The R.I.M.E Student Evaluation Framework

What is the RIME method of evaluation?

Dr Pangaro developed the R.I.M.E method of student evaluation and can be used to evaluate students. The R.I.M.E method of evaluation is frequently adopted as it improves inter-rater reliability.   It also assists with providing useable feedback to medical students and residents.   There are four cognitive levels that mark the natural progression in a medical skills development.

Evaluation Vocabulary (R.I.M.E.)

Adapted from Emory University School of Medicine & Pangaro LN.   Academic Medicine 1999; 74:1203-7

Reporter

• Obtains and reports basic information accurately:   answers the "What" questions about patients
• Clearly communicates clinical facts about patients, and follows data daily
• Uses proper terminology
• Is beginning to interpret data: has basic knowledge to know what to look for in a history and physical
• Has the ability to recognize normal from abnormal and confidence to label a new problem
• Reliable, honest, hard-working
• Works well with patients, staff and colleagues: solid professional qualities.

Interpreter Expected level - Senior medical student, first year resident

• Good working fund of knowledge
• Active participant in patient care: consistently prepared for rounds, the OR, clinic, etc.
• Consistently able to interpret data: can identify and prioritize new problems
• Can offer a differential diagnosis: can present 2-3 reasonable possibilities for new problems and cite reasons they may apply to this patient
• Not always correct, but has a higher level of knowledge, more skill in selecting clinical findings which support possible diagnoses and applying these to specific patients
• Answers the "Why" questions about his/her patients

Manager Expected level - Second year resident

• Excellent general fund of knowledge
• Broad/deep knowledge of his/her own patients
• Excellent level of patient care: actively suggests management options, answers the "What's next" questions about his/her patients
• Has the skill to select among options for his/her patients: is proactive rather than reactive, actively suggests management options
• Confidence/willingness to state own preferences
• Diagnostic plans include more than one appropriate treatment option, and therapeutic plan considers the merits of all reasonable therapies
• More judgment in deciding which action needs to be taken: can tailor plan to patient's circumstances and preferences (finds common ground)

Educator Expected level - Ideal senior resident

• Can cite evidence that new therapies, tests, and procedures are worthwhile
• Takes an active role in educating themselves, colleagues and patients
• Open to new knowledge
• Skilled in identifying questions that can't be answered from textbooks
• Superior fund of knowledge
• Provides superior patient care and consistently possesses superior knowledge of his/her patients

1 Pangaro L. A new vocabulary and other innovations for improving descriptive in-training evaluations. Acad Med. 1999 Nov;74(11):1203-7