STUDENT CLINICAL SITE & PRECEPTOR EVALUATION STUDENT/PRECEPTOR REVIEW OF INSTRUCTIONAL OBJECTIVES AND LEARNER OUTCOMES

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 Agree nor 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 the setting 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 the students 4. The preceptor provides students with the opportunity to present patients to them 5. The preceptor provides guidance regarding student’s clinical note writing 106

6. The preceptor gives the students feedback regarding their performance throughout the clinical rotation 7. The preceptor encouraged the student to ask question and was approachable

Site/Preceptor Evaluation

1. Would you recommend this site to other students? a.Yes b.No c.Unsure d.Why or why not (please be detailed and use professional language)

2. Would you recommend this preceptor to other students? a.Yes b.No c.Unsure d.Why or why not? (Please be detailed and use professional language)