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University of Illinois College of Medicine SURGERY CLERKSHIP STUDENT EVALUATION FORM Student's Name: Evaluation Date Name: Attending Rotation Time Period: Resident Intern Fellow Inpatient Outpatient
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How to fill out a blank clerkship evaluation:

01
Start by reviewing the evaluation form and familiarizing yourself with the criteria and rating scales. This will give you a clear understanding of what is being evaluated and how to fill out the form.
02
Provide honest and objective feedback. Reflect on your experience during the clerkship and evaluate the clerk's performance based on the given criteria. Use specific examples and anecdotes to support your ratings and comments.
03
Be constructive in your feedback. If there are areas where the clerk needs improvement, offer suggestions or resources that may help them develop those skills or knowledge areas.
04
Use clear and concise language. Avoid using jargon or technical terms that may not be easily understood by others who will be reviewing the evaluation.
05
Complete all sections of the evaluation form. Make sure to address each aspect of the clerk's performance and provide a rating or comment for each one.
06
Proofread your evaluation before submitting it. Check for any grammatical errors or typos that may affect the clarity or credibility of your feedback.

Who needs blank clerkship evaluation?

01
Medical schools: Blank clerkship evaluations are needed by medical schools to assess the performance of their students during their clerkship rotations. These evaluations help in determining if the students have met the required competencies and if they are ready to progress in their medical education.
02
Residency programs: Residency programs require clerkship evaluations as part of their application process. These evaluations provide an insight into the applicant's clinical abilities, professionalism, and other qualities that are crucial for success in their chosen specialty.
03
Clerks: Blank clerkship evaluations are used as a tool for self-reflection and improvement. By receiving feedback from their supervisors and colleagues, clerks can identify their strengths and areas needing improvement, allowing them to grow and develop as future healthcare professionals.
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Blank clerkship evaluation refers to a form used to assess the performance of a clerk during their training period.
The supervisor or instructor who oversees the clerkship is generally required to file the blank clerkship evaluation.
The blank clerkship evaluation form typically requires the supervisor to rate the clerk's performance in various areas and provide comments or feedback.
The purpose of the blank clerkship evaluation is to provide feedback to the clerk on their performance and to assess their readiness to practice independently.
The blank clerkship evaluation usually includes details on the clerk's skills, knowledge, professionalism, and overall performance during the training period.
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