Hi, I'm Jenny Christner Associate Professor of Pediatrics, and Associate Dean for Undergraduate Medical Education at Upstate Medical University. Today I'm going to be talking to you about the RIME model for learner assessment and feedback. The RIME model was first developed and described by Lou Pangaro, so I want to give him full credit for that. After you complete this module, you'll be able to describe the RIME method of assessment. And you'll be able to utilize RIME for feedback and assessment in interactions with your students and learners. RIME is really a developmental framework for evaluation. It helps you describe performance goals for your trainees. And what's really nice about it is that you can apply it to a single encounter literally with one patient, or you can apply it to someone's overall performance with you. Let's talk about what each of those letters stands for. So R is for reporter. I is for interpreter. M is manager, and E is for educator. So let's talk about each one of those in more detail. One of the nice things about the RIME schema is that it's very understandable. Everyone understands at some level kind of what those names mean, and we'll just talk a little bit more in depth. So for example for a reporter. A learner who is a reporter really has mastered some very basic skills. So you might expect a end year second year student or certainly a beginning third year student to be at a reporter level. They're able to go and take a basic history and physical. They can recognize some very simple normal from abnormal history and physical exam findings. They're also reliable. So you can also build professionalism into a reporter as well. So they're able to do the task that you ask of them. They show up on time. They go to see the patient that you ask them to see. And they can answer the 'what' questions for you. Then we move on to interpreter. So this is the next level up. You might think about that for example a end of third year student should be at an interpreter level. Or, you might think about an intern in this framework. And an intern on something very common, maybe in their first couple months, a problem that's very common to your speciality, they might already be ready to be able to be an interpreter for that. So an interpreter can actually then begin to use some clinical reasoning when they look at patients. They can take the history in the physical exam, come up with what some of the pertinent positives and negatives are. Create a differential diagnosis, and begin to prioritize that differential diagnosis by reasoning through the things that they have found out in the history, perhaps lab tests that they've ordered. They can answer some of those why questions. Next in this schema, is the manager. The manager can do just what it says. They can begin to give you some reasonable options in how you might manage that patient. What the assessment is, what the plan will be. Very important at this stage, is that the manager can keep this plan patient centered. So they're able to take into account what the patient's needs are, what the family needs are and come up with a patient centered plan that will hopefully help with compliance. They can answer those 'how' questions. The final developmental framework is that of the educator. The educator now is taking control of their learning and even other people's learning on the team. They can engage in self directed learning. Define what are some important questions about the case. They're going to look for evidence in the literature. And what are some of the larger teaching points behind it. And then they're going to share what they learn. So they may share the information with a patient. They may share it with you as the attending physician. And certainly, they're expected to share the information with other members of the team. So now we're going to take a minute and have you look at some videos of learners giving various presentations, and have you try to define what stage in the RIME schema you think they're at.
