Name Jay Hildebrand

PGY-3 Categorical Track Residency Start date: July 1, 2006 End date: June 30,2009

Date-2/6/2009 meeting with Dr. Rouan

Director's Comments:

Subspecialty Interests:

V Awards and Recognition:

CEX exams completed 08-09:

Professionalism Index:

ITE exam Results:

Resident Rotation/FacuIty/Program Evaluation Compliance:

<> ln-Trai n i n ~ Exam <>In-Training Exam <>In-Training Exam

MentorJDr. Diers Reports and Comments:

Letters of Commendation/Concern:

Pre-/Post- Rotation Examination Scores:

None Recorded!

2006 2007 2008

Clinical Quality Performance Reports:

p----

L ~ I - L I ~ J ~ ~ I ; ~ S\ndsoinc Unmaskcci b y Trileptal

54 54 6 8

40 16 64

Poster Presentation

Ohio ACP - Columbus, OH

10- 16- 08

Oral Presenta

Performance Review: Strengths: - Overall:

Procedures and Comments: I/

Poster Presenta

CPP C Code T

<>Brunada Syndrome Unmasked by Trileptal

, . . .~. %. . . a .. .. - . ,. . . .-... , * . - . ; ~- .,.... TYr-.. . .... =- .-* ---. *- - - - . --7 . &t ' . Confirmed

:redentid Total T d Confirmed (Nor O/O for Credential T S rroceuure Name _. Brset Loqqed Loqqed (Passed) Passed) [Confirmed/Passe& Refused

Abdominal Paracentesis (Internal Medicine) 3 1 33.33% 0 0 0% 0

Arterial Line (Internal Medicine) 3 0 0% 0 0 0% 0

Arterial Puncture Blood Gas (Internal Medicine) 3 0 0% 0 0 0% 0

Bone Marrow Biopsy (Internal Medicine) 0 0 0% 0 0 0% 0

Bone Marrow Bx (Internal Medicine) 0 0 0% 0 0 0% 0

Bronchoscopy (Internal Medicine) 0 0 0% 0 0 0% 0

Central Venous Femoral Line Insert (Internal Medicine) 3 5 looO/o 0 0 0% 0

Central Venous Internal Jugular (Internal Medicine) 5 5 looO/o 0 0 0% 0

Central Venous Subclavian Pun (Internal Medicine) 5 5 100% 0 0 0% 0

Certified By Acls-L1 (Internal Medicine) 0 0 0% 0 0 0%

Certified By Acls-U (Internal Medicine) 0 0 0% 0 0 0% 0

Certified By Laboratory Medicine Course (Internal Medicine)

0 0% 0 0 0% 0

Chest Roentgenogram Interp (Internal Medicine) 150 0 0% 0 0 0% 0

Chest Tube Insertion (Internal Medicine) 5 0 0% 0 0 0% 0

Colposcopy (Internal Medicine) 0 0 0% 0 0 0% 0

Conscious Sedation IM/IV (Internal Medicine) 0 0 0% 0 0 0% 0

Cordis Catheter Internal Jugular (Internal Medicine) 1 0 0% 0 0 0% 0

Cordis Catheter Subclavian (Internal Medicine) 1 0 0% 0 0 0% 0

Echcardiography (Internal Medicine)

0 0 0% 0 0 0% 0

Ekg Interpretation (Internal Medicine) 150 0 0% 0 0 0% 0

Ekg Perform (Internal Medicine) 1 0 0% 0 0 0% 0

Examples

Midwest SGIM, Chicago, IL Oral Presentation

09-26- 08

Emergent Cardioversion (Internal Medicine) Endotracheal Intubation (Internal Medicine)

Floey Catheter (Male) (Internal Medicine) Fluoroscopy (Internal Medicine)

Foley Catheter (Female) (Internal Medicine) Gram Stain Of Sputum (Internal Medicine) Holter Monitor Interp (Internal Medicine)

I & D of Abscess (Internal Medicine) I And D Abcess (Internal Medicine) Indirect Laryngoscopy (Internal Medicine)

InsertJPlcmt Swan Ganz (Internal Medicine) Insertion Arterial Line (Internal Medicine)

Insertion Central Line Catheter (Internal Medicine) Interp Rightside Catheter Tracing (Internal Medicine) Intrademal Injection (Internal Medicine)

