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Program Evaluation
Program Evaluation Form
Please complete the following questions appropriate to your time at Children's. All items with a red star * are required fields. When complete, scroll down and click the submit button.
Rotation Information
 
*Campus
 *Unit/Dept
 *If Other Dept, where?
*Start Date
  MM/DD/YYYY 		*End Date
  MM/DD/YYYY 		Preceptor
*Staff Type
 *Training Level
 *Med School/Residency Program
Evaluation
Weak Below
Average		 Average Above
Average		 Very
Strong
*1. Diversity of Patient Problems
*2. Use of Patients for teaching purposes
*3. Opportunities to exercise own clinical judgement
*4. Meaningful discussion of patients with supervising resident, fellow, lead or attending
*5. Teaching Rounds
*6. Conferences
*7. Overall Educational value of this rotation
*8. How satisfied with the experience
*9. Do you feel this rotation has prepared you to care for children
*10. Adequacy of patient volume
*11. If you are a resident, were you able to comply with the Work hour Guidelines?
12. Comments on Work Hour Guidelines
13. General Comments
  
Date Last Modified: 09/13/2012 16:09