Information
-
Student Name
-
Conducted on
Evaluation Form
-
INSTRUCTIONS:
Evaluate the student at their CURRENT LEVEL OF TRAINING as a year one student.
OPEN THE DISCUSSION
-
Introduction
-
Agenda Setting
BUILD A RELATIONSHIP
-
Listening
-
Empathy & Attitude
-
Understand patient's perspective
-
Nonverbal Behavior
GATHER INFORMATION
-
History
-
Pace
-
Organization & Transitions
CONTENT OF HPI
-
OLDCARTS of CC
-
Associated Symptoms
-
PMHx relevant to CC
-
Fam Hx relevant CC
-
Social & Habits Hx
-
Allergies & Medications including Self-Medications
CLOSE THE INTERVIEW
-
Shares Information
-
Transition to Preceptor's Entrance Summary
GLOBAL ASSESSMENT
-
Overall Assessment of Interview
-
Additional Comments:
