Ophthalmology

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Presentation

1. ●blurry vision
2. ●double vision
3. ●eye pain
4. ●red eye
5. ●sudden loss of vision
6. ●trauma or chemical injury
7. ●other (please specify)

Medical Expert

• □ME 2.2 Gather a history relevant to the patient’s presentation
• □ME 2.2 Apply an organized approach to history-gathering
• □ME 2.2 Synthesize and organize information for clear and succinct presentation to a supervisor

Communicator

• □COM 1.2 Optimize the physical environment for patient comfort, dignity, and privacy
• □COM 1.1 Establish rapport and explain the purpose of the visit
• □COM 2.1 Conduct the interview in a patient-centred manner
• □COM 2.3 Identify other sources of information (e.g., family, medical record) that may assist in a patient’s care
• □COM 5.1 Document the history using a structured approach

Professional

• □P 1.1 Behave in a professional manner

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Medical Expert

• □ME 1.3 Apply knowledge of the normal anatomy of intraocular structures
• □ME 2.2 Demonstrate appropriate technique in the use of instruments for clinical assessment
• □ME 2.2 Perform a basic ophthalmic examination
• □ME 2.2 Apply an organized approach to the ophthalmic examination
• □ME 2.2 Identify and differentiate normal and abnormal findings
• □ME 2.2 Synthesize and organize information for clear and succinct presentation to a supervisor

Communicator

• □COM 1.1 Maintain rapport and explain the steps and purpose of the examination
• □COM 1.2 Optimize the physical environment for patient comfort, dignity, and privacy
• □COM 5.1 Document the clinical examination using a structured approach

Professional

• □P 4.1 Position the patient and/or equipment to optimize comfort and ergonomics
• □P 1.1 Behave in a professional manner

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Medical Expert

• □ME 2.1 Recognize instability and acuity in a clinical presentation
• □ME 2.1 Determine the priorities for patient care
• □ME 2.2 Provide assessment and initial stabilization of ABCs
• □ME 2.2 Perform a history and physical exam relevant to the patient presentation, in a time- effective manner
• □ME 2.2 Select and/or interpret investigations
• □ME 2.4 Develop and implement a plan for initial management
• □ME 4.1 Determine the appropriate disposition and/or setting for ongoing care

Communicator

• □COM 5.1 Document the clinical encounter to adequately convey clinical reasoning and the rationale for decisions

Collaborator

• □COL 1.3 Work effectively with other members of the health care team

Professional

• □P 1.1 Work within personal limits, seeking assistance as needed

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Service

1. ●dermatology
2. ●emergency medicine
3. ●endocrinology
4. ●internal medicine
5. ●neurology
6. ●pediatrics
7. ●plastic surgery
8. ●rheumatology
9. ●other (please specify)

Medical Expert

• □ME 2.2 Gather a relevant clinical history
• □ME 2.2 Perform a physical exam relevant to the presentation
• □ME 2.2 Develop a differential diagnosis
• □ME 2.2 Select and/or interpret investigations
• □ME 2.2 Synthesize and organize information for clear and succinct presentation to a supervisor
• □ME 2.4 Develop and implement a plan for initial management

Communicator

• □COM 2.1 Use patient-centred interviewing skills
• □COM 5.1 Document the clinical encounter to adequately convey clinical reasoning and the rationale for decisions

Collaborator

• □COL 1.2 Work effectively as a member of the clinical team

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Activity observed

1. ●history
2. ●examination

Specialized techniques used

1. ●not applicable
2. ●cover-uncover test followed by alternate cover test
3. ●gonioscopy
4. ●Hertel exophthalmometry
5. ●peripheral retinal examination
6. ●slit lamp grading of cells and flare

Medical Expert

• □ME 2.2 Gather a relevant clinical history
• □ME 2.2 Select examination techniques relevant to the presentation
• □ME 2.2 Perform the ophthalmic examination, including specialized techniques, in a skilful manner
• □ME 2.2 Identify and differentiate normal and abnormal findings
• □ME 2.2 Interpret findings in the context of the patient’s presentation
• □ME 2.2 Propose a differential diagnosis
• □ME 2.1 Determine the acuity of the condition
• □ME 2.2 Synthesize and organize information for clear and succinct presentation to a supervisor

