Mid Core Evaluation
100%
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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
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