Clinical Immersion and Instructor Evaluation
Name: 


  1. What was your primary reason for taking this Clincal Immersion?
    Required
    Personal Interest
    Recommended by a colleague
    Was offered by
    Other


  1. Please evaluate the Instructor:

            1 2 3 4 5      
      The instructor was well prepared. Strongly agree  Strongly disagree  
      The instructor explained the procedure well. Strongly agree  Strongly disagree  
      The instructor answered questions well. Strongly agree  Strongly disagree  
      The instructor shows genuine concern for students. Strongly agree  Strongly disagree  


  1. The Clinical Immersion exceeded my expectations
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. I recommend colleague to attend this Clinical Immersion.


  1. What aspects of the clinical immersion were of most relevance to you?


  1. Please rate:

            1 2 3 4 5      
      Program / Format Disappointing Excellent  
      Covidien Facilitator Disappointing Excellent  
      Surgeon Preceptor Disappointing Excellent  
      Learning Resorces Disappointing Excellent  
      Venue Disappointing Excellent  


  1. Which postal address would you like your Certificate of Attendance sent?





Cardinal Health ANZ