Student Evaluation of the Clinical Rotation
100%
Exit Survey
Student Name
Student ID
Date
Name of the Hospital or Clinic
Name of the Rotation
Rotation Dates
Student Name
Student ID
Date
Name of the Hospital or Clinic
Name of the Rotation
Rotation Dates
Student Name
Student ID
Date
Name of the Hospital or Clinic
Name of the Rotation
Rotation Dates
Student Name
Student ID
Date
Name of the Hospital or Clinic
Name of the Rotation
Rotation Dates
How satisfied are you with the following:
5 = Excellent
4 = Very Good
3 = Good
2 = Fair
1 = Poor
N/A
Attitude & willingness to teach of preceptor
Attitude of other clinical personnel (nurses, interns, residents)
Approachability of clinical coordinator
Observation of procedures
Performance of procedures
Number of patient contacts per day
Number of history & physical exams per day
Scope and volume of pathology
Night and weekend coverage
Didactics (ie. Lectures, reading, rounds, etc.)
Living quarters and meals
Overall rotation evaluation
Would you in retrospect, take this rotation again?
Would you recommend it to those who follow you?
Please briefly describe the strongest and weakest areas of this rotation
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