General Dentistry Check-Off List for Tri-Annual Resident Evaluation

Faculty evaluation of resident
1. Review of Portfolio
  1. Copy of CPR Card
  2. Copies of Treatment Electronic Plans with Appropriate Signatures
  3. Case Completes/Quality Assessments (at least 10)
  4. Mentor List, Class Roster, Clinic Schedule
  5. Case Presentations/Mini Presentations
  6. Quarterly Procedural Utilization Forms
  7. Quarterly Productivity Forms
  8. Treatment Requirement Forms
  9. Tri-Annual Evaluations With Signatures
  10. Competency Statements
  11. Competency and Proficiency Certifications Forms
  12. Resume
  13. Acknowledgement Statement – Orientation Manual
  14. Other documentation (Biopsy Report, Prescriptions, Consult, CE Certificates, Transcripts, etc)
  15. Screening Information, ADA Codes
2. Review of Status of Patient Treatment
3. Review of Needs (treatment areas where resident needs more experience)
4. Review of Clinical Performance
  1. Quality of Work
  2. New Techniques Learned
  3. Complexity of Cases
  4. Quantity of Work (Productivity sheets)
  5. Q.A. Review (Case Complete and Chart Audits)
5. Review of Didactic Performance
  1. Quality of Portfolio
  2. Seminar Planning and Leading
  3. Seminar Participation
  4. Examination scores and grade transcripts
Resident Evaluation of Program
1. Quality and relevance of seminars
2. Quality and amount of clinical instruction
3. Clinical and laboratory support
4. Staff’s approach
5. Faculty’s approach
6. Q.A. review (End of year evaluations)