Anesthesia Align

Daily Sync Behavioral Assessment

Reviewer's Name In-Coming Physician's Name Shift Context

⚖️ The Bias Check: Style vs. Safety

UNSAFEViolates physiological principles or established safety guidelines. Mark as Concern.

UNFAMILIARDoes not know local protocol (e.g. blood bank location). Mark as Training Need.

DIFFERENTSafe, but different technique/drugs than you prefer. Mark as Competent.

Non-Technical Skills (ANTS)

ℹ️ Scoring Guide (1-4 Rubric)

1

Unsafe: Fails to recognize or respond to critical patient instability. Ignores safety alarms. Demonstrates lack of vigilance. Requires physical intervention to prevent harm.

2

Marginal: Safe but disorganized. Relies on others to prompt planning. Communication ambiguous.

3

Standard: Proactive. Plans contingencies. Adheres to guidelines. Shares info voluntarily. (Target)

4

Exemplary: Anticipates future states. Coordinates team explicitly. Prioritizes dynamic tasks.

1. Task Management

Planning cases, preparing equipment, organizing workspace, adhering to standards.

Unsafe (1)Exemplary (4)

2. Team Working

Exchanging information, supporting nursing/staff, assertiveness/authority.

Unsafe (1)Exemplary (4)

3. Situation Awareness

Gathering info, recognizing changes, anticipating next steps.

Unsafe (1)Exemplary (4)

Categorization

Observation Category (The Bias Check)

Explicitly document your observation type here.

Global Recommendation Reviewer Notes / Comments

CBME Deep Dive Competency-Based Evaluation

Assessment Tool

Reviewer Name

Physician Name

CBD: Clinical Reasoning

Case Focus Complexity Prompt Used

Quality of Reasoning Criteria

Justification: Decisions were evidence-based and logical. Flexibility: Explained alternative plans (Plan B/C). Risk Awareness: Anticipated complications/safety limits. Reflection: Identified what went well vs. improved.

DOPS: Procedural Details

Procedure Urgency Observed Competencies:

Asepsis: Maintained sterile technique. Technique: Tissue handling & Instrument control. Safety: Patient monitoring.

Notes on Competencies

Mini-CEX: Interaction

Setting

Criteria: Patient Assessment

Communication: Avoided jargon, checked understanding. Empathy: Validated patient anxiety/concerns. Organization: History/Exam was structured.

Criteria: Handover

Structure: Used SBAR / ISBAR format. Completeness: Covered critical history, meds, & plan. Transfer: Ensured receiver accepted responsibility (Closed Loop).

Criteria: Team Interaction

Shared Decision Making: Invited input from surgeon/nursing. Clarity: Instructions were specific and audible. Professionalism: Respectful tone during stress/conflict.

360° Team Feedback

Your Name & Role

Professionalism & Safety Check

Respectful: Maintained professional tone, even during stress. Acknowledged team roles/input. Clear Communication: Orders were audible/specific. Used closed-loop communication. Safety Conscious: Vigilant to monitors. Prioritized patient stability over speed/efficiency.

Concerns (Check if observed)

Dismissive / Rude: Invalidated team concerns. Used demeaning language or tone. Failed to acknowledge safety warnings. Unsafe Practice: Violated sterility or protocol. Ignored critical alarms. Required physical intervention to prevent harm.

Rating / Overall Impression

Novice (1)Expert (5)

Feedback Given

Gap Analysis Self-Assessment

Low confidence is NOT negative; it guides your orientation.

1. Equipment Familiarity

Anesthesia Machine

Our Current Models: GE Aisys CS2 / Dräger Perseus

Video Laryngoscope

Standard: Glidescope / C-MAC

Video Laryngoscope

Standard: Flexible Bronchoscope

Medication Infusion Pumps

Plum 360. and MedFusion Pumps

Ultrasound Machine

Standard: GE Logiq / Sonosite

2. Systems & EMR

Electronic Medical Record (EMR)

System: ORM

Medication Dispenser

Picis

Department Protocols

Familiarity with Massive Transfusion (MTP)?

My Submission History

A record of evaluations you have submitted from this device.

Physician	Type	Status