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Evaluation

Tracking progress

Evaluation of your undergraduate learner will differ depending on the year of the student.  These evaluations reflect the graduated responsibility we would expect of our students as they progress through their four years of training. All student In-Training Evaluation Reports (ITERs) will be located on One45. You will receive an email notification when you are due to complete the ITER. 

In addition to the ITER, Med 3 students are required ask their preceptors to complete two Mini-Clinical Evaluation Exercises (Mini-CEX). These provide the student with formative feedback regarding their performance in the domains of good patient care, like history-taking, physical examination, communication, patient counselling, clinical reasoning and professionalism.

Please refer to our website for more detailed information regarding the type of learner you are working with.

Postgraduate

The CFPC Evaluation Objectives state that “Competence is determined through a process of continuous sampling, observation, and reflection of learner performance...”  This requires that we as educators obtain regular assessments of our trainees and share it with them. We should encourage reflection on the issues and support the trainees’ progress.

The CCFP objectives further cite “key features and observable behaviours for a series of problems [PDF - 706 KB] (priority topics, procedures, themes) throughout the phases of the clinical encounter.” To achieve this, the students must get regular, valid and useful feedback throughout their training. Our program must work with our residents to track and document competencies.

For more on this topic view the definitions of these terms below and for the executive summary click here [PDF - 179 KB]. We have been using “Field Notes” since 2005. They are a useful tool to provide feedback to our trainees and to collect a series of observations on their performance. This process helps the faculty and the student direct learning to meet the student’s needs. The collection of notes over time is also critical in evaluating the student’s progress. We use the notes to complete the In Training Assessment Report (or ITAR) at points during the student’s educational experience.      

The Field Notes are organized by two criteria. They allow you to specify which phase of the encounter you are going to focus on: history, physical, hypothesis generation, investigation, diagnosis, procedure, management and treatment, referral and follow-up. There are also six skill dimensions including selectivity, clinical reasoning, professionalism, patient-centred approach, procedural skills and communication which may be employed in any phase of the encounter.

The completion of as field note is a collaborative effort between the student and the teacher. It often takes less than five minutes to do a field note.

If they do not bring it up themselves, the student should be prompted to suggest a case for discussion. You might ask them what they thought they did well on, and what they think they need to work on. You then provide corroboration where appropriate and guidance if necessary. A discussion on how you will follow up on the issue under consideration is useful. 

See the appendix for an example. There are several videos on use of the field notes on our website.

We recommend at least one field note per half day in the clinic. You may generate more if you wish, and you can even create two on a single encounter if there are opportunities to.

More on Priority Topics and Key Features

The Complete Document on Competence: priority topics, key features and phases of the encounter [PDF - 1.25 MB]

You may wish to download this and save it to your computer for future reference. It comes well organized with bookmarks and is searchable.

Back to Table of Contents                                Next: In Training Resident Assessment (ITAR)