Student Evaluation of the Clinical Preceptor

Student Name

Student ID

Date

Name of the clinical preceptor

Hospital or Clinic

Rotation

Rotation Dates

DIRECTIONS: Reflecting back on your experience so far this year, check the box that most accurately describes your preceptor.

	Strongly Agree	Agree	Neither Agree nor Disagree	Disagree	Strongly Disagree
Established a conducive learning environment (enthusiastic, respectful, approachable, encouraging)

Was prepared and organized for preceptorship

Observed your clinical skills periodically

Provided adequate practice time for clinical skills

Provided timely and constructive feedback of clinical performance

Provided a stimulating introduction to my clinical medicine clerkship

Overall, my preceptor is an effective teacher

Comments/Suggestions: