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Health Sciences

College of Education and Professional Studies

Preceptor Evaluation Form

Paramedicine Program

All information collected is strictly confidential. Your primary preceptor for each shift should be evaluated fully with honest, constructive information. A preceptor evaluation form must be completed for each 48 hour shift. Even if you have previously rated the preceptor, you must complete one evaluation for each shift.

Introduced self & applicable personnel; checked out the vehicle with student at the beginning of the shift; reviewed equipment operations (including radio operations).
Introduced self and clearly explained his/her expectations of the student.
The preