PRIME for Evaluation and Feedback

Key To Giving Good Feedback Observation

Barriers to Feedback Not enough time! Not enough training Discomfort Others?

Use The PRIME System For Structure Professionalism Reporter Interpreter Manager Enhanced Communication

USING PRIME For feedback, student is at the level that is the lowest they have mastered

Feedback Using The PRIME Structure Professionalism Timeliness Honesty Attitude

Feedback Using the Prime Structure Reporter History taking skills Write ups Oral presentation skolls Organization

Feedback Using The PRIME Structure Interpreter Interpreting what labs/info should be included in write ups/OCP Differential diagnosis Weighted differential

Feedback Using The PRIME Structure Manager /Enhanced Communication Offers management plans for patients Functions as the patients doctor Is able to explain things to patients and families so that they understand them 3 components: “Ward clerk”, Creativity in management and selling it (EC)

Using PRIME If student has problems with organization and presentations, but is managing patients and communicating with patients and families extremely well, they are at the Reporter level (once they master that they will quickly likely move to manager)

Example of Written Feedback Using PRIME Professionalism: Great attitude, enthusiastic. Need to make sure you attend the required clerkship coordinator Monday/Tuesday sessions (have missed or been late to three of these) and Chief resident sessions. Your contributtions to the sessions are very much appreciated. Reporter: Good thorough case presentations. Write ups are good and are improving. doing an excellent job of incorporating feedback. Interpreter: Making strides with differential diagnosis, still an area to work on. Manager: Doing a good job with order writing, very little independent management so far Enhanced communication: Great rapport with patients and staff, able to explain things well.

Another Way To Use PRIME You are prepared, professional and a great listener for your patients Your reporting skills were excellent- your write ups were accurate with very detailed, accurate history and exam You need to review problem lists and update med lists in EPIC, this is part of the write up You did a good job staying organized doing your in room presentations You worked at interpreting, coming up with appropriate diagnosis You took a stab at management- this is an area where you can grow- more detail is needed in the why behind the plans- for example, you did a good job with Mr W in bringing up that he might have had more obstruction causing his increased creatinine, but go the next step and say that you would be concerned with prostatitis causing increased obstruction at the prostate- also, explain the why behind the Ua- what is the purpose of looking for proteinuria?  Overall, I see you at the interpreter level- working on being more consistent in your management suggestions/ comprehensive plan

Example of Unhelpful Evaluation Comments “superb job!” “Pleasant and hardworking” “Excellent student” “Met all areas of the clerkship” “Great team player”

More Poor Comments “Overall shows good potential for Internal Medicine” “Will make an excellent physician” “Great student. Would be an asset to any residency program”

Examples of Poor Formative Comments Needs to read more Meets expectations

Example of Stellar Evaluation M, you performed well on the HMC wards. You are an enthusiastic learner with a strong grasp of pathophysiology and are gaining experience with how to apply that knowledge practically. You gather enough data and are learning how to do that intuitively. Your formal communication skills are very good; you have improved your ability to explain your assessment and rationale for management in particular. An important area for growth is to approach your patient care responsibilities with the same confidence and assertiveness you demonstrate during didactics. You demonstrate a great deal of self reflection in your responses to constructive criticism. You have mastered reporting and interpreting- You are functioning at the interpreter level