Health Promotion Project Grading Form

Student Clinical Site & Preceptor Evaluation

Your feedback regarding your clinical experience is very important to the ongoing assessment and improvement process of the Hofstra Physician Assistant Studies Program. Please complete this confidential evaluation of your clinical site and preceptor on Exxat. We also ask that you provide detailed recommendations, using professional language, on how this experience may be improved. Your input is voluntary and appreciated. Your comments will not in any manner, affect your final clerkship grade.

ROTATION:

1- FM 2- Med 3- Ob/Gyn 4- Surg 5- EM 6- Psych 7- Peds 8-Elective:

ROTATION NUMBER: 12 3 4 5 6 7 8 ROTATION SITES:

Please rate the following learning experiences as appropriate to your rotation as: 5= Strongly Agree 4= Agree 3= Neither Agreenor Disagree 2= Disagree 1= Strongly Disagree N/A = Not Applicable to this clinical rotation

Clinical Rotation Site Evaluation

1. The clinical site provided students with an orientation to thesetting 2. The clinical site provided students with the opportunity to collaborate with/become a part of the medical team 3. The clinical site made students feel comfortable approaching staff with questions 4. The clinical site provided students with opportunities to interview and examine patient 5. The clinical site provided students with the ability to observe, learn, assist and/or perform clinical procedures 6. The clinical rotation, in conjunction with self-study, enabled the students to achieve stated learning objectives

Preceptor Evaluation

1. The preceptor provides students with the opportunity to formulate differential diagnoses and management plans 2. The preceptor provides students with the ability to observe, learn, assist and/or perform clinical procedures 3. The preceptor provides adequate supervision for thestudents 4. The preceptor provides students with the opportunity to present patients tothem 5. The preceptor provides guidance regarding student’s clinical notewriting 105