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    Student Self-Assessment Faculty Assessment

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    This document contains a student evaluation form with sections for student self-assessment, faculty assessment, and assessment of competencies. The faculty provides feedback on areas the student is doing well and can improve, and rates the student's competencies. The student is required to bring their completion records and both the student and faculty sign off on the evaluation.

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    Student Self-Assessment Faculty Assessment

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    26 views1 page
    This document contains a student evaluation form with sections for student self-assessment, faculty assessment, and assessment of competencies. The faculty provides feedback on areas the student is doing well and can improve, and rates the student's competencies. The student is required to bring their completion records and both the student and faculty sign off on the evaluation.

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    Mid_Clerkshipform

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    This document contains a student evaluation form with sections for student self-assessment, faculty assessment, and assessment of competencies. The faculty provides feedback on areas the student is doing well and can improve, and rates the student's competencies. The student is required to bring their completion records and both the student and faculty sign off on the evaluation.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    26 views1 page

    Student Self-Assessment Faculty Assessment

    Uploaded by

    max
    This document contains a student evaluation form with sections for student self-assessment, faculty assessment, and assessment of competencies. The faculty provides feedback on areas the student is doing well and can improve, and rates the student's competencies. The student is required to bring their completion records and both the student and faculty sign off on the evaluation.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
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    of 1

    STUDENT NAME: _ ______________________SITE: __ ________________________

    EVALUATOR: _ ________________________________DATE: ________________

    Student Self-Assessment Faculty Assessment


    What am I doing well? What is the student doing well?
    1. 1.
    2. 2.
    3. 3.

    Where can I improve? Where can the student improve?


    1. 1.
    2. 2.
    3. 3.
    Faculty Assessment Something to Doing Well A Particular Cannot Assess
    of Competencies: Focus On Strength
    Medical Knowledge
    Patient Care
    Interpersonal &
    Communication Skills
    Practice Based
    Learning and
    Improvement
    Systems-based Practice
    Professionalism

    Student must bring Meditrek print out that shows that at least half Mandatory Encounters have
    been completed.

    ¨ I have reviewed the student’s Meditrek log.


     Deficiencies/gaps noted:
    ______________________________________________________________
    Student Plan/Action Items in Response to Above Feedback:
    1.
    2.
    3.
    Evaluator Signature: ___________________________________ Date: __________________
    Student Signature: ____________________________________ Date: __________________

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