Mid Core Evaluation
100%
Questions marked with an * are required Exit Survey
 
 
Preceptor Name
   
Student Name
   
Student ID
   
Date
   
Core Rotation
   
Start Date
   
 
 
How satisfied are you with the following:
5 = Excellent 4 = Very Good 3 = Good 2 = Fair 1 = Poor 0 = Fail N/A
Patient Care: Performs patient interviews; uses judgment; is respectful of patient preference.
Medical Knowledge : Exhibits knowledge of diseases and underlying pathophysiology
Clinical Skills: Prioritizes H&P data; reviews vital signs and abnormal findings; provides a patient management plan.
Practice-based learning and improvement: Self-assesses; uses new technology; accepts feedback, Demonstrates skills in evidence-based medicine.
System-based practice : Demonstrates team work.
Interpersonal & Communication Skills: Establishes relationships with patients/families; educates and councils patients/families; maintains comprehensive, timely, legible medical records.
Professional Behavior: Shows compassion, respect, and honesty; accepts responsibility for errors; considers needs of patients/colleagues.
Patient electronic Log Book Check
 
 
 
Comments/Suggestions:
   
 
 
 
* Preceptor Signature
   
 
 
 
Please sign here