ARC RC BRS CLASS OF 2004 SETZER, QUENTIN

CLINICAL PRECEPTOR
BEHAVIORAL RATING SCALE
FOR
QUENTIN SETZER
RESPIRATORY CARE
CLASS OF 2004

Instructions: Please be candid 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

Name


Student Name:




Clinical Facility:




Respiratory Course Number:
51L
52L
53B
54B


Clinical Rotation Dates:




Evaluator Name & Title:




The Student

Initiates unambiguous and goal-directed communication


STRONGLY AGREE
AGREE
UNDECIDED
DISAGREE
NOT APPLICAPLE / NOT OBSERVED


The Student

Established priorities and efficiently plans activities/assignments


STRONGLY AGREE
AGREE
UNDECIDED
DISAGREE
NOT APPLICABLE / NOT OBSERVED


The Student

Displays adequate knowledge of essential concepts


STRONGLY AGREE
AGREE
UNDECIDED
DISAGREE
NOT APPLICABLE / NOT OBSERVED


The Student

Exhibits courteous and pleasant demeanor


STRONGLY AGREE
AGREE
UNDECIDED
DISAGREE
NOT APPLICABLE / NOT OBSERVED


The Student

Demonstrates thoroughness and attention to safety requirements


STRONGLY AGREE
AGREE
UNDECIDED
DISAGREE
NOT APPLICABLE / NOT OBSERVED


The Student

Reports on patient's status/needs by observation and assessment


STRONGLY AGREE
AGREE
UNDECIDED
DISAGREE
NOT APPLICABLE / NOT OBSERVED


The Student

Exhibits self-direction and responsibility for actions


STRONGLY AGREE
AGREE
UNDECIDED
DISAGREE
NOT APPLICABLE / NOT OBSERVED


The Student

Displays cooperativeness and receptivity to suggestions and ideas


STRONGLY AGREE
AGREE
UNDECIDED
DISAGREE
NOT APPLICABLE / NOT OBSERVED


The Student

Maintains concise and accurate records


STRONGLY AGREE
AGREE
UNDECIDED
DISAGREE
NOT APPLICABLE / NOT OBSERVED


The Student

Presents a well-groomed and tidy personal appearance


STRONGLY AGREE
AGREE
UNDECIDED
DISAGREE
NOT APPLICABLE / NOT OBSERVED


The Student

Grasps new experiences and readily adjusts to changing conditions


STRONGLY AGREE
AGREE
UNDECIDED
DISAGREE
NOT APPLICABLE / NOT OBSERVED


The Student

Provides for adequate care and maintenance of equipment and supplies


STRONGLY AGREE
AGREE
UNDECIDED
DISAGREE
NOT APPLICABLE / NOT OBSERVED


The Student

Displays forthrightness and integrity in dealings with patients and peers


STRONGLY AGREE
AGREE
UNDECIDED
DISAGREE
NOT APPLICABLE / NOT OBSERVED


The Student

Accepts and applies supervisory guidance and constructive criticism


STRONGLY AGREE
AGREE
UNDECIDED
DISAGREE
NOT APPLICABLE / NOT OBSERVED


The Student

Demonstrates the relationship(s) between theory and clinical practice


STRONGLY AGREE
AGREE
UNDECIDED
DISAGREE
NOT APPLICABLE / NOT OBSERVED


The Student

Completes delegated tasks and assignments on schedule


STRONGLY AGREE
AGREE
UNDECIDED
DISAGREE
NOT APPLICABLE / NOT OBSERVED


The Student

Seeks out new or additional activities on own initiative


STRONGLY AGREE
AGREE
UNDECIDED
DISAGREE
NOT APPLICABLE / NOT OBSERVED


The Student

Demonstrates consideration and respect for patient's needs/rights


STRONGLY AGREE
AGREE
UNDECIDED
DISAGREE
NOT APPLICABLE / NOT OBSERVED


The Student

Follows directions and exhibits sound judgment


STRONGLY AGREE
AGREE
UNDECIDED
DISAGREE
NOT APPLICABLE / NOT OBSERVED


The Student

Displays punctuality and dependable adherence to time schedules


STRONGLY AGREE
AGREE
UNDECIDED
DISAGREE
NOT APPLICABLE / NOT OBSERVED


The student and clinical preceptors was supplied with specific written objectives and tasks that were current and appropriate to the assigned area.
STRONGLY AGREE
AGREE
UNDECIDED
DISAGREE
NOT APPLICABLE / NOT OBSERVED


There were adequate resources (personnel, supplies, equipment) available for student learning.
STRONGLY AGREE
AGREE
UNDECIDED
DISAGREE
NOT APPLICABLE / NOT OBSERVED


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.




Comments and Impressions




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