Preceptor Evaluation of Student Preceptor Evaluation of Student – Family Medicine Preceptorship Preceptor NameName of Clinic/PracticeStudent NamePlease complete this assessment of how thoroughly this student accomplished the objectives of the preceptorship program.During the preceptorship experience, the student:Was punctual on each assigned clinic day. Outstanding Above Average Average Below Average Presented/dressed in a professional manner. Outstanding Above Average Average Below Average Displayed a positive attitude and was eager to learn. Outstanding Above Average Average Below Average Related well to clinic support staff. Outstanding Above Average Average Below Average Related well to patients. Outstanding Above Average Average Below Average Appropriately demonstrated the elements of an effective patient interview, including a history and physical. Outstanding Above Average Average Below Average Used scientific reasoning in a standard approach to clinical problem solving. Outstanding Above Average Average Below Average Observed and/or performed simple diagnostic and therapeutic procedures. Outstanding Above Average Average Below Average Learned the value of maintaining accurate medical records. Outstanding Above Average Average Below Average Learned the basic principles of office management and standard methods of business practice. Outstanding Above Average Average Below Average In your observation, what did the student do well?Would you be willing to serve as a preceptor for future students? Yes No
