Department of Pediatrics
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  Jon Smith                                       


Annual Self-Assessment

Name: Jon Smith
Learning Objectives for Academic Year: 2002
Status: New

Please take this opportunity to reflect on your own strengths and weaknesses. This activity is designed to help you plan your learning objectives for the upcoming academic year. Realizing that we all have strengths and weaknesses, please assign a number from 1 to 12 next to each of the attributes listed in the table below. The number 1 should be assigned to your greatest strength and the number 12 to your greatest weakness. The numbers 2 to 11 then will represent the move from relative strengths to relative weaknesses, respectively. Use a number only once and use every number from 1 through 12. Please note that there are only 10 attributes listed to enable you to add two that are essential for you and that may not be part of the given list.

1

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

2

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

3

Ability to recognize limitations and admit errors

4

Ability to work with others

5

Attention to detail

6

Time Management

7

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

8

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

9

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

10

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

11

12


Self Attribute 1:
Self Attribute 2:

Please write three objectives that you will work to achieve during the upcoming academic year. You may use the needs assessments above to help you get started but do not need to limit yourself to those areas. 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:
Objective 2:
Strategies to achieve objective 2:
Objective 3:
Strategies to achieve objective 3:
I have completed this form and am ready to submit.