ANNUAL SELF-ASSESSMENT

 

Please take this opportunity to reflect on your own strengths and weaknesses. The hope is that this activity will help you to plan your learning objectives for the upcoming academic year. Realizing that we all have strengths and weaknesses, please assess your own in each area using a 10 point scale (1 is lowest, 10 highest). Please be honest with yourself, as your assessment will help guide how we can best work with you in developing skills.

 

Attributes/Abilities

Relative Strengths & Weaknesses

Initiative (will help to get the job done regardless of whose job it is)

1  2   3   4   5   6   7   8   9   10

Perseverance (ability to overcome frustrations that occur in working toward a goal)

1  2   3   4   5   6   7   8   9   10

Ability to recognize limitations and admit errors

1  2   3   4   5   6   7   8   9   10

Ability to work with others

1  2   3   4   5   6   7   8   9   10

Attention to detail

1  2   3   4   5   6   7   8   9   10

Time management

1  2   3   4   5   6   7   8   9   10

Confidence (including the ability to respectfully challenge those in authority)

1  2   3   4   5   6   7   8   9   10

Response to feedback (ability to use feedback to improve performance)

1  2   3   4   5   6   7   8   9   10

Communicate skills (including both effective and efficient verbal and written formats)

1  2   3   4   5   6   7   8   9   10

Striving for excellence (not being content with a satisfactory performance)

1  2   3   4   5   6   7   8   9   10

Learning Objectives for Academic Year _____________

 

Please write three objectives that you will work to achieve during the upcoming academic year. You may use the needs assessment above to help you get started but do not need to limit yourself to the areas described above. We will come back to these objectives at the end of the year to determine whether you think they have been met and if not, why not.

 

For each objective, list two strategies that you intend to use to help you achieve that particular objective.

 

Objective 1:

 

 

 

Strategies to achieve objective 1:

 

 

 

 

 

 

 

Has objective been met? If not, why not? If not met please include this objective with your objectives for the upcoming year with some new strategies that will help you to better achieve what you set out to do.

1 year follow-up:

 

 

 

 

 

 

Objective 2:

 

 

 

Strategies to achieve objective 2:

 

 

 

 

 

 

 

Has objective been met? If not, why not? If not met please include this objective with your objectives for the upcoming year with some new strategies that will help you to better achieve what you set out to do.

1 year follow-up:

 

 

 

 

 

 

Objective 3:

 

 

 

Strategies to achieve objective 3:

 

 

 

 

 

 

 

Has objective been met? If not, why not? If not met please include this objective with your objectives for the upcoming year with some new strategies that will help you to better achieve what you set out to do.

1 year follow-up:

 

 

 

 

 

 

 

 

 

Resident: _______________________________                         Date:________________

 

 

Mentor:_________________________________                       Date:________________