1��s�EDž&�@YP� ��օ�t�\� ��x���P�5����Ú8�g9WV���W6�}1?%`]��u�Ky*�. Occupational Exposure Report (PDF) Request Forms ____a. 2. Even if you have previously rated the preceptor, you must complete one evaluation for … stream PRECEPTOR EVALUATION FORM. v�YZ��{���}ٴ`�� �v@[����Jв+���oֿ�����r������'f�Q1�"�,�2���H�=�a Extremely Helpful____ Usually helpful___ Somewhat helpful___ Not helpful____ Please Explain: 5. An evaluation is important to ensure not only the effectiveness of the program, but also to ensure the quality of the program is maintained and regularly updated as required. 1 0 obj Feedback provided in this evaluation will remain confidential. endobj As a human resource professional, on several occasions it becomes difficult to frame these performance evaluations correctly and without sounding overtly casual. The preceptor�s development and presentation of material were consistent with the goals of the internship.3. Clothing and uniform was appropriate, neat, clean, & well maintained; exhibited good personal hygiene and grooming. :稨f��Q <> 8. 1. How clear was the relevance or significance of the major project to the overall field of public health? Does not provide feedback at all Level 2. endobj STUDENT EVALUATION FORM. $ & � 5. 2 0 obj R���~/J��q!��2kn���z4�_n�E�I���k�r��5��4�%b������"{�(���m(�. st:deb:pro:prcp/eval3010 Page 1 09/04/2015. )��w�y)v��9n �v���{ܝy�Q�B� �IJl���SR <>>> ���I��6����u:�Q/=��$���q��ۈ�����:)�ԇ `Y�]o��}�A��&~��������.�~O1�4�i�C��؎�;=�����å}Z)�%����N;~��A���BO��S'��՚N½��@�a��lW�'U�! The preceptor�s overall capability was of the highest quality level. � �x������- �����[��� 0����}��y)7ta�����>j���T�7���@���tܛ�`q�2��ʀ��&���6�Z�L�Ą?�_��yxg)˔z���çL�U���*�u�Sk�Se�O4?׸�c����.� � �� R� ߁��-��2�5������ ��S�>ӣV����d�`r��n~��Y�&�+`��;�A4�� ���A9� =�-�t��l�`;��~p���� �Gp| ��[`L��`� "A�YA�+��Cb(��R�,� *�T�2B-� Appendix C: Preceptor Evaluation Form Department of Public Health Sciences MHA INTERNSHIP EVALUATION BY PRECEPTOR Thank you for your sponsorship of this intern. ۥ�eP�_�b���g����Lr�Z��n�� �|�0 I would recommend this internship/field placement to other students with the following revisions: ____c. 596 0 obj <>/Filter/FlateDecode/ID[<3969AF60D7B55A41B3ABAF105F677D6B>]/Index[586 36]/Info 585 0 R/Length 75/Prev 418517/Root 587 0 R/Size 622/Type/XRef/W[1 3 1]>>stream endstream endobj startxref Intern: Insert name of intern here Semester/Year of internship: Sem/Yr Agency: Insert name of agency here Preceptor: Insert name of preceptor here . Preceptor: This preceptor evaluation is to be completed by the student towards the end of the experience using the following scale below. ��ࡱ� > �� � � ���� � � ���������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������� � �� � bjbj$$ DZ F| F| � F �� �� �� � D ���&[`�M���"K.�C��]���‘�̉����2�L�������N:m Consistently punctual; rapid response times. Sample Clinical Preceptor Evaluation Instructions: For each of the following clinical activities please select the rating that most closely represents the medical student’s highest sustained performance that you observed during the course. � � � � � � j � endobj Appendix C: Preceptor Evaluation Form Department of Public Health Sciences MHA INTERNSHIP EVALUATION BY PRECEPTOR Thank you for your sponsorship of this intern. Feedback and Evaluation Level: Feedback and Evaluation * Level 1. endstream endobj startxref x��]ݏ�6�7��AO��"-���!�v�=�[o��=�Оod�{v��N��?V)Q"�R�չ w�,Y,�U?�߼}>��l.��߿y{8l.ﮯ�_�|�=����?���|���o7����ͧ�/x�_כ��狋����~�&)���Q��V����_��߿D�ׯ�}~���O"j��7�_ U'�D$�2I�e�T��GU篟��v�ڋn�[������_WQ�����~��j��_�e�)�����2l���I����7������#/��v��)ս��Y��*ʫDVu7)��������kQ��c�����ju��ճz(V{xx�>֫C,��q����V����i���ǻ�"��i9������U�"ɋ1f�.��S5���W��C���2�d�2��e��uK�?n��z�.We"���sz��*)�= Evaluation Forms. Your comments should reflect thoughtful consideration of your experience, and relevant criticisms or shortcomings of the experience should be presented in a constructive, forthcoming manner. 586 0 obj <> endobj Demonstrated mastery of skills/knowledge; exhibited ability to use resources to find information; displayed a thorough knowledge of local protocols and ambulance operations; followed policies, procedures and physician/medical command orders. .��6�R�e��L)�F=�J�r &�������~�E�eѨA��I�J� �Dd����&U"9�H��g�4�,�\�$��H�U���Ϸ��������r��3����ڕ��R�O����Z������*]�C��K�!T���~|jnK>>%��rhc���jI4`4�|ژ��ko��-�. I would consider accepting employment at this agency.PRECEPTOR1. Preceptor: This preceptor evaluation is to be completed by the student towards the end of the experience using the following scale below. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Even if you have previously rated the preceptor, you must complete one evaluation for each shift. Demonstrated the ability to trust personal judgment; displayed an awareness of strengths and limitations; exercised good personal judgment. � What was the most valuable aspect of your internship? D Evaluation). Q�B��O6����}[Dns��g ���j��4�UPu0����J���X�&B�2�����j��zp�58�? How did your internship experiences differ from your expectations? Check the one that is most applicable and explain. <> 9. & discussion with student regarding expectations, performance, remediation, & positive reinforcement; adjusted communication strategies to various situations. stream %PDF-1.6 %���� Introduced self & applicable personnel; checked out the vehicle with student at the beginning of the shift; reviewed equipment operations (including radio operations). The student provides the preceptor with mid-term and final evaluation forms. Each evaluation statement includes examples of defining characteristics for the item. ��j�u��5J��p;�O�����-2aب�@�,�v!��qS�y���2�^�G�4��أ)���#��L�(v�����ύ=|s�z���*rW��{?�w�X��~����Z�c" �vl�C�K8~�� x� -���+�.&��:֧����������~�/�� �ݵ� x��]m��6��n��A��Y$�jsplgoy����tƚq#=ӳ�3ޝ���"�"���Z�b=�n��%��b�(%/�%_����{�d���7o^'�z�,K3�_�x�%��[5<9�ϟ������o>��?c�(K�צH3I��i�'n%�_�W��Q2LnԷ�����_V��|uh���j]����X��!y�~Y�r���w���a��K��n�kI�]��O��aݬ���M>�����R�,͢Jz��D��_&�p�ڵX]=������;�t�w�%P$��ݮݬ�ձM��6y�_?����rL�}����;94T�U}�_6�x��x��m2ox]�E���`7���S}��o�*�5��OOJׅthx\e�����?����F��h-Pj��|XH5QWiQ��T�E��� �x�7�,�n�C"M�o�����4źvn�H�?He��U��F����>\/ԋB�V�"���i6<7c>A,����� �:�� Did not allow personal bias or feelings interfere with patient care or the student’s educational process; provided accurate evaluation of student performance in order to provide a highly effective learning environment; protected and respected patient/student confidentiality and dignity.