University Of North Florida Doctor Of Physical Therapy Reference Form (Page 2 of 3) in pdf

University Of North Florida Doctor Of Physical Therapy Reference Form Page 2

University of North Florida Doctor of Physical Therapy Reference Form

Please answer the following questions about the applicant.

1. How long have you known the applicant?

2. In what capacity do you know the applicant?

3. Assessment of the applicant: Using the scale below, please evaluate the

applicant. The ten generic abilities listed are essential for successful practice as

a physical therapist. The items were developed by Warren May and Associates

of the University of Wisconsin-Madison’s Physical Therapy Program and have

been adopted for our use. Please feel free to write any additional comments in

the space provided.

4 – Excellent

3 – Good

2 – Average

1 – Poor

0 – Unsure

________ Commitment to learning. The ability to self-assess, self-correct, and self

direct. Identifies needs and sources of learning; continually seeks new self

knowledge and understanding.

________ Interpersonal skills. The ability to interact effectively with patients,

families, colleagues, other health care professionals, and the community; deals

effectively with cultural or ethnic diversity issues.

________ Communication skills. The ability to communicate effectively (speaking,

body language, reading, writing, listening) for varied audiences and purposes.

________ Effective use of time and resources. The ability to obtain the maximum

benefit from minimum investment of time and resources.

________ Use of constructive feedback. The ability to identify sources and seek

out feedback; effectively uses and provides feedback to improve interpersonal

interaction.

University Of North Florida Doctor Of Physical Therapy Reference Form Page 2