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Post-Shift Clinical Rotation Evaluation by the Clinical Preceptor

We use this information to improve our students, our instructors, and our program.
What paramedic student are you evaluating
First Name:   
Last Name:   
Preceptor information
First Name:   
Last Name:   
Title / Position
   
When did the student start his/her shift?
Clinical Site:
If Other, please specify:   
Department:
If Other, please specify:   
General Assessment Matrix.
Consider each item separately and rate each item independently of all others.

Please do not skip any rating, if the statement does not apply to your experience, select "Not applicable."
 Strongly AgreeGenerally AgreeNeutral (acceptable)Generally DisagreeStrongly DisagreeNot Applicable
The paramedic student values guidance by any healthcare personnel and demonstrates a willingness to learn.

The paramedic student communicates compassionately and effectively with patients and family.

The paramedic student communicates compassionately and effectively with patients and family.

The paramedic student communicates well with other members of the patient care team.

The paramedic student demonstrates professional behavior (tasks done in a timely manner, is dependable, courteous, motivated and shows initiative).

The paramedic student completes patient care documentation clearly and legibly.

The paramedic intern is dressed properly and is clean at all times.

The paramedic intern adheres to all rules and procedures of the specific clinical site.

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