf$$Iflֈ$")- 3BX t0644 l` apyt  $(P$Ifa$gd=b$(P$Ifa$gd (P$Ifgd (P$Ifgd=b  kdF$$Iflֈ$")- 3BX t0644 l` apyt  . 4 5 6 B $(P$Ifa$gd=b$(P$Ifa$gd (P$Ifgd (P$Ifgd=bB C kd&$$Iflֈ$")- 3BX t0644 l` apytC K r w x y $(P$Ifa$gd=b$(P$Ifa$gd (P$Ifgd (P$Ifgd=b kd$$Iflֈ$")- 3BX t0644 l` apyt $(P$Ifa$gd=b$(P$Ifa$gd (P$Ifgd (P$Ifgd>H    , - : ; 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