Sub-Internship Expected Inpatient Competencies/Feedback*

Patient Care

• resident and attending are recognized as supervisors
• accurately elicits history from the patient
• routinely ascertains if patient understands and agrees with the plan of care
• involves family members in discussions about care and keeps them updated
• can admit a patient in less than 1.5 hours
• can present a new patient in 15 minutes

Medical Knowledge

• creates a differential diagnosis and thorough problem list without prompting
• determines which basic studies are needed for work-up
• interprets basic test results but may need help with more complex ones
• starting to choose appropriate treatments for common diagnoses
• starting to determine the appropriateness of admission/discharge

Interpersonal and Communication

• communicates information and “to do’s” clearly at sign-out
• shows active listening with patients through eye contact, paraphrasing, and reflection   
• learning to redirect talkative patients to move ahead with important agenda items
• avoids jargon when talking to patients
• starting to establish boundaries with challenging patients

Professionalism

• arrives to morning report on time and with a professional appearance
• greets patient with handshake and introduces self and other team members
• recognizes when an interpreter is necessary
• completes assigned tasks and helps with other team needs when able
• acknowledges errors and is able to say “I don’t know”
• notifies chief or attending when s/he needs support

Practice-based Learning

• investigates learning opportunities and shares learning with the team
• gives one short educational talk per week
• asks the question “what is the evidence for this intervention?”
• recognizes deficits in knowledge and notifies supervisors of learning needs/goals
• asks for and provides feedback to the chief/attending

System-based Practice

• reviews medication list, fluids, IV access, need for catheters and telemetry on assigned patients
• addresses prevention of adverse outcomes in the hospital: IS, VTE prophylaxis, fall risk, EtOH w/d
• routinely seeks out nurses to get input and communicate plan
• coordinates with other resources (team members, RN, SW, financial, PT/OT) to meet patient needs
• submits progress notes day of service
• writes a discharge summary for the chief at the time of patient discharge
• thinks about system issues that led to hospitalization and what may complicate outpatient care
• attempts to provide cost efficient care

*This reference lists the expected competencies of a Sub-I midway through their rotation