Communicator

• □COM 2.1 Conduct the interview in a patient-centred manner

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Diagnostic test

1. ●B-scan
2. ●neuroimaging
3. ●OCT
4. ●visual field testing

Results

1. ●normal
2. ●vision/life-threatening
3. ●other

Medical Expert

• □ME 2.2 Assess the quality and validity of the study, and any impact on the diagnostic interpretation
• □ME 1.3 Apply knowledge of anatomy, physiology, and pathophysiology
• □ME 2.2 Identify normal structures and anatomic landmarks
• □ME 2.2 Recognize findings that signify a potential vision- or life-threatening condition
• □ME 2.2 Interpret findings in the context of the patient’s presentation
• □ME 2.1 Determine the acuity of the condition

Professional

• □P 1.1 Work within personal limits, seeking assistance as needed

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Medical Expert

• □ME 2.2 Synthesize and interpret information from the clinical assessment
• □ME 2.2 Propose a differential diagnosis
• □ME 2.1 Determine the acuity of the condition
• □ME 2.1 Respond appropriately to vision- or life-threatening conditions
• □ME 2.4 Develop and implement a plan for initial management

Communicator

• □COM 3.1 Provide accurate information about the condition and/or management plan

Professional

• □P 1.1 Work within personal limits, seeking assistance as needed

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Procedure

1. ●corneal foreign body removal
2. ●corneal scraping

Medical Expert

• □ME 1.3 Knowledge of procedure: Understand steps, potential risks, and the means to overcome them
• □ME 3.1 Pre-operative plan: Assess clinical information to determine/confirm diagnosis and appropriateness of procedure
• □ME 3.4 Case preparation: Position patient correctly, understand approach and required instruments, be prepared to deal with probable complications
• □ME 3.4 Efficiency and flow: Demonstrate planned course of procedure, economy of movement and flow
• □ME 3.4 Technical performance: Perform steps of procedure efficiently, avoiding pitfalls and respecting tissues
• □ME 3.4 Visuospatial skills: Demonstrate 3D spatial orientation, position instruments where intended
• □ME 3.4 Post-procedure plan: Establish an appropriate and complete post-procedure plan

Communicator

• □COM 3.1 Provide information about the procedure and/or operative findings to the patient and/or family in a clear, accurate and timely manner

Collaborator

• □COL 1.2 Professional and effective communication/utilization of assistants

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Patient/family input

1. ●yes
2. ●no

Patient demographic

1. ●adult
2. ●pediatric

Communicator

• □COM 1.1 Establish rapport with the patient and family
• □COM 1.6 Tailor the approach to communication to the needs of the patient and/or family
• □COM 1.1 Engage the patient in the discussion as appropriate for their age and/or developmental stage
• □COM 3.1 Provide accurate information about the condition and/or the management plan
• □COM 3.1 Use plain language and avoid medical jargon
• □COM 4.3 Solicit and answer questions from the patient and/or family
• □COM 3.1 Verify understanding of the information conveyed
• □COM 4.3 Use communication skills and strategies that help the patient and/or family make an informed decision
• □COM 4.1 Communicate in a manner that is respectful, non-judgmental and culturally aware

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Type of documentation

1. ●discharge summary
2. ●off-service consult note
3. ●ophthalmology consultation report
4. ●transfer of care/referral note

Medical Expert

• □ME 2.2 Synthesize and interpret information from the clinical assessment

Communicator

• □COM 5.1 Organize information in appropriate sections
• □COM 5.1 Document all relevant findings and investigations
• □COM 5.1 Convey clinical reasoning and the rationale for decisions
• □COM 5.1 Provide a clear plan for ongoing management
• □COM 5.1 Use terms and abbreviations as appropriate to the specialty
• □COM 5.1 Complete clinical documentation in a timely manner

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Service

1. ●emergency medicine
2. ●endocrinology
3. ●dermatology
4. ●internal medicine
5. ●neurology
6. ●ophthalmology
7. ●pediatrics
8. ●plastic surgery
9. ●rheumatology
10. ●other (please specify)

Includes input from

1. ●not applicable
2. ●nurse(s)
3. ●ophthalmic technologist(s)
4. ●other health care professional(s)
5. ●other physician(s)
6. ●other resident(s) or student(s)
7. ●other supervisor(s)

Collaborator

• □COL 1.2 Demonstrate an understanding of the scope and expertise of other health care professionals
• □COL 1.3 Communicate effectively with physicians and other health care professionals
• □COL 1.1 Respond appropriately to input from other health care professionals

Professional

• □P 1.1 Demonstrate punctuality
• □P 1.1 Complete assigned responsibilities
• □P 1.1 Behave in a professional manner
• □P 1.1 Respond punctually to requests from patients or other health care professionals
• □P 1.1 Accept feedback readily and incorporate suggestions for improvement

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Domain

1. ●external disease and cornea
2. ●glaucoma
3. ●neuro-ophthalmologic disorders
4. ●oculoplastic and orbital disorders
5. ●retina and vitreous disorders
6. ●uveitis

Requiring low vision rehabilitation

1. ●yes
2. ●no

Medical Expert

• □ME 1.3 Apply knowledge of anatomy, physiology, and pathophysiology
• □ME 2.2 Focus the clinical encounter, performing it in a time-effective manner, without excluding key elements
• □ME 2.2 Gather a relevant clinical history
• □ME 2.2 Select examination techniques relevant to the presentation
• □ME 2.2 Perform the ophthalmic examination, including specialized techniques, in a skilful manner
• □ME 2.2 Select appropriate investigations
• □ME 2.2 Interpret findings in the context of the patient’s presentation

Communicator

• □COM 3.1 Communicate effectively with the patient and/or family during the examination
• □COM 2.1 Actively listen and respond to patient cues
• □COM 5.1 Complete clinical documentation in a timely manner

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Presentation

1. ●amblyopia
2. ●strabismus
3. ●anterior segment
4. ●posterior segment

Examination under anesthesia

1. ●yes
2. ●no

Medical Expert

• □ME 1.3 Apply knowledge of the differences between adult and pediatric anatomy and physiology
• □ME 2.2 Gather a relevant clinical history
• □ME 2.2 Select examination techniques relevant to the presentation
• □ME 2.2 Perform the ophthalmic examination, including specialized techniques, in a skilful manner
• □ME 2.2 Adapt the clinical assessment to the child’s age and developmental stage
• □ME 2.2 Interpret findings in the context of the patient’s presentation
• □ME 2.2 Select appropriate investigations
• □ME 2.2 Recognize findings suggestive of non-accidental injury
• □ME 4.1 Determine the need and timing of referral to another health care professional

Communicator

• □COM 3.1 Communicate effectively with the patient and/or family during the examination
• □COM 5.1 Complete clinical documentation in a timely manner

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Activity observed

1. ●interpretation
2. ●performance

Investigation

1. ●B-scan
2. ●fluorescein angiography, including fundus photographs
3. ●neuroimaging
4. ●OCT
5. ●visual field

Finding

1. ●not applicable
2. ●brain lesion
3. ●chiasmal and/or retrochiasmal visual field loss
4. ●glaucomatous optic neuropathy
5. ●intraocular tumor
6. ●non-glaucomatous optic neuropathy
7. ●optic nerve lesion
8. ●orbital lesion
9. ●vitreoretinal disease

Medical Expert

• □ME 1.3 Apply knowledge of the principles, strengths and limitations of diagnostic investigations
• □ME 2.2 Assess a patient’s suitability to proceed with a diagnostic test
• □ME 2.2 Perform B-scan ultrasonography in a skilful manner
• □ME 2.2 Assess the quality and validity of the study, and any impact on the diagnostic interpretation
• □ME 1.3 Apply knowledge of anatomy, physiology, and pathophysiology
• □ME 2.2 Interpret findings in the context of the patient’s presentation
• □ME 2.2 Summarize findings of clinical relevance and, as appropriate, provide suggestions for further testing

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Domain

1. ●external disease and cornea
2. ●glaucoma
3. ●neuro-ophthalmologic disorders
4. ●oculoplastic and orbital disorders
5. ●pediatric ophthalmic disorders and strabismus
6. ●retina and vitreous disorders
7. ●uveitis

Medical Expert

• □ME 2.2 Integrate the clinical data to establish the diagnosis including the stage and/or severity, if relevant
• □ME 2.4 Develop and implement a plan which may include further investigation, surveillance, and/or operative or non-operative intervention

Communicator

• □COM 3.1 Provide the patient/family with information about the indications, contraindications, risks, and alternatives for a given procedure or therapy
• □COM 5.1 Document the clinical encounter to adequately convey clinical reasoning and the rationale for decisions

Collaborator

• □COL 1.3 Work effectively with other health care professionals to implement a management plan

Health Advocate

• □HA 1.2 Provide recommendations for resources for patient education and support

Scholar

• □S 3.4 Integrate best evidence and clinical expertise into decision-making

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Setting

1. ●clinical
2. ●simulation

Case mix

1. ●standard cataract surgery
2. ●dense cataract
3. ●IFIS
4. ●post vitrectomy
5. ●pseudoexfoliation
6. ●toric lens
7. ●white cataract

Complication(s)

1. ●not applicable
2. ●anterior chamber intraocular lens
3. ●posterior capsule rupture
4. ●removal of intraocular lens
5. ●suturing a wound
6. ●vitreous loss

Medical Expert

• □Part A: ME 1.3 Knowledge of procedure: Understand steps, potential risks, and the means to overcome them
• □Part A: ME 3.1 Pre-operative plan: Assess clinical information to determine additional instruments, medications, modification of phacoemulsification settings and/or approach, and appropriateness of procedure
• □Part A: ME 3.4 Case preparation: Position patient correctly, understand approach and required instruments, be prepared to deal with probable complications
• □Part A: ME 3.4 Efficiency and flow: Demonstrate planned course of procedure, economy of movement and flow, and appropriate positioning for use of foot pedals and ergonomics
• □Part A: ME 3.4 Technical performance: Perform steps of procedure efficiently, avoiding pitfalls and respecting zonular and capsule integrity, corneal endothelium and iris
• □Part A: ME 3.4 Visuospatial skills: Demonstrate 3D spatial orientation, position instruments where intended
• □Part A: ME 3.4 Post-procedure plan: Establish an appropriate and complete post-procedure plan

Communicator

• □Part A: COM 3.1 Provide information about the procedure and/or operative findings to the patient and/or family in a clear, accurate and timely manner

Collaborator

• □Part A: COL 1.2 Professional and effective communication/utilization of assistants and OR team

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Procedure

1. ●recession
2. ●resection
3. ●probing

Medical Expert

• □Part A: ME 1.3 Knowledge of procedure: Understand steps, potential risks, and the means to overcome them
• □Part A: ME 3.1 Pre-operative plan: Assess clinical information to determine/confirm diagnosis and appropriateness of procedure
• □Part A: ME 3.4 Case preparation: Position patient correctly, understand approach and required instruments, be prepared to deal with probable complications
• □Part A: ME 3.4 Efficiency and flow: Demonstrate planned course of procedure, economy of movement and flow
• □Part A: ME 3.4 Technical performance: Perform steps of procedure efficiently, avoiding pitfalls and respecting tissues
• □Part A: ME 3.4 Visuospatial skills: Demonstrate 3D spatial orientation, position instruments where intended
• □Part A: ME 3.4 Post-procedure plan: Establish an appropriate and complete post-procedure plan

Communicator

• □Part A: COM 3.1 Provide information about the procedure and/or operative findings to the patient and/or family in a clear, accurate and timely manner

Collaborator

• □Part A: COL 1.2 Professional and effective communication/utilization of assistants and OR team

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Procedure

1. ●repair of an open globe
2. ●repair of corneal perforation
3. ●superficial keratectomy
4. ●pterygium removal

Setting

1. ●clinical
2. ●simulation

Medical Expert

• □Part A: ME 1.3 Knowledge of procedure: Understand steps, potential risks, and the means to overcome them
• □Part A: ME 3.1 Pre-operative plan: Assess clinical information to determine/confirm diagnosis and appropriateness of procedure
• □Part A: ME 3.4 Case preparation: Position patient correctly, understand approach and required instruments, be prepared to deal with probable complications
• □Part A: ME 3.4 Efficiency and flow: Demonstrate planned course of procedure, economy of movement and flow
• □Part A: ME 3.4 Technical performance: Perform steps of procedure efficiently, avoiding pitfalls and respecting tissues
• □Part A: ME 3.4 Visuospatial skills: Demonstrate 3D spatial orientation, position instruments where intended
• □Part A: ME 3.4 Post-procedure plan: Establish an appropriate and complete post-procedure plan

Communicator

• □Part A: COM 3.1 Provide information about the procedure and/or operative findings to the patient and/or family in a clear, accurate and timely manner

Collaborator

• □Part A: COL 1.2 Professional and effective communication/utilization of assistants and OR team

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Presentation

1. ●acute angle closure glaucoma
2. ●capsular opacification
3. ●narrow angle glaucoma
4. ●open angle glaucoma

Procedure

1. ●capsulotomy
2. ●laser peripheral iridotomy
3. ●argon laser trabeculopasty
4. ●selective laser trabeculoplasty

Medical Expert

• □Part A: ME 1.3 Knowledge of procedure: Understand steps, potential risks, and the means to overcome them
• □Part A: ME 3.1 Pre-operative plan: Assess clinical information to determine/confirm diagnosis and appropriateness of procedure
• □Part A: ME 3.4 Case preparation: Position patient correctly, understand approach and required instruments, be prepared to deal with probable complications
• □Part A: ME 3.4 Efficiency and flow: Demonstrate planned course of procedure, economy of movement and flow
• □Part A: ME 3.4 Technical performance: Perform steps of procedure efficiently, avoiding pitfalls and respecting tissues
• □Part A: ME 3.4 Visuospatial skills: Demonstrate 3D spatial orientation, position instruments where intended
• □Part A: ME 3.4 Post-procedure plan: Establish an appropriate and complete post-procedure plan

Communicator

• □Part A: COM 3.1 Provide information about the procedure and/or operative findings to the patient and/or family in a clear, accurate and timely manner

Collaborator

• □Part A: COL 1.2 Professional and effective communication/utilization of assistants

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Procedure

1. ●anterior chamber tap
2. ●intravitreal injection
3. ●laser retinopexy
4. ●pan retinal photocoagulation

Medical Expert

• □Part A: ME 1.3 Knowledge of procedure: Understand steps, potential risks, and the means to overcome them
• □Part A: ME 3.1 Pre-operative plan: Assess clinical information to determine/confirm diagnosis and appropriateness of procedure and order the appropriate medication
• □Part A: ME 3.4 Case preparation: Position patient correctly, understand approach and required instruments including type and settings of laser, be prepared to deal with probable complications
• □Part A: ME 3.4 Efficiency and flow: Demonstrate planned course of procedure, economy of movement and flow
• □Part A: ME 3.4 Technical performance: Perform steps of procedure efficiently, avoiding pitfalls and respecting tissues
• □Part A: ME 3.4 Visuospatial skills: Demonstrate 3D spatial orientation, position instruments where intended
• □Part A: ME 3.4 Post-procedure plan: Establish an appropriate and complete post-procedure plan

Communicator

• □Part A: COM 3.1 Provide information about the procedure and/or operative findings to the patient and/or family in a clear, accurate and timely manner

Collaborator

• □Part A: COL 1.2 Professional and effective communication/utilization of assistants

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Procedure

1. ●biopsy of eyelid lesion
2. ●canthotomy and cantholysis
3. ●chalazion removal
4. ●punctoplasty
5. ●repair of eyelid margin laceration
6. ●repair of superficial eyelid laceration
7. ●suture repair of lower eyelid entropion
8. ●tarsorraphy
9. ●temporal artery biopsy

Medical Expert

• □Part A: ME 1.3 Knowledge of procedure: Understand steps, potential risks, and the means to overcome them
• □Part A: ME 3.1 Pre-operative plan: Assess clinical information to determine/confirm diagnosis and appropriateness of procedure
• □Part A: ME 3.4 Case preparation: Position patient correctly, understand approach and required instruments, suture/needle types, be prepared to deal with probable complications
• □Part A: ME 3.4 Efficiency and flow: Demonstrate planned course of procedure, economy of movement and flow
• □Part A: ME 3.4 Technical performance: Perform steps of procedure efficiently, using appropriate technique, avoiding pitfalls and respecting tissues
• □Part A: ME 3.4 Visuospatial skills: Demonstrate 3D spatial orientation, position instruments where intended
• □Part A: ME 3.4 Post-procedure plan: Establish an appropriate and complete post-procedure plan

Communicator

• □Part A: COM 3.1 Provide information about the procedure and/or operative findings to the patient and/or family in a clear, accurate and timely manner

Collaborator

• □Part A: COL 1.2 Professional and effective communication/utilization of assistants and OR team

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Domain

1. ●external disease and cornea
2. ●glaucoma
3. ●neuro-ophthalmologic disorders
4. ●oculoplastic and orbital disorders
5. ●pediatric ophthalmic disorders and strabismus
6. ●retina and vitreous disorders
7. ●uveitis

Case type

1. ●medical
2. ●surgical

Medical Expert

• □ME 1.4 Perform a clinical assessment that addresses all relevant issues
• □ME 2.2 Interpret the results of investigations performed to monitor the condition and/or treatment
• □ME 2.2 Synthesize patient information to determine response to treatment, status of the disease, and/or presence of complications
• □ME 2.2 Integrate the patient’s other medical problems, overall functioning, and current health status into the decision regarding plan of care
• □ME 2.4 Develop and implement a plan which may include further investigation, surveillance, and/or operative or non-operative intervention
• □ME 4.1 Determine the frequency and timing of future investigations and visits
• □ME 4.1 Determine the need and timing of referral to another health care professional

Communicator

• □COM 3.1 Convey information about diagnosis, prognosis and/or current health status clearly and compassionately

Health Advocate

• □HA 1.1 Facilitate timely patient access to services and resources
• □HA 1.3 Incorporate prevention, health promotion and health surveillance into patient interactions

Scholar

• □S 3.4 Integrate best evidence and clinical expertise into decision-making

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Consultation type

1. ●communication with off-site physician for patient requiring transfer
2. ●communication with off-site physician for patient with acute, vision- threatening presentation(s)
3. ●direct communication with a patient

Medical Expert

• □ME 2.2 Interpret the clinical data to establish an appropriate differential diagnosis
• □ME 2.1 Identify clinical emergencies and prioritize response
• □ME 2.4 Determine the setting of care appropriate for the patient’s health needs
• □ME 4.1 Provide recommendations for additional investigations and/or next steps in management and treatment

Communicator

• □COM 2.3 Gather patient information from a family member or health care professional
• □COM 5.1 Document advice provided by telephone to patients or other health care providers

Collaborator

• □COL 3.1 Determine when a patient should be transferred to ensure optimal patient care
• □COL 1.3 Work effectively with other physicians and health care professionals

Leader

• □L 2.1 Apply knowledge of the health care resources available in other care settings

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Setting

1. ●clinical
2. ●simulation

Medical Expert

• □ME 2.1 Ascertain participants’ understanding of the situation and the reason for the encounter

Communicator

• □COM 1.1 Demonstrate empathy, respect and compassion
• □COM 3.1 Share information and explanations that are clear and accurate
• □COM 3.1 Verify understanding of the information conveyed
• □COM 1.4 Identify, verify and validate non-verbal cues
• □COM 4.3 Answer questions in a respectful manner
• □COM 2.2 Manage the flow of the encounter
• □COM 1.5 Recognize when strong emotions (such as anger, fear, anxiety, or sadness) are impacting an interaction and respond appropriately
• □COM 1.5 Establish boundaries as needed in emotional situations
• □COM 2.2 Summarize and close the encounter effectively
• □COM 5.1 Document the encounter to convey the discussion and its outcome

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Leader

• □L 4.1 Organize work to balance clinical duties, research, and other responsibilities

Scholar

• □S 4.4 Generate research questions for scholarly investigation
• □S 3.3 Critically evaluate the integrity, reliability and applicability of health-related research and literature
• □S 4.5 Summarize the findings of a literature review
• □S 4.4 Select appropriate investigation methods of addressing a given research question
• □S 4.4 Collect data for a scholarly project
• □S 4.4 Perform data analysis
• □S 4.4 Integrate existing literature and findings of data collection
• □S 4.4 Identify areas for further investigation
• □S 4.5 Summarize and communicate the findings of research and scholarly inquiry

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Type of presentation

1. ●didactic session (e.g., AHD, UGME teaching, grand rounds, etc.)
2. ●journal club
3. ●research day presentation

Scholar

• □S 2.4 Identify the learning needs and desired learning outcomes of others
• □S 2.4 Develop learning objectives for a teaching activity
• □S 3.3 Critically evaluate the integrity, reliability and applicability of health-related research and literature
• □S 3.4 Integrate best evidence and clinical expertise
• □S 2.4 Present the information in an organized manner to facilitate understanding
• □S 2.4 Use audiovisual aids effectively
• □S 2.4 Provide adequate time for questions and discussion

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Case mix

1. ●new patients
2. ●follow-up
3. ●post-op
4. ●procedures

Medical Expert

• □ME 2.1 Triage referrals on the basis of the patient’s condition
• □ME 1.4 Perform relevant clinical assessments
• □ME 2.4 Establish patient-centered management plans
• □ME 3.4 Perform interventional procedures in a skilful and safe manner

Communicator

• □COM 5.1 Document clinical encounters in an accurate, complete and timely manner

Leader

• □L 4.1 Manage time effectively in the outpatient clinic
• □L 4.2 Book operative cases with appropriate urgency, duration, and equipment
• □L 4.1 Integrate supervisory and teaching responsibilities into the overall management of the clinical service

Professional

• □P 1.1 Behave in a professional manner

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Case mix

1. ●anterior segment laser procedures
2. ●cataract extractions
3. ●oculoplastic procedures
4. ●pediatric surgeries
5. ●retinal procedures

Medical Expert

• □ME 3.4 Anticipate and prepare for technical challenges and/or significant findings
• □ME 3.4 Select appropriate materials and equipment for the procedure
• □ME 3.4 Perform surgical procedures in a skilful and safe manner, adapting to unanticipated findings or changing clinical circumstances
• □ME 3.4 Manage unexpected intraoperative findings and perioperative issues, adjusting the procedure as appropriate
• □ME 4.1 Establish plans for post-operative care

Communicator

• □COM 3.1 Convey information about the procedure, operative findings, and patient status to the family clearly and compassionately
• □COM 5.1 Document surgical procedures in an accurate, complete and timely manner

Scholar

• □S 2.3 Allocate appropriate time for junior learners’ educational activities while ensuring patient care, efficiency, resources, and safety are maintained

Professional

• □P 1.2 Prepare for the day, reviewing the list of planned procedures
• □P 4.1 Maintain professional clinical performance in demanding or stressful clinical settings

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Type of observation

1. ●direct
2. ●feedback from other learners

Type of teaching

1. ●clinical teaching
2. ●procedural teaching

Scholar

• □S 2.2 Create a positive and respectful learning environment
• □S 2.3 Provide opportunities for appropriate graded clinical responsibility
• □S 2.3 Be available and accessible to junior learners
• □S 2.4 Identify the learning needs and desired learning outcomes of others
• □S 2.4 Provide clinical teaching and/or other informal learning activities
• □S 2.5 Provide feedback to enhance learning and performance

Case description

Feedback provided

Next steps

Entrustment (how much supervision did this activity need?)

1. ●I had to do
2. ●I had to talk them through
3. ●I needed to prompt
4. ●I needed to be there just in case
5. ●I didn’t need to be there

Leader

• □L 4.2 Examine personal interests and career goals
• □L 4.2 Adjust educational experiences to gain competencies necessary for future practice

Scholar

• □S 1.2 Interpret data on personal performance to identify opportunities and knowledge gaps for learning and improvement
• □S 1.1 Define learning needs related to personal practice and/or career goals
• □S 1.1 Create a learning plan that is feasible, includes clear deliverables and a plan for monitoring ongoing achievement
• □S 1.1 Identify resources required to implement a personal learning plan

Professional

• □P 2.1 Demonstrate a commitment to maintaining and enhancing competence

Case description

Feedback provided

Next steps