Evaluation of Fellows
The primary goal of the fellowship program is for fellows to obtain core knowledge and skill in palliative care and achieve their professional development goals. In designing our evaluation program, we have drawn upon several sources. First, we have ensured that our evaluation program includes those components required of residency training programs in the sub-specialties of internal medicine by the Accreditation Council for Graduate Medical Education. Second, we have structured our evaluation program to assess the core competency areas of palliative medicine as identified by the voluntary standards for training programs in palliative medicine. Third, we have developed our assessment program using the framework of adult learning theory such that the evaluation program itself enhances and contributes to each fellow’s education. Our evaluation process provides a structured framework for learners to establish their own goals and objectives based upon subjective and objective self-assessment, to develop an individual program to meet these goals, and to regularly evaluate whether they are meeting their own educational objectives.
Identification and Review of Individual Goals
At the beginning of their fellowship, each new fellow will establish their career goals with the fellowship director and establish a plan to develop these goals. For example, whereas it is expected all fellows will leave the program with the core knowledge and skills in palliative care, some fellows will plan to pursue a career as a clinician educator whereas others may plan a career primarily in clinical research. Thus, each fellow will be expected to develop a plan to meet the educational needs of their chosen career path and will establish specific concrete and measurable benchmarks to mark the achievement of their goals. For example, a person pursuing a career as a clinician educator might want to develop expertise in using various teaching paradigms. Over the course of their fellowship, this fellow would be expected to develop a didactic lecture series in pain and symptom management, lead workshops in teaching communication skills, and lead bedside or clinic teaching rounds. A palliative care faculty member will observe each of these activities and give structured feedback to the fellow. Additionally, this fellow might use the research year to design and conduct a study comparing approaches to educational assessment. The fellowship director will meet at least twice each year with each fellow to review her progress with respect to the goals and objectives set forth during their initial goal-setting meeting.
Assessment of Palliative Care Knowledge and Skills
Regular evaluations continue throughout the fellowship program. The fellow receives continuous feedback throughout the rotations as appropriate. At the conclusion of each rotation, the fellow receives both written and verbal feedback from their supervising attending physicians incorporating input from the interdisciplinary team as to their performance on the rotation. In addition, the palliative care faculty meet twice a year to complete a Clinical Competency Evaluation for each fellow. During these meetings, all palliative care attending physicians at Mount Sinai gather and discuss each fellow’s performance and specifically discuss how the fellow is meeting the required competencies. This feedback is then shared in an anonymous fashion with the individual fellows.
Because working as a member of an interdisciplinary team is a core component to being a successful palliative care physician, feedback from all members of the clinical team is solicited. Our 360° Evaluation occurs during a twice yearly meeting of the interdisciplinary team. Feedback for each fellow is elicited in each of the six core ACGME competencies and is aggregated into an Interdisciplinary Clinical Competency Evaluation. This feedback is then shared in an anonymous fashion with the individual fellows.
The family meeting has been described as the “procedure” performed by palliative care clinicians. To assure fellows have the necessary skill set to effectively and expertly conduct a family meeting, they are observed and formally evaluated at least twice a year by the fellowship leadership.
Evaluation of Faculty
Fellows have many opportunities to formally and informally evaluate the faculty members in the following manner: 1) fellows complete a written anonymous evaluation of the faculty preceptor at the completion of each rotation; 2) fellows complete a comprehensive, anonymous program evaluation form annually which includes questions about faculty members; and 3) fellows are encouraged to provide feedback about their experiences with faculty during the monthly fellow’s meeting and during individual sessions with the directors.
Evaluation of Fellowship Program
Standardized seminar evaluation forms are completed by all those in attendance at didactic sessions and grand rounds. A summary of the results is provided to the speakers and are used to select speakers and topics for future seminars.
Annual Program Evaluation
Fellows are asked to complete a Program Evaluation Form at the end of the training year. The intent is to evaluate the quality of the fellows’ experiences and to assure the balance of clinical, teaching, and research commitments. This comprehensive form details all aspects of the program in a quantitative manner and encourages qualitative narrative. These data are used to complement the fellows’ feedback provided during the monthly fellows’ meetings and during individual sessions with the director.
Evaluation of Graduates
After graduation, fellows will furnish information about their career development to the program on a yearly basis for 10 years following fellowship graduation. Graduating fellows will be contacted on a yearly basis through email with a standardized questionnaire regarding their careers and related topics.
Brookdale Department of Geriatrics and Palliative Medicine
One Gustave L. Levy Place
New York, NY 10029-6574