Department of Family & Community Medicine

Student Evaluation of Clerkship Activities

Please evaluate your experiences here at the Family & Community Medicine Clerkship.  Be specific about strengths and weaknesses in your comments.  Your honest and constructive criticism will be used to improve the clerkship for students in the future. 

Name:  

Clerkship Rotation: 

1=Poor, not useful;  2=Below Average, barely useful;  3=Average;  4=Above Average, quite useful;  5=Excellent, very useful

Discussion Groups

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2

3

4

5

The chosen readings complemented similar cases seen and broadened my knowledge base.

The discussion group process helped my understanding of the readings.

The process of connecting and meeting was…

The discussion group process provided a useful education tool to facilitate my learning in the FCM clerkship.

The provided information was evidence-based.

The information gained will be useful in the future.

Comments/Suggestions:

1=Poor, not useful;  2=Below Average, barely useful;  3=Average;  4=Above Average, quite useful;  5=Excellent, very useful

Curricular Assignments

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2

3

4

5

Patient-Centered Medical Home Reflective Writing

How useful was this assignment?

Appropriate content for your level of training

How useful were the presentations of others?

Quality Improvement Sheet/PDSA

How useful was this assignment?

Appropriate content for your level of training

Essential Evidence Plus Worksheet

How useful was this assignment?

Appropriate content for your level of training

How useful were the presentations of others?

Case related secure messages

How useful was this assignment?

Appropriate content for your level of training

COPC/ Health Literacy Assignment

How useful was this assignment?

Appropriate content for your level of training

How useful were the presentations of others?

Critical Appraisal/ Pub Med

How useful was this assignment?

How useful were the presentations of others?

This helped my understanding of basic & clinical sciences.  

Comments/Suggestions:

1=Poor, not useful;  2=Below Average, barely useful;  3=Average;  4=Above Average, quite useful;  5=Excellent, very useful

Simulated Patient Encounters/Clinical Competency Exam (CCX)

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3

4

5

How would you rate the quality of the cases (challenging, realistic, etc.)?

How useful was faculty feedback?

Overall rating:  

Comments/Suggestions:  (Please feel free to comment on the SP also)

1=Poor, not useful;  2=Below Average, barely useful;  3=Average;  4=Above Average, quite useful;  5=Excellent, very useful

Computer and Written Quizzes:  Rate each station on content and how well you think they assessed your skills.

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5

Chronic Care Model

COPC

Health Disparities

Health Literacy

Legal/Ethical

PCMH

Population Health

Practice Management

Pub Med Literature Search

QI/PDSA

Secure Messaging

Comments/Suggestions:

1=Poor, not useful;  2=Below Average, barely useful;  3=Average;  4=Above Average, quite useful;  5=Excellent, very useful

NBME Exam

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2

3

4

5

This was useful for evaluating my knowledge in the FCM clerkship

Comments/Suggestions:

1=Poor, not useful;  2=Below Average, barely useful;  3=Average;  4=Above Average, quite useful;  5=Excellent, very useful

Overall Clerkship Evaluation:

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2

3

4

5

The design and organization of the clerkship promoted student learning.

Overall rating of the FCM Clerkship

The overall teaching I received was ...

The overall feedback I received was ...

The clerkship directly increased my knowledge and skills.

Comments/Suggestions:

How did the clerkship give you a better understanding of the discipline of Family Medicine?

List the beneficial/positive experiences or aspects of this clerkship.

List the negative/weak experiences or aspects of this clerkship.

What recommendations can you make for improvement of the clerkship? 

Have you personally experienced or witnessed student abuse during this clerkship?  If yes, briefly describe.

Yes   No 

In this clerkship was an appropriate amount of time devoted to basic science concepts?  

Yes   No 

Other comments or suggestions:

 

PRECEPTOR EVALUATION

 

Preceptor Name:

1=Poor, not useful;  2=Below Average, barely useful;  3=Average;  4=Above Average, quite useful;  5=Excellent, very useful

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2

3

4

5

Preceptor showed enthusiasm about teaching and about having me in the office.

Preceptor encouraged me to ask questions.

Preceptor encouraged me to formulate treatment plan and follow up.

Preceptor encouraged me to spend time with other staff in the office.

Preceptor provided me with timely and appropriate feedback.

Preceptor alerted me to clinical insights, data or cues I had missed.

I was given appropriate and sufficient autonomy.

I felt comfortable with the amount of responsibility given to me.

I was listened to and treated professionally.

I felt that I made an active and positive contribution to patient care.

I assisted in the management of care in the hospital if available.

I accompanied my preceptor to hospital meetings, clinic/business meetings, home visits, nursing home, Emergency room

If your mentor used an EHR, did your mentor allow you to access the EHR in the course of patient care?

If your mentor used an EHR, did your mentor have you complete an office visit note in the EHR for the patients you saw? 

I had clear understanding of what I should do to improve my performance.

Overall rating of preceptor.

Other comments or suggestions:

 

  Thank you for taking time to complete this information.

  

 


 Contact us: Harald Lausen, DO (Curriculum Information)
Jean Afflerbach (Web Master)

Page last updated 02/19/2015

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