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University of Alabama School of Medicine Student Evaluation Insert Student Picture Here Student s Name: Clerkship: Clerkship Dates: Rater s Name: Ward/Service: Dates on Service: CONSIDERING THE OVERALL
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How to fill out clerkship evaluation form1doc:

01
Start by carefully reading the instructions provided on the form. It is essential to understand what information you need to provide and how to format it correctly.
02
Begin by entering your personal information in the designated fields. This typically includes your name, contact details, and any identification numbers required.
03
Next, provide details about the clerkship or internship program you are evaluating. This may include the name of the institution or organization, the dates of your clerkship, and the department or specialty you were assigned to.
04
Evaluate your overall experience by rating different aspects of the clerkship program such as educational opportunities, supervision, clinical exposure, workload, and support from faculty or staff. Use the rating scale provided and offer specific comments or examples to support your ratings if required.
05
Assess your performance during the clerkship, if applicable. This may involve rating your own knowledge, skills, attitude, and professionalism throughout the program.
06
Provide feedback or suggestions for improvement. Use this opportunity to highlight positive aspects of the program and also suggest any changes that could enhance the experience for future participants.
07
Review your responses to ensure accuracy and completeness. Double-check that all mandatory fields have been filled correctly.
08
Sign and date the form as required. This confirms that the information provided is accurate to the best of your knowledge.
09
Submit the completed form as per the instructions given. This may involve giving it to a designated person or returning it electronically.

Who needs clerkship evaluation form1doc:

01
Medical students or participants in a clerkship or internship program who are required to evaluate their experience.
02
Clerkship administrators or coordinators who use these evaluations to assess the quality of their program and make necessary improvements.
03
Faculty or staff who receive these evaluations to understand the strengths and weaknesses of their educational approach and adjust as needed.
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