Intubation Endotracheal (Internal Medicine) Joint Aspiration (Internal Medicine) Joint Aspiration Knee (Internal Medicine)

Joint Injections (Internal Medicine) Laceration Closure/Repair (Internal Medicine)

Lumbar Puncture (Internal Medicine) Maintenance Of Open Airway (Internal Medicine) Manage-Mechanical Vent (Internal Medicine) Microscopic Exam Of Urine (Internal Medicine) Mini-CEX (Internal Medicine)

Mole Removal (Internal Medicine) Nasogastric Intubation (Internal Medicine)

Orogastic Intubation (Internal Medicine) Pap And Pelvic Examination (Internal Medicine) Pericardioncentesis Emergent

(Internal Medicine)

Peripheral Blood Smear Interp (Internal Medicine) Peripheral Iv Lines (Internal Medicine) Peritoneal Lavage (Internal Medicine) Peritoneocentesis/Paracentesis (Internal Medicine) Placement-External Pacer (Internal Medicine)

Plcmt of Temp Jugular and Femoral Catheters for Dialysis (Internal Medicine) Pleural Needle Biopsy (Internal Medicine) Pulmonary Artery Catheter Plac (Internal Medicine) Quinton Catheter (Internal Medicine) Radiation Producing Devices (Internal Medicine) Sigmoidoscopy Flexible (Internal Medicine) Skin Biopsy (Punch) (Internal Medicine) Spirometry-Pulmonary Function (Internal Medicine) Subcutaneous Injection (Internal Medicine)

Suture Removal (Internal Medicine) Temporary Pacer Placement Emerg (Internal Medicine) Tenkoff Catheter (Internal Medicine)

Thoracentesis (Internal Medicine) Thoracentesis Aspiration (Internal Medicine)

Tonometry (Schiotz) (Internal Medicine) Treadmill Exercise Study (Internal Medicine) Trigger Point Injections (Internal Medicine)

Triple Lumen Catheter (Internal Medicine) Vaginal Discharge-Cand/Trich (Internal Medicine) Vein Puncture (Internal Medicine)

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

Export to Excel

Overall Totals: Overall Total I Overall Ohi of Total ( Overall Total I 01:erall Total Not ( Overall O/O for 1 Overall Total

Comments:

Logged

24

Summary . ~ and Evaluation . . Comments: .+., - .. .- ~ .. ..# . . ... . ,. - . .~~

Questionnaire R-3 Sta~idard NamelTitle t a t ~ a o r v / O ~ ~ ~ s t i o n Scalc A v e r a a ~ AVPI-me Min i rn~~m Maxim~~m Deviatinn

Evaluation of Resident 2008-2009 UNIVERSITY OF CINCINNATI MEDICAL CENTER DEPARTMENT OF INTERNAL MEDICINE EVALUATION OF RESIDENT 2008-2009

Logged

5.33%

-. .. 2 - ,! x- - - - - -.- - - - 2 - - - 2 - -

PATIENT CARE

Incomplete, Superb, accurate, inaccurate medical comprehensive interviews, physical medical interviews, examinations, and physical review of other examinations, review data; incompetent of other data, and performance of procedural skills; 1-9 7.48 7.00 6.00 essential always makes procedures; fails to diagnostic and analyze clinical therapeutic decisions data and consider based on available patient preferences evidence, sound when making judgement, and medical decisions patient preferences

Passed

0

PATIENT CARE

Medical Interviewing: Incomplete, illogical, superficial

Passed

0

Logica thorou efflcie~

1, ~gh, and It.

Credential

0%

PATIENT CARE Physical Examination: Complete

3 Incomplete, inaccurate, and 7.41 6.80 6.00 9.00 1.30 cursory, nondirected, unreliable accurate.

PATIENT CARE

Procedural Skills: Proficient, Inept, careless, minimizes 1-9 7.36 6.00 6.00 6.00 disregards risk and patients' discomfort to patients discomfort.

MEDICAL KNOWLEDGE

Exceptional Limited knowledge knowledge of basic of basic and and clinical sciences; clinical sciences; highly resourceful minimal interest in development of

5 learning; does not knowledge; 1-9 7.32 6.80 6.00 9.00 1.30 understand comprehensive complex understanding of relationships, complex mechanisms of relationships, disease mechanisms of

disease

Refused

0

PRACTICE-BASED LEARNING AND IMPROVEMENT

Fails to perform self-evaluation; lacks insight, initiative; resists or ignores feedback; fails to use information technology to enhance patient care or pursue self- improvement

Constantly evaluates own performance, incorporates feedback into improvement activities; effectively uses technology to manage information for patient care and self-improvement

INTERPERSONAL AND COMMUNICATION SKILLS

Does not establish adequate, effective, humanistic and therapeutic relationships with patients and families; conveys poor, ineffective listening, narrative or nonverbal skills; does not provide education or counseling to patients, families, or colleagues.

Establishes highly effective humanistic and therapeutic relationships with patients and families; demonstrates excellent listening, l-g narrative and 7.75 7.25

nonverbal skills; successful in educating and counseling patients, families, and colleagues; always "interpersonally" engaged

PROFESSIONALISM

Lacks respect, compassion, integrity, honesty; disregards need for self-assessment; fails to acknowledge errors; does not consider needs of patients, families, colleagues; does not display responsible behavior

Always demonstrates respect, compassion, integrity, honesty; teaches/role models responsible behavior; total commitment to self-assessment; willingly acknowledg consistently considers n~ patients, fa1 .....,,, colleagues

SYSTEM-BASED LEARNING

les errors;

eeds of milip+

Unable to access/mobilize outside resources; resists efforts to improve systems of care; does not use systematic approaches to reduce error and improve patient care

Effectively accesses/utilizes outside resources; effectively uses systematic approaches to reduce errors and improve patient care; enthusiastically assists in developing systems' improvement

10 OVERALL CLINICAL COMPETENCE 1-4 3.61 3.20

This rating represents your assessment of the resident's overall performance during this month of training.

Superior: Far exceeds reasonable expectations.

Satisfactory: Always meets and occasionally exceeds reasonable expectations.

Marginal: Meets some expectatic occasionally falls short.

Ins but

Unsatisfactory: Consistently falls short of reasonable expectations.

OVERALL CLINICAL COMPETENCE No 11 Has this form be reviewed by the Boolean (5) Yes

resident? (2)

OVERALL CLINICAL COMPETENCE

12 Number of patients admitted during this Comment rotation

OVERALL CLINICAL COMPETENCE

13 Number and types of procedures done Boolean Yes during this rotation were reviewed and (2 ) documented

OVERALL CLINICAL COMPETENCE

14 Medical Records, e.g. Boolean Yes

dictation/signatures, are complete (5)

OVERALL CLINICAL COMPETENCE

Attending's Comments (Required): Comment

- - -- Evaluator &est~on Comments -

Wilkin, lames 12) uncertain but about 2/day (20-25 for the 2 weeks) 08/28/2008 IM-CAR-VA Kinder, Brent 10/28/2008 12) 0 IM-PULM- ADVCC-UH Knepler,

lames 12) 15 02/04/2009 IM-PUL-UH

Wilkint 15) Jay has done an excellent job. Like all consult services this rotation is difficult in terms of scheduling $~~12008 with his continuity clinics etc. HIS eagerness to learn is exemplary and I ams sure he has been an excellent

IM-CAR-VA resident on most rotations.

Marinakis, V~cki

0910212008 15) 1 did not have sufficient contact with Jay to properly give an evaluation. IM-Night Med Team- UH Mohmand, Hashim 09/16/2008 15) Brief contact given the nature of rotatron

IM-Night

Med Team- UH Rashkin, Mitchell 10/07/2008 15) Should be evaluated by Dr Kinder IM-PULM- ADVCC-UH Kinder, Brent 15) Jay was performing this rotation as an elective and had many outside activities that made his availability 10/28/2008 in the ICU quite limited. I am not sure whether this was a meaningful experience for him given the IM-PULM- scheduling constraints and would recommend reconsidering offering this rotation as a part time elective. ADVCC-UH El-Khatib, Mahmoud 11/24/2008 15) I was not on service. Dr Singh to evaluate IM-NEPH- UH Johnson, KaY 15) Jay's skills in consultative medicine improved during our month together. He can identify problems and 12/03/2008 assess them in an efficient manner. IM-GIM-UH

Singh, Sahvant 12/17/2008 15) Did well overall. IM-NEPH- UH Shizukuda, Yukitaka 01/27/2009 15) I assume that he worked for the CCU service, not my service. Please forward this to the CCU attending. IM- Thank you. Dr. Shizukuda CARDS/6S- UH Knepler, James 15) Very good month. Good knowledge base and seemed inquisitive. 02/04/2009 IM-PUL-UH

Evaluation of Tean Leader 2008-2 UNIVER! OF CINCINNA' MEDICAL CENTER DEPART -- OF INTE MEDICIF EVALUA' OF TEA) LEADER 2009

MENT RN AL dE nON

PATIENT CARE Incomplete, Superb, accurate, inaccurate medical comprehensive interviews, physical medical interviews, examinations, and physical review of other examinations, review data; incompetent of other data, and performance of procedural skills; essential always makes procedures; fails to diagnostic and analyze clinical therapeutic decisions data and consider based on available patient preferences evidence, sound when making judgement, and medical decisions patient preferences

PATIENT CARE Performance needs attention Checkbox

MEDICAL KNOWLEDGE

Limited Exceptional knowledge of knowledge of basic basic and clinical and clinical sciences; sciences; minimal highly resourceful 7.72

interest in development of learning; does not knowledge; understand comprehensive

complex relations, understandir - mechanisms of complex relz disease mechanisms

disease

MEDICAL KNOWLEDGE

Performance needs attention

PRACTICE-BASED LEARNING AND IMPROVEMENT

Fails to perform self-evaluation; lacks insight, initiative; resists or ignores feedback; fails to use information technology to enhance patient care or pursue self- improvement

Constantly evaluates own performance, incorporates feedback into improvement activities; effectively uses technology to manage information for patient care and self-improvement

PRACTICE-BASED LEARNING AND 6 IMPROVEMENT

Performance needs attention

INTERPERSONAL AND COMMUNICATION SKILLS

Does not establish even minimally effective therapeutic relationships with patients and families; does not demonstrate ability to build relationships through listening, narrative or nonverbal skills; does not provide education or counseling to patients, families, or colleagues

Establishes a highly effective therapeutic relationship with patients and families; demonstrates excellent relationship building through listening, narrative and nonverbal skills; excellent education and counseling of patients, families, and colleagues; always interpersonally engaged

INTERPERSONAL AND 8 COMMUNICATION SKILLS

Performance needs attention

PROFESSIONALISM

Lacks respect, compassion, integrity, honesty; disregards need for self-asses! fails to acknowlec errors; do1 consider needs of patients, families, colleagues; does not display responsible behavior

Ige es not

. . ,

Always demonstrates respect, compassion, integrity, honesty; teaches/role models responsible behavior; total commitment to self- assessment; willingly acknowledges errors; always considers needs of patients, families, colleagues

Checkbox

Checkbox

Checkbox

PROFESSIONALISM

Performance needs attention Checkbox

SYSTEM-BASED LEARNING

Unable to accesslmc outside n actively rf efforts to

11 systems c does not I systematit approaches to reduce error and improve patient care

~bilize sources; :sists improve ~f care; use C

Effectively accesseslutilizes outside resources; effectively uses systematic approaches to reduce errors and improve patient care; enthusiastically assists in developing systems improvement

SYSTEM-BASED LEARNING

l2 Performance needs attention Checkbox

SYSTEM-BASED LEARNING

13 Residents Overall Clinical Competence in 1-9 7.78 8.00 7.00 9.00 1.00 Internal Medicine on Rotation

SYSTEM-BASED LEARNING

l4 Performance needs attention Checkbox

SYSTEM-BASED LEARNING

l5 Interns ~c Comment

Evaluator Question Cornrnf

Patel, Veer

1011712008 15) lay is an excellent senior. He teaches as much as he can. It was a wonderful experience to work with lM-Night him and would love to have him as my senior. Med Team- UH

Howard, Tammi T

10'21'2008 15) Jay was very resourceful and taught pertinent points during the night. Great personality as well. IM-Night Med Team- UH

Ayli, Elias Emile

1212112008 15) great senior IM-Night Med Team- UH

Notes: A blank Standard Deviation indicates that there is ether no deviation (only one score) or that thls statistic does not apply to the question

Export to Excel

Signature