請針對院內醫師的整體狀況就下列各項敘述勾選適當的同意或不同意程度 適用受評醫師身分：□實習醫學生 □PGY 醫師 □住院醫師
受評醫師姓名： 單位： 職稱：
同意非常 同意 普通 不同意 不同意非常
10 9 8 7 6 5 4 3 2 1
評 核 項 目 95 90 85 80 75 70 65 60 55 50
1.該醫師對病患與家屬能耐心解釋 □ □ □ □ □ □ □ □ □ □ 2.該醫師會盡其所能減輕病患的痛苦 □ □ □ □ □ □ □ □ □ □ 3.該醫師會主動參與並關心醫院的公共事務 □ □ □ □ □ □ □ □ □ □ 4.該醫師會出席並積極參與醫院內部的會議 □ □ □ □ □ □ □ □ □ □ 5.該醫師願意和院內同仁討論關於病人病情的知識 □ □ □ □ □ □ □ □ □ □ 6.該醫師在醫療事務(例：值班)認真負責 □ □ □ □ □ □ □ □ □ □ 7.對於業務上需配合的事情，該醫師會盡力完成 □ □ □ □ □ □ □ □ □ □ 8.該醫師與其他醫療團隊能維持良好的溝通及互動 □ □ □ □ □ □ □ □ □ □ 9.該醫師會盡可能提供同仁所需的協助 □ □ □ □ □ □ □ □ □ □ 10.我很樂意和該醫師共事 □ □ □ □ □ □ □ □ □ □
【評估者基本資料】
1.服務部門：□醫護人員 □醫師(同儕) □導師 □臨床教師 2.性 別：□男 □女
十二、教學回饋
成立住院醫師訓練委員會，以提昇住院醫師教學與訓練品質(本委員會 組織成員計 9 位，其基本成員為次專科科主任 5 名、主治醫師 1 名、
教學總醫師 1 名及住院醫師代表 2 名。委員會主席由訓練計畫主持人 擔任，其餘委員由主席指派之。並設總幹事 1 名，委由主席指派，協 助處理委員會相關業務)。每 2-3 個月定期召開會議，制訂相關評估機 制，可有效鑑別住院醫師學習成效，並針對評核結果不理想之住院醫 師進行補強訓練。落實雙向回饋機制，檢討住院醫師的回饋意見，進 行持續的教學改進。評估方式為：
(一)教學成果之評估
1. 閱片測驗：住院醫師於每年 1、7 月舉行科內自辦之閱片測驗。
此外，自 95 年 6 月始與三軍總醫院、高雄榮民總醫院、高雄長 庚醫院及高雄醫學大學附設醫院等院之放射診斷科，每 3 個月 舉行聯合閱片測驗，其後改為全台聯合閱片模擬考試，藉以檢 視學習成效與待加強之處。
2. 院內筆試測驗：自 100 年起住院醫師於每年 3 月及 7 月期間舉 行院內自辦之筆試測驗，其內容包含臨床醫療實務以及專科醫 師模擬測驗，提供住院醫師晉升之依據並且作為專科醫師考試 之準備。
(二)雙向回饋機制 教師評核學員
1. 每項影像訓練(每二個月)後，填寫迷你臨床演練與評估單
(Mini-CEX, Clinical Evaluation Exercise)，由導師評估學習成果。
2. 使用表單：
(1).特殊攝影檢查/血管攝影檢查：DOPS Sheet; EPA/ACGME form
(2).其他攝影檢查及影像判讀：Mini-CEX Sheet; EPA/ACGME form
3. 對於學習成效不良之住院醫師，於住院醫師委員會提出討論，
決議補強機制，並委由導師及教學總醫師執行。
學員評核教師
1. 每二月填寫主治醫師教學滿意度評核表。
2. 評核結果做為晉升及主治醫師晉用之參考依據。
3. 外院及臨床科於本科受訓醫師，每月兩次導生座談，並於受訓 結束後，反應意見彙整後上報，俾供日後改進。
4. 本科於外院受訓醫師於訓練結束後心得分享，提供日後參考。
財團法人奇美醫院
迷你臨床演練與評估 (Mini-CEX, Clinical Evaluation Exercise)
學員姓名：_________ 學員級職: ________ 實施日期: ___年____月____日 教師姓名: ______ ____ □主治醫師 □總醫師 □ 住院醫師 實施場所: ______
病人主要問題/診斷: _____________________________________________________
病人基本資料: 姓名: _________ 病例號: _______ 年齡: _____ 性別: _____ 科別: ______
4. 人道專業 (interventional procedures) □未評估
□表現尊重 □愛心與同理心 □建立良好關係與信賴感
□能注意並處理病人是否舒適 □注意病人隱私 □對病患的需求可以適當滿足
□能有詳細解說處理程序 □其它
5. 影像診斷 □未評估
□能綜合臨床資訊與影像結果 □能用影像解釋病人症狀 □鑑別診斷之能 力 □臨床診斷之合理性與邏輯性 □建議其他相關檢查之優點與風險
6. 諮商衛教 □未評估
□同意書之取得 □解釋檢查或處置的理由 □說明檢查結果等候時間 □解釋檢查結果及臨床相關性 □有關檢查或處置之衛教與諮商
7. 組織能力及效率(procedures 及閱片能力) □未評估
□按優先順序處置 □適時處理，有條不紊 □專業而熟練 □緊急應變能力
8.整體臨床技能 □未評估
□人道專業：對病人的態度(愛心,同理心) □整合資料與判斷的能力
□組織能力及效率 □諮商衛教 □影像診斷
回饋評語:
學員簽名: ____________
教師簽名: ____________
1 2 3 4 5 6 7 8 9 評量結果
有待加強 達到預期標準 優良
1 2 3 4 5 6 7 8 9 評量結果
有待加強 達到預期標準 優良
1 2 3 4 5 6 7 8 9 評量結果
有待加強 達到預期標準 優良
1 2 3 4 5 6 7 8 9 評量結果
有待加強 達到預期標準 優良
1 2 3 4 5 6 7 8 9 評量結果
有待加強 達到預期標準 優良
奇美醫療財團法人奇美醫院 奇美醫療財團法人奇美醫院奇美醫療財團法人奇美醫院
奇美醫療財團法人奇美醫院--- 影像醫學部影像醫學部影像醫學部影像醫學部 EPA/ACGME Form (Diagnostic Radiology)
Title Specifications & Limitations
Consequence of Failure
Most relevant domain of competences
Required knowledge, Skills, Attitude
How to access
Which level of supervision EPA Level 1 2 3 4 5 Which level of ACGME milestone ACGME Level 1 2 3 4 5 Expiration date 12 months after non-practice
EPA level 1: observe (學員觀察主治醫師影像報告、檢查); EPA level 2: direct
supervision (主治醫師監督學員完成影像報告、檢查); EPA level 3: indirect supervision (學員進行影像報告、檢查有必要時再找主治醫師協助); EPA level 4: supervision post hoc (主治醫師在學員完成報告或檢查後再回顧學員完成的影像報告); EPA level 5:
supervise others (學員已可監督資淺學員完成影像報告、檢查)
ACGME level 1: Makes core observations, formulates differential diagnoses, and recognizes critical findings; Differentiates normal from abnormal;
ACGME level 2: Makes secondary observations, narrows the differential diagnosis, and describes management options ACGME level 3: Provides accurate, focused, and efficient interpretations
Prioritizes differential diagnoses and recommends management ACGME level 4: Makes subtle observations; Suggests a single diagnosis when
appropriate; Integrates current research and literature with guidelines to recommend management
ACGME level 5: Demonstrates expertise and efficiency at a level expected of a subspecialist; Advances the art and science of image interpretation
奇美醫療財團法人奇美醫院 奇美醫療財團法人奇美醫院奇美醫療財團法人奇美醫院
奇美醫療財團法人奇美醫院--- 影像醫學部影像醫學部影像醫學部影像醫學部 EPA/ACGME Form (Interventional Radiology)
Title Specifications & Limitations Consequence of Failure
Most relevant domain of competences Required knowledge, Skills, Attitude How to access
Which level of supervision EPA Level 1 2 3 4 5 Which level of ACGME milestone ACGME Level 1 2 3 4 5 Expiration date 12 months after non-practice
EPA level 1: observe (學員觀察主治醫師影像報告、檢查); EPA level 2: direct
supervision (主治醫師監督學員完成影像報告、檢查); EPA level 3: indirect supervision (學員進行影像報告、檢查有必要時再找主治醫師協助); EPA level 4: supervision post hoc (主治醫師在學員完成報告或檢查後再回顧學員完成的影像報告); EPA level 5:
supervise others (學員已可監督資淺學員完成影像報告、檢查)
ACGME level 1: Describes normal and common variant vascular and organ anatomy ACGME level 2: Describes pathophysiology of the target organ; Describes the various
embolic agents and their mechanism of action; Describes the common complications of embolic therapy
ACGME level 3: Describes the benefits of and indications for treatment of target organ pathology; Chooses appropriate embolic agent/dose;
Describes appropriate steps to reduce the risk of complications of transcatheter embolization
ACGME level 4: Demonstrates appropriate decision making for the treatment of the target organ; Describes the management of complications of transcatheter embolization
ACGME level 5: Teaches other learners or professionals aspects of embolization materials and/or treatment; Publishes peer-reviewed, original research on embolic material/therapy; Presents original research on embolic material/therapy at a national or international
meeting
EPA (Entrustable Professional Activities) 評估機制評估機制評估機制評估機制
EPA level 1: observe (學員觀察主治醫師影像報告學員觀察主治醫師影像報告學員觀察主治醫師影像報告學員觀察主治醫師影像報告、、、、檢查檢查檢查檢查) EPA level 2: direct supervision (主治醫師監督學員完成影像報告主治醫師監督學員完成影像報告主治醫師監督學員完成影像報告主治醫師監督學員完成影像報告、、、、檢查檢查檢查檢查) EPA level 3: indirect supervision (學員進行影像報告學員進行影像報告學員進行影像報告學員進行影像報告、、、、檢查有必要時再找檢查有必要時再找檢查有必要時再找 檢查有必要時再找 主治醫師協助主治醫師協助主治醫師協助主治醫師協助)
EPA level 4: supervision post hoc (主治醫師在學員完成報告或檢查主治醫師在學員完成報告或檢查主治醫師在學員完成報告或檢查主治醫師在學員完成報告或檢查後再後再後再 後再 回顧學員完成的影像報告回顧學員完成的影像報告回顧學員完成的影像報告) 回顧學員完成的影像報告
EPA level 5: supervise others (學員已可監督資學員已可監督資學員已可監督資學員已可監督資淺淺淺學員完成影像報告淺學員完成影像報告學員完成影像報告學員完成影像報告、、、檢、檢檢檢 查查查) 查
#若若若影像診斷評估學員若影像診斷評估學員影像診斷評估學員影像診斷評估學員為為為為 EPA level 4 or 5 再再再根據再根據根據根據 ACGME (Accreditation Council for Graduate Medical Education and The American Board of Radiology) Diagnostic Radiology Milestone Project (2015) 分分分分為為為為
ACGME level 1: Makes core observations, formulates differential diagnoses, and recognizes critical findings
Differentiates normal from abnormal
ACGME level 2: Makes secondary observations, narrows the differential diagnosis, and describes management options ACGME level 3: Provides accurate, focused, and efficient interpretations
Prioritizes differential diagnoses and recommends management
ACGME level 4: Makes subtle observations
Suggests a single diagnosis when appropriate
Integrates current research and literature with guidelines to recommend management
ACGME level 5: Demonstrates expertise and efficiency at a level expected of a subspecialist
Advances the art and science of image interpretation
#若若若介若介介介入入入入性診療性診療性診療(invertentional radiololgy, IR)評估學員性診療 評估學員評估學員評估學員為為為 EPA level 4 or 為 5 再再再根據再根據根據根據 ACGME (Accreditation Council for Graduate Medical Education and The American Board of Radiology) Interventional Radiology Milestone Project (2015) 分分分為分為為為
ACGME level 1: Describes normal and common variant vascular and organ anatomy
ACGME level 2: Describes pathophysiology of the target organ
Describes the various embolic agents and their mechanism of action
Describes the common complications of embolic therapy ACGME level 3: Describes the benefits of and indications for treatment of target
organ pathology
Chooses appropriate embolic agent/dose
Describes appropriate steps to reduce the risk of complications of transcatheter embolization
ACGME level 4: Demonstrates appropriate decision making for the treatment of the target organ
Describes the management of complications of transcatheter embolization
ACGME level 5: Teaches other learners or professionals aspects of embolization materials and/or treatment
Publishes peer-reviewed, original research on embolic material/therapy
Presents original research on embolic material/therapy at a national or international meeting
影像診斷 EPA/ACGME Form (Diagnostic Radiology)
Title Abdominal CT
Specifications & Limitations General cases of abdominal CT of patients, either from OPD or in-ward. No limitation.
Consequence of Failure Disease progression because of delay or wrong diagnosis.
Most relevant domain of competences Cross-sectional anatomy and imaging findings of various pathology.
Required knowledge, Skills, Attitude
Systemic approach of CT of abdomen and pelvis; understandings of CT techniques, contrast administration; artifacts; lesion detection and imaging differential diagnosis How to access Reports finished by trainees
Which level of supervision EPA Level 1 2 3 4 5 Which level of ACGME milestone ACGME Level 1 2 3 4 5 Expiration date 12 months after non-practice
EPA level 1: observe (學員觀察主治醫師影像報告、檢查); EPA level 2: direct
supervision (主治醫師監督學員完成影像報告、檢查); EPA level 3: indirect supervision (學員進行影像報告、檢查有必要時再找主治醫師協助); EPA level 4: supervision post hoc (主治醫師在學員完成報告或檢查後再回顧學員完成的影像報告); EPA level 5:
supervise others (學員已可監督資淺學員完成影像報告、檢查)
ACGME level 1: Makes core observations, formulates differential diagnoses, and recognizes critical findings; Differentiates normal from abnormal;
ACGME level 2: Makes secondary observations, narrows the differential diagnosis, and describes management options ACGME level 3: Provides accurate, focused, and efficient interpretations
Prioritizes differential diagnoses and recommends management ACGME level 4: Makes subtle observations; Suggests a single diagnosis when
appropriate; Integrates current research and literature with guidelines to recommend management
ACGME level 5: Demonstrates expertise and efficiency at a level expected of a subspecialist; Advances the art and science of image interpretation
介 EPA/ACGME Form (Interventional Radiology)
Title TACE for HCC
Specifications & Limitations Perform TACE for patients with HCCs. No limitations.
Consequence of Failure Tumor progression or complications due to procedure.
Most relevant domain of competences
Selective catheterization of feeding artery of HCC; TAE with embolization agents;
monitoring patients durng interventional procedures.
Required knowledge, Skills, Attitude
Tumor biology of HCC; tumor staging, imaging studies of HCC, complications, indications and contrasindication of TACE.
How to access Observe the whole procedure by attending staff.
Which level of supervision EPA Level 1 2 3 4 5 Which level of ACGME milestone ACGME Level 1 2 3 4 5 Expiration date 12 months after non-practice
EPA level 1: observe (學員觀察主治醫師影像報告、檢查); EPA level 2: direct
supervision (主治醫師監督學員完成影像報告、檢查); EPA level 3: indirect supervision (學員進行影像報告、檢查有必要時再找主治醫師協助); EPA level 4: supervision post hoc (主治醫師在學員完成報告或檢查後再回顧學員完成的影像報告); EPA level 5:
supervise others (學員已可監督資淺學員完成影像報告、檢查)
ACGME level 1: Describes normal and common variant vascular and organ anatomy ACGME level 2: Describes pathophysiology of the target organ; Describes the various
embolic agents and their mechanism of action; Describes the common complications of embolic therapy
ACGME level 3: Describes the benefits of and indications for treatment of target organ pathology; Chooses appropriate embolic agent/dose;
Describes appropriate steps to reduce the risk of complications of transcatheter embolization
ACGME level 4: Demonstrates appropriate decision making for the treatment of the target organ; Describes the management of complications of transcatheter embolization
ACGME level 5: Teaches other learners or professionals aspects of embolization materials and/or treatment; Publishes peer-reviewed, original research on embolic material/therapy; Presents original research on embolic material/therapy at a national or international
十三、各類特殊檢查之流程簡介