SIU School of Medicine, Department of Psychiatry

Student Evaluation of Psychiatry Clerkship


Please respond to each item carefully and thoughtfully.  Select the appropriate rating
for each item.  Add specific comments at the bottom of this form regarding strengths and areas for improvement


NAME:    

Clerkship Rotation: 


 

1.  Inpatient Experience:

 


Excellent

Very
Good


Good


Fair


Poor

Very
Poor

N/A

 

Consult/Liaison

 

Lincoln Prairie Behavioral Health

 

McFarland Mental Health Center Adolescent Unit

 

Memorial Medical Center 5A/5G

 

Substance Abuse

 

St. John's 10th Floor

2.  Outpatient Experience

 
 


Excellent

Very
Good


Good


Fair


Poor

Very
Poor

N/A

 

Acute Care Clinic 

 

Acute Care Clinic - MHCCI

 

Child/Adolescent Clinic   

 

Child/Adolescent NPE   

 

Child Medication Management

 

Children's Center Clinic

 

Community Support Network

 

Forensic Clinic  

 

Gateway

 

Geriatric Clinic  

 

Jacksonville Developmental Center

 

Medication Management

 

New Patient Evaluation

 

NPE Disposition

 

Psych/Onc - Head and Neck Clinic

 

Psych/Onc - Prostate Clinic

 

Psych/Onc - Breast Clinic

 

Psych/Onc - Urology Clinic

 

Psychotherapy

 

Rural Psychiatry

 

Special Needs Clinic  

 

Telepsychiatry Clinic

 

TMS Clinic

3.  Assigned Responsibility for patients was commensurate with your training

 


Excellent

Very
Good


Good


Fair


Poor

Very
Poor

N/A

 

Inpatient:

 

Outpatient: 

4.  Patients were assigned to you with an appropriate range of psychiatric disorders

 


Excellent

Very
Good


Good


Fair


Poor

Very
Poor

N/A

 

Inpatient:

 

Outpatient: 

5.  Goals and expectations were clearly communicated: 

 

6.  Specific feedback on your work was given: 

 
7.  Feedback on written notes was worthwhile:

 

8.  Faculty were role models:

 

9.  Residents were role models:

 

10.  Seminars were useful and practical: 

 

11.  Recommended readings were appropriate:

 

12.  Overall organization of the clerkship:

 

  OVERALL COMMENTS:

What is your overall rating of this clerkship?

Excellent

Very Good

Good

Fair

Poor

Please provide comments on strengths of the clerkship:

What would you do to change this learning experience for future years?

Please comment on quality of teaching you received:

Please list and comment on the texts you used:

Have you personally experienced or witnessed student abuse during this clerkship?  Yes   No 

If yes, briefly describe:

In this clerkship was an appropriate amount of time devoted to basic science concepts?  Yes   No 

     


For problems with this page, please contact Jean Afflerbach
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Revised: March 26, 2014