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Evaluation of Faculty
Residents evaluate faculty and seminars in an ongoing manner. Each clinical supervisor and service chief is evaluated midway through every rotation and at the conclusion of the service. Each seminar and its leader are evaluated at the conclusion of the course. The faculty evaluations are completed anonymously and returned to the Training Director.
Clinical faculty members are evaluated as to whether they have adequately taught and demonstrated each of the six core competencies in their particular service or treatment. They, too, are graded as satisfactory or needing improvement. There is ample room on the evaluation forms for comments. It is an expectation that if a resident grades a faculty member as needing improvement, the exact nature of a weakness is described in detail.Faculty seminar leaders are evaluated as to the quality of seminar presentation and content. There are also questions as to whether the seminar was useful in helping residents in each of the six core competencies. The seminar is evaluated as to whether it has met its goals and objectives, whether the leader has attended all sessions and whether the readings and discussions were useful for the resident. The seminar is given an overall rating. Residents are asked whether the seminar should remain in the required core curriculum and whether the number of sessions is appropriate. Ample space is allowed for narrative comments.It is expected that residents give faculty members feedback, in both clinical and didactic areas, as to how helpful they are in transmitting knowledge, skills and attitudes relevant to child and adolescent psychiatry. Residents give the Training Director a verbal evaluation of each faculty member in the formal biannual individual review meetings with the Training Director and in an annual mid-year Retreat (see below).At the end of each year, the Training Director sends each faculty member an annual review of his or her teaching and supervision, based on the anonymous resident evaluations, the individual discussions with each resident and the written report of the annual resident retreat, as well as from other sources, e.g., support staff, other faculty members.Evaluation of Clinical ServicesResidents provide the Training Director an anonymous evaluation of each clinical service at the conclusion of the rotation. This includes an assessment of the patient population seen, in terms of number and variety of cases, the ability of the service to teach the six core competencies, the effectiveness of teaching specific clinical skills and an assessment of the administration of the service. Each resident is also asked whether the rotation should be required, whether its length is adequate and whether the supervision is satisfactory. The resident is asked to produce a formulation about the rotation, including its strengths and weaknesses. Each clinical service evaluation is sent to each of the service chiefs at the end of the year.Resident Annual RetreatOnce each year, both classes of residents meet with the Training Director for a half-day Residents’ Retreat. During the retreat, every component of the Training Program is reviewed: clinical rotations, supervision, didactic seminars, on-call duties and program administration. The residents write up a comprehensive Retreat Report, which is given to the Training Committee as well as to Drs. Gottlieb, Rosenbaum and Cohen. Each faculty member’s review is placed in his or her file and is included in the annual summary evaluation sent by the Training Director. The Report is kept confidential to all faculty members except members of the Training Committee and Administration.Program EvaluationBoth residents and faculty are required to provide evaluations of the overall Training Program. Residents fill out a confidential evaluation form biannually. The form asks residents to assess the clinical, didactic and administrative components of the Training Program. It also asks if the educational goals and objectives of the Training Program have been met. In addition, they evaluate the program in their annual Resident Retreat report.Each faculty member is required to fill out a Faculty Program Evaluation Form on an annual basis. The faculty evaluates the Program in terms of the resources available to the Program, the contribution of each institution participating in the Program, the financial and administrative support of the Program, the volume and variety of patients available to residents for educational purposes, the performance of members of the teaching staff and the quality of supervision of residents.The accumulated clinical service, seminar, faculty summary and Retreat Report evaluations are a part of the Training Committee’s annual review of the entire Program. The evaluations and the direct input of the residents to the Training Committee help it determine what modifications in the teaching program are necessary for improvement in the coming year.
Faculty: Expectations and Supervisory Lines of Responsibility The faculty plays a fundamental role in the Training Program. Faculty members are responsible for the comprehensive professional development of the residents. Faculty members are responsible for resident training in areas of education, clinical service and supervision (direct and indirect), research and scholarship and evaluation.
Definitions of Supervision:
Education As educators each faculty member must:
Clinical Service and Supervision As clinicians and supervisors each faculty member must:
Research and Scholarship As members of an academic Training Program, each faculty member must have one or more areas of academic expertise. Each faculty member, through supervision, didactic seminars or individual tutorials must:
Evaluation of Residents and the Training Program As members of the Training Program, the faculty is crucial in providing ongoing evaluation and feedback of resident performance in the six core competencies and in specialized areas of interest. In addition, the faculty is essential in the continued development of the Training Program. Each faculty member must:
Administration of the Training Program and Departmental Duties As members of the Training Program, faculty members are expected if called upon to:
Policies and Proecedures
List of residents pairs: AY 11/12
Each resident would be paired with another resident in the same year or across years. Using an alternating weekend schedule, residents would sign-out their pages from Friday 8pm until Monday 8AM.
Fatigue and Sleep Deprivation Training
Guidelines for Circumstances and Events in Which Residents/Fellows Must Communicate with Appropriate Supervising Faculty Members, Such as Transfer of a Patient to an Intensive Care Unit, Transfer to Higher Level of Care, or in End of Life Situations:
Guidelines for Appropriate Levels of Supervision
Trainees in their 1st and 2nd year of fellowship (PGY-4 and PGY-5 or above) take call on the inpatient unit. Attendings are available for indirect supervision with direct supervision available. Such supervision is available from the “Attending Back-Up on Call”. That individual should be contacted if there is unmanageable volume, acuity or the resident becomes ill while on duty or experiences fatigue interfering with performance, if there are not available back-up options within the residency program (e.g. if the resident is sick before call and arranges to trade call with a fellow resident).
Hand-off Policies Hand offs on all services are described in detail at the beginning of the rotation. Residents use a variety of measures to report and document hand offs, including written sign outs, HIPPA secured email notes, verbal reports, and the electronic medical record.
The medical director and/or attendings of record of each service are responsible for documenting the effectiveness of the hand off system. These reports are presented at the Executive Training Committee on a regular basis.
All facilities have electronic medical records, and these are increasingly being utlilized for documenting all hand offs, and disposition of cases.
The specifics for each major rotation follows:
Documentation of Effective Handoffs: All residents must provide documentation of at least one successful handoff on every clinical service. The service chiefs will be responsible along with the residents to document the efficiency, effectiveness and outcome of handoffs with spot checks at various intervals during their rotations by using the Handoff Assessment Form.
Quality Improvement Requirements Every resident MUST be included in an annual quality improvement project including both classes of residents. This usually involves improving one or more clinical services in the training program.
Use of the Electronic Medical Record All residents and faculty are trained in the use of the electronic medical record (Longitudinal Medical Record aka LMR). The LMR has a number of important templates that must be filled out by residents. Due to the sensitivity of some material in child and adolescent psychiatry, there is a special “Restricted Notes” section that only the treating clinician or designated approved clinicians may view. Dr. Masek, Clinical Director of the Outpatient Clinic receives a monthly report of any inappropriate viewing of the restricted notes in the LMR.
The residents are routinely given “Chart Stimulated Reviews,” an MGH Child Psychiatry Competency Tool (see below) with two sections: 1) a compliance section about documentation in concert with national regulatory guidelines and 2) a section in which the attending asks the resident to present a comprehensive case report. This exercise attempts to evaluate the ability of a resident to present an efficient, effective and complete case report.
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