Logan Health Preceptor Evaluation

Please rate your preceptor on how frequently she/he demonstrated the following clinical and professional characteristics. Thank you! We value your feedback.

Efficient use of time *
1 Poor   2 Fair   3 Average   4 Good   5 Very Good  

Sound clinical judgment *
1 Poor   2 Fair   3 Average   4 Good   5 Very Good   N/A  

Clinical proficiency *
1 Poor   2 Fair   3 Average   4 Good   5 Very Good   N/A  

Effective teaching skills *
1 Poor   2 Fair   3 Average   4 Good   5 Very Good  

Interest in new experiences *
1 Poor   2 Fair   3 Average   4 Good   5 Very Good   N/A  

Self-directedness *
1 Poor   2 Fair   3 Average   4 Good   5 Very Good  

Ability to establish rapport with others *
1 Poor   2 Fair   3 Average   4 Good   5 Very Good  

Copes well with change *
1 Poor   2 Fair   3 Average   4 Good   5 Very Good   N/A  

Demonstrates positive professional image *
1 Poor   2 Fair   3 Average   4 Good   5 Very Good  

Interest in working with students *
1 Poor   2 Fair   3 Average   4 Good   5 Very Good  

Preceptor Name *

Student Name

Date of Experience

Enter Your School Name

Enter the name of your program

Enter the KRH department where you had this experience: *

Please add any additional comments/suggestions: