Family Medicine Clerkship Student Evaluation (Page 2 of 2) in pdf

Family Medicine Clerkship Student Evaluation Page 2

13. Clinical judgment

NA/CA

Can integrate medical knowledge with clinical information in the care of patients. Weighs risks/benefits.

14. Humanistic attributes

NA/CA

Demonstrates empathy, altruism, sensitivity, respect for the individual, professionalism.

15. Relationships with staff

NA/CA

and colleagues

Ability to interact cooperatively with other members of team. Respectful, professional

16. Attitude, interest, and

NA/CA

responsibility

Reliable, available, prompt. Participates actively in rounds and teaching conferences. Assumes responsibility and is

dependable.

Use the following scale to rate the student’s overall performance

Unacceptable

Marginal Performance

Typical Performance

Superior Performance

Honors

(Needs improvement)

(Expected for

(Top 20%)

(Top5%)

a UVA student)

Designations of “Unacceptable” , “Marginal” and “Honors” require supporting evidence in the required narrative comments.

OVERALL PERFORMANCE:

Cannot rate(explain below)

Contact with student: _________Minimal (1-2 clinics/sessions) __________Moderate (3-5 days) ___________ Extensive (1-2 weeks)

NARRATIVE COMMENTS (required):

Narrative comments are essential in the evaluation process and offer important points of feedback in contributing to the

professional development of the student physician. Evaluations must provide a clear and forthright picture of the student. Be

honest and fair, as these comments may be used in their entirety in the student’s Medical School Performance Evaluation

(formerly known as the Dean’s Letter). Use an additional sheet if necessary.

Have you discussed this evaluation with the student?

Yes____No______

Have you observed this student interacting with patients/families? Yes___ No_____

Have you observed this student perform: elements of the history/physical exam? Yes____ No_____

PLEASE HAVE STUDENT RETURN THIS FORM OR FAX WITHIN ONE WEEK TO: 434-982-0390

Family Medicine Clerkship Student Evaluation Page 2