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Standardized Patient Evaluation of Student
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Standardized Patient Evaluation of Student
Standardized Patient Evaluation of Student
Sam Turner
2019-06-28T12:58:55-06:00
Your Name:
*
First
Last
Student Name:
*
First
Last
Evaluation Date:
*
Date Format: MM slash DD slash YYYY
Did the Student Doctor Verify Your Name and Date of Birth:
*
Yes
No
Only Verified Name
Only Verified Date of Birth
Was the Student Doctor’s Appearance Professional:
*
Yes
No
If not Professional, Please Leave a Comment Why:
*
Did the Student Doctor Wash Their Hands Before Examining You? (With Soap/Water or Hand Sanitizer)
*
Yes
No
Did the Student Doctor Speak in a Way That Was Easy to Understand:
*
Yes
No
Comments:
*
Did the Student Doctor Show Empathy During the Visit? (Showed they Cared, Empathize over condition, deaths in family, etc.):
*
Yes
No
Comments:
*
During the Visit Did the Student Doctor:
Help You Up Onto and Off The Exam Table:
*
Yes
No
Maintain Your Modesty (While Adjusting Gown, Placing Drape, Examining, etc):
*
Yes
No
Shared Information: Clarified, Summarized, Answered Questions, and Discussed Next Steps**:
*
**next steps: report to attending (first year students) or discuss plan (second year students)
Yes
No
Showed Effective Time Management:
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Yes
No
Would you want this student doctor as your doctor in the future?
*
Yes
No
Comment:
*
X
X
