I want to take a few minutes and talk about a framework by which we can, analyze the performance or think about providing feedback. I'm not sure which setting people are in. You may be in the Canmeds model. You may be in the physician practice model in another, country. But I'm going to talk to you about two models that we often use. The first one is the ACGME, which is our graduate medical education model. And that's medical knowledge, patient care, communication, professionalism, systems based practice, and practice based learning and improvement. The other one is the RIME model: reporter, interpreter, manager, and educator. The reason I bring this up at this time, is that it helps us provide feedback in a directed area. If when you're watching performance you don't really know where you should be focusing your attention. You may choose to watch performance or comment on performance, or provide feedback in these different areas. So you can go to the model which you use in your medical system, or you might use one of these models to help you provide feedback in that area. For example, if I'm working with a resident, and they say, I'm working on communication, or I think they need to work on communication. I may choose to focus on communication for that entire time period that I'm working with them, and then provide them feedback on that area. Likewise, if I'm thinking about the RIME model, I may choose one of the areas of the RIME model to provide feedback on. For those of you not familiar with the RIME model, I'm going to cover some of these areas now, and we will do them in a later session. The first thing with the RIME model is reporter. A reporter gathers information and communicates data. So it's this, the RIME model's a process by which learners develop from kind of novice to expertise and you can place learners on the spectrum of this process. So is, as a student begins, they're really just a reporter. They can accurately collect information about a patient, but they can't really interpret it. So they're just collecting information. For example, they might say this child has, bumps on her face that are a rash and she has a fever. But she, the learn, the learner is just reporting what they're seeing, but is not making an interpretation. When they get to the interpreter level, they'll actually say this child has chicken pox. They, so they're able to say that they have both a rash, what the rash looks like, being a reporter level, and they can interpret the fact that this is actually chicken pox or varicella. The next level is that they can manage it. It's the understanding of what needs to happen with the disease or the interpretation that they are making. So that they will manage the situation either through medication or whatever fever control, antipyretics treatment of dehydration those sorts of things. The final level of the RIME model is that of educator, and that's where they will both educate their learner, educate their patients, educate their families and educate themselves. And so if, if a learner is really at the top level, then they're able to understand where the gaps of their own knowledge are, where the gaps of the, of the patient, or the family member, or the other team members are, and they become an educator, which is the top level of this RIME model. All right. Let's return to the video. And what I want you to do is to look at this video and think about which level of the RIME model the learner is in. So that you can use that to provide feedback to the learner.
