Student Evaluation of Preceptor

For additional information, please contact:
Amy White, Director of TPS Foundation and the General Pediatric Preceptorship Program
401 West 15th Street, Suite 682
Austin, Texas 78701
(512) 370-1519

Date:

Preceptor:

Student:

Please complete the following items by selecting the response that best describes your experience with the preceptor being evaluated. Use the following scale. Omit any question that you are unable to evaluate.

1. I enjoyed my preceptorship experience:

4. My preceptor and I established goals at the outset of the program:

5. My preceptor gave constructive feedback about my performance during the month:

6. My preceptor made adequate time for teaching/learning sessions:

7. My preceptor provided me with the amount of responsibility I thought was appropriate:

8. My preceptor seemed to enjoy teaching and having me in his/her office:

9. My preceptor made my position as a medical student clear to the patient:

10. My preceptor selected appropriate patients for me to interact with.:

11. I gained useful information about office management procedures and office organization:

12. I felt comfortable during my preceptor experience:

13. I gained insight and experience with the community health resources available to my preceptor:

14. My preceptor demonstrated a good balance of personal and professional life:

15. I could see that my preceptor was involved in community medical activities:

16. As a result of the preceptorship experience, I am more likely to enter pediatrics:

The things I found most useful about the preceptorship were:

The things I found least useful about the preceptorship were:

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Student Evaluation of Preceptor

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