Student Evaluation of Preceptor

For additional information, please contact:
Anslee Boozer, Pediatric Preceptorship Program Coordinator
401 West 15th Street, Suite 682
Austin, Texas 78701
(512) 370-1563

Date

Month

Day

Year

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.

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 *

Leave this field blank

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