YL9 Rating Scales

YL9 RATING SCALE FOR PERFORMANCE
(SKILLS)
Date: _______________________ Name of Intern: _________________________________
Rotation: ____________________Hospital: _______________________________________
Procedure: __________________________________________________________________
Lowest
Highest
Made sure that the correct procedure was being done to

the correct patient at the correct site
0.25
0.5
0.75 1 1.25 1.5
1.75
Maintained good rapport with the patient, including

making an effort to put the patient at ease and to
minimize discomfort and pain
0.25
0.5
0.75 1 1.25 1.5
1.75
Paid meticulous attention to basic asepsis and antisepsis

techniques
0.25
0.5
0.75 1 1.25 1.5
1.75
Paid strict and meticulous attention to basic surgical /

procedural techniques throughout the procedure
0.25
0.5
0.75 1 1.25 1.5
1.75
Correctly used the proper instruments during the entire

procedure
0.25
0.5
0.75 1 1.25 1.5
1.75
FINAL SCORE
Consultants Signature
________________________________
Consultants Name
________________________________
YL9 RATING SCALE FOR PROFESSIONALISM

Lowest
Highest
Has good working relationship with other team

members, enhances the value of the team
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1.0
Shows proper respect for patients, peers, faculty, and

allied health personnel
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1.0
Shows sensitivity and compassion to patients culture,

age, gender, and disabilities
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1.0
Maintains honesty and integrity at all times
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1.0
Demonstrates a commitment to ethical principles

(confidentiality of patient information, informed
consent, provision or withholding of clinical care, and
business practices)
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1.0
Demonstrates initiative and a desire for excellence
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1.0
Accepts limitations and failings, open to feedback and

criticism, shows desire for self-improvement
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1.0
Maintains a professional demeanor in manner, dress and

action, and excludes self-confidence
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1.0
Demonstrates organizational ability, responsibility,

dependability
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1.0
Punctual and complete attendance
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1.0
FINAL SCORE
Evaluators Signature
________________________________
Evaluators Name
Evaluators Position
________________________________
Consultant
Resident
Faculty
YL9 FOR CLINICAL PERFORMANCE EVALUATION FORM

Topic: ____________________________________________________________________
Lowest
Did the intern carry out a rational diagnostic approach?
Highest
<=5
6 7 8 9
10 11 12
Did the intern describe the patients clinical manifestations clearly, concisely
and accurately?
<=5
6 7 8
9 10 11
Did the intern arrive at a good clinical impression?
<=8
9 10 11 12
13 14 15 16
<=5
6 7 8
9 10 11
Was the intern able to explain the underlying pathophysiology of the

patients illness?
Was the intern able to discuss / suggest / carry out a rational and appropriate
treatment plan for the patients?
<=8
9 10 11 12
13 14 15 16
Was the intern able to analyze the patients clinical course / response to
treatment?
<=5
6 7 8
9 10 11
Was the intern able to explain appropriate preventive health care measures
that may be recommended to the patient and family?
<=5
6 7 8
9 10 11
Was the intern able to make a concise yet fairly complete contextual analysis
of the patients over-all biologic, physchologic, socioeconomic, and spiritual
status?
Obtained pertinent data and also sought to exclude other possible

diagnosis
Obtained accurate and complete history in a logical manner
Performed a complete and systematic physical exam
Was the intern able to recognize salient features and correlate data
to make a diagnosis?
Did the intern rule in/out pertinent and plausible differential diagnosis?
Did the intern recommend / request appropriate tests?
Was the intern able to rationalize the use of such test?

2
FINAL SCORE
Consultants Signature
________________________________
Consultants Name
________________________________

YL9 Rating Scales

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YL9 Rating Scales

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YL9 RATING SCALE FOR PERFORMANCE

Made sure that the correct procedure was being done to

0.75 1 1.25 1.5

Maintained good rapport with the patient, including

0.75 1 1.25 1.5

Paid meticulous attention to basic asepsis and antisepsis

0.75 1 1.25 1.5

Paid strict and meticulous attention to basic surgical /

0.75 1 1.25 1.5

Correctly used the proper instruments during the entire

0.75 1 1.25 1.5

YL9 RATING SCALE FOR PROFESSIONALISM

Has good working relationship with other team

Shows proper respect for patients, peers, faculty, and

Shows sensitivity and compassion to patients culture,

Maintains honesty and integrity at all times

Demonstrates a commitment to ethical principles

Demonstrates initiative and a desire for excellence

Accepts limitations and failings, open to feedback and

Maintains a professional demeanor in manner, dress and

Demonstrates organizational ability, responsibility,

Punctual and complete attendance

YL9 FOR CLINICAL PERFORMANCE EVALUATION FORM

Did the intern arrive at a good clinical impression?

Was the intern able to explain the underlying pathophysiology of the

Obtained pertinent data and also sought to exclude other possible

Obtained accurate and complete history in a logical manner

Performed a complete and systematic physical exam

Did the intern recommend / request appropriate tests?

Was the intern able to rationalize the use of such test?

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