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ARC RESPIRATORY CARE BEHAVIORAL RATING SCALE -
BEHAVIORAL RATING SCALE
Instructions: Please be frank and honest in reacting to the following
statements regarding your opinion of the student’s clinical performance. Check
the appropriate response.
SA means you
strongly agree
A means you
agree
U means you are
undecided
D means you
disagree
NA means
not applicable or
not observed
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Student Name:
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Clinical Facility:
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Respiratory Course Number:
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Clinical Rotation Dates:
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Evaluator Name & Title:
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The Student
Initiates unambiguous and goal-directed communication
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The Student
Established priorities and efficiently plans
activities/assignments
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The Student
Displays adequate knowledge of essential concepts
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The Student
Exhibits courteous and pleasant demeanor
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The Student
Demonstrates thoroughness and attention to safety
requirements
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The Student
Reports on patient's status/needs by observation and
assessment
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The Student
Exhibits self-direction and responsibility for actions
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The Student
Displays cooperativeness and receptivity to suggestions and
ideas
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The Student
Maintains concise and accurate records
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The Student
Presents a well-groomed and tidy personal appearance
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The Student
Grasps new experiences and readily adjusts to changing
conditions
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The Student
Provides for adequate care and maintenance of equipment and
supplies
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The Student
Displays forthrightness and integrity in dealings with
patients and peers
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The Student
Accepts and applies supervisory guidance and constructive
criticism
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The Student
Demonstrates the relationship(s) between theory and
clinical practice
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The Student
Completes delegated tasks and assignments on schedule
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The Student
Seeks out new or additional activities on own initiative
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The Student
Demonstrates consideration and respect for patient's
needs/rights
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The Student
Follows directions and exhibits sound judgment
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The Student
Displays punctuality and dependable adherence to time
schedules
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Critical Incident Descriptions:
Include (where applicable) the events leading up to
the incident (antecedents), the behavior itself, and any observed consequences
of the behavior. Be as specific and objective as possible.
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Comments and Impressions
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Recommendations
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