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Individualized CAE Rotation Evaluation Form

This form is for Individualized CAE rotations that are evaluated with a letter grade.

Directions:

For each aspect of clinical work, check the box that best describes the student's performance.

Please use comments to describe strengths and weaknesses. Be specific with your feedback and provide examples where appropriate. Marginal/unsatisfactory grades should be accompanied by specific feedback to assist if remediation becomes necessary.

The final letter grade is not derived from a formula driven by the categories below, but is one, single letter grade of the supervisor's choosing, that he/she feels best represents the student's overall performance.

Levels of performance on the grading form roughly correlate with the following letter grades:

  • A = Superior
  • B = Satisfactory
  • C = Marginal - Needs Improvement/remediation
  • E = Unsatisfactory - Failure/will result in dismissal

Note: Not all categories and key phrases apply to all rotations


 

Please provide the name of the location/practice where the student completed the rotation.
Please provide the name of the advisor who supervised the student during their rotation.
Please provide the date the student began their rotation.
Please provide the date the student finished their rotation.
Not ObservedUnsatisfactoryMarginalSatisfactorySuperior
Knowledge of anatomy and physiology *
Knowledge of diseases *
Knowledge of therapeutics *
Rounds participation *
Not ObservedUnsatisfactoryMarginalSatisfactorySuperior
History taking *
Physical exam *
Technical or procedural skills *
Patient care *
Case presentation *
Organizational skills and efficiency *
Written communication *
Not ObservedUnsatisfactoryMarginalSatisfactorySuperior
Development of problem lists *
Assessment and reasoning in case management *
Appropriate diagnostic and therapeutic plans *
Independent learning/self-directed use of reference materials/resources *
Not ObservedUnsatisfactoryMarginalSatisfactorySuperior
Verbal communication *
Non-verbal communication *
Teamwork and collegiality *
Not ObservedUnsatisfactoryMarginalSatisfactorySuperior
Reliability *
Punctuality *
Self-motivation and initiative *
Self-aware of strengths and limitations *
Respectfulness *
Not ObservedUnsatisfactoryMarginalSatisfactorySuperior
Formulate clear plans for wellness based on life stage *
Apply disease prevention and control strategies *
Promote food security and safety *
Practice good biosecurity *