Faculty Observed: Reviewee Name, Select Degree	Faculty Title: Choose an item.

Department:	_____________________	Track: E^^ Track

Observation Dates:

Reviewer: REVIEWER NAME, Degree	Position: [Professor, Director, etc.]

Academic Unit: UA College of Medicine-Tucson	Department:

Purpose of Evaluation: I conducted this observation and evaluation at the physician’s request as a peer evaluation to be considered as part of her promotion and tenure process.

Observation Summary

Click or tap here to enter text.

Protocol

Pre-observation Meeting

I met with the reviewee before observations were conducted (^Date) to review the protocol for peer evaluation of teaching, select an observation tool and adapt it as needed. We agreed to use this instrument for the evaluation process.

Observations

I observed the reviewee on multiple occasions in the following settings or clinical services:

☐ Rounding	☐ Bedside teaching	☐ Outpatient clinic	☐ Operating Room

☐ Emergency Department ☐ Trauma Unit ☐ ICU

☐ Classroom setting	Please indicate: ☐ Large Group ☐ Small Group

Observations included teaching of the following learners:

☐ Pre-med students	☐ Medical students ☐ Residents ☐ Fellows ☐ Other

There are several categories of observations included in this observation guide:

Assessment of Medical Knowledge	2

Assessment of Procedural/Clinical Skills	2

Interaction/Dynamics with Learners	2

Encourages Learner Independence	3

Learning Climate	3

Constructive Feedback	3

Approach to Teaching	4

Assessment of Medical Knowledge
Consider whether and how the instructor assesses learners’… ability to apply scientific and medical knowledge to specific issues or problems ability to analyze or synthesize knowledge/concepts knowledge of factual medical information skills related to patient communication or other aspects of clinical practice
Comment

Assessment of Procedural/Clinical Skills
Consider whether and how the instructor provided learners with... Opportunities for practicing or developing: communication skills clinical skills problem solving skills Relevant resources for application to patient care or future learning Guidance, explanations and examples or demonstrations of skills
Comment

Interaction/Dynamics with Learners
Consider whether and how the instructor... Treats learners with respect Is available as needed Encourages and is receptive to questions Encourages active participation in learning and patient care Attempts to motivate Learners Varies teaching strategies to fit Learner and/or situation
Comment

Encourages Learner Independence
Consider whether and how the instructor: Encourages learners to: Self-assess their knowledge, skills or understanding Engage in independent or follow-up learning and/or research Recall, apply or extend prior knowledge Directs learners to resources or to locate resources to assist in their improvement Offers opportunities for learners to demonstrate comprehension, engage in peer teaching, or apply, evaluate or synthesize medical knowledge in relation to specific patients or situations
Comment

Learning Climate
Consider whether and how the instructor… Creates comfortable atmosphere for asking and responding to questions Encourages learners to seek help as needed Demonstrates enthusiasm for clinical practice, teaching and learning Models respectful communication with colleagues and learners Shares experience with learners to support their learning and improvement Encourages multiple perspectives, differing ideas, intellectual debate
Comment

Constructive Feedback
Consider whether and how the instructor… Offers evaluation of learner performance Guides Learners in making improvements to knowledge or skills Provides feedback in real time or in a timely manner Communicates feedback in a helpful or constructive manner Receptive to student questions and concerns Encourages peer to peer constructive feedback

Approach to Teaching
Consider whether and how the instructor… Promotes active engagement in learning Facilitates or encourages critical thinking and problem-solving Allows for a reasonable amount of “wait time” when asking questions Establishes expectations for Learner performance in a clear manner Uses time in clinic for teaching Learners Incorporates visual aids or technology to facilitate comprehension or skill development Relates clinical practice to literature or standards of clinical practice Offers relevant clinical examples to explain key concepts or highlight clinical practices
Comment

________________________________________	_________________________

Click or tap here to enter name	Date

Select Title/Rank

UA College of Medicine-Tucson

Department of	Click or tap here to enter text.

Email:	Click or tap here to enter text.	Phone: Click or tap here to enter text.

Reviewee Acknowledgement

☐ I have read the foregoing evaluation and acknowledge that I met with the evaluator before the evaluation process to discuss the process and evaluation form, and after observations to review the evaluation and/or receive feedback on teaching and was offered an opportunity to give input in this process.

________________________________________________

^Reviewee Name, Faculty Title, Department