Evaluation of Fellowship Faculty

For each of the following criteria, please rate the Faculty whose rotation you have just completed.
Name: 


  1. Please List the faculty preceptor you are evaluating.


  1. Role of Preceptor?
    Attending Physician
    Nurse Case Manager
    Clinical Social Worker
    Hospice Chaplain
    Music Care Services Team Member
    Advanced Practice Nurse


  1. Availibility:

            1 2 3 4 5       N/A
      Physician was prompt. Excellent  Poor  
      Physician spent enough time on rounds; was unhurried. Excellent  Poor  
      Encouraged active housestaff participation. Excellent  Poor  


  1. Teaching Duties:

            1 2 3 4 5       N/A
      Asked questions in a non-threatening way Excellent  Poor  
      Used bedside teaching to demonstrate history taking and physical skills Excellent  Poor  
      Emphasized problem solving Excellent  Poor  
      Accommodated teaching to actively incorporate all members of team Excellent  Poor  


  1. Medical Knowledge:

            1 2 3 4 5       N/A
      Demonstrated broad knowledge of medicine Excellent  Poor  
      Identified important elements in case analysis Excellent  Poor  
      Used relevant medical/scientific literature in supporting clinical advice Excellent  Poor  


  1. Patient Care and Professionalism:

            1 2 3 4 5       N/A
      Displayed sensitive, caring, respectful attitude toward patients Excellent  Poor  
      Showed respect for students Excellent  Poor  
      Served as a role model Excellent  Poor  
      Was enthusiastic and stimulating Excellent  Poor  


  1. Practice Based Learning and Improvement:

            1 2 3 4 5       N/A
      Explicitly encourage further learning Excellent  Poor  
      Motivated resident to self learn Excellent  Poor  
      Evaluated residents ability to analyze or synthesize knowledge Excellent  Poor  


  1. System Based Practice

            1 2 3 4 5       N/A
      Provided useful feedback including constructive criticism to team members Excellent  Poor  
      Balanced service responsibilities and traching functions Excellent  Poor  


  1. Please comment on any answers you provided above.


  1. Would you recommend that this faculty continue to serve as a preceptor for this training program?
    Yes
    No


  1. Rotation Evaluation:
    Please Rate the following.

            1 2 3 4 5       N/A
      The teaching/ didactics Excellent  Poor  
      The relativity of the curriculum to the practice of medicine Excellent  Poor  
      The work schedule Excellent  Poor  
      The responsibility Excellent  Poor  
      Access to procedures Excellent  Poor  
      Time to read and review interesting cases Excellent  Poor  
      Level of meeting rotation goals and objectives Excellent  Poor  


  1. The overall rotation evaluation
      1 2 3 4 5  
    Excellent   Poor





Abbe Leffel
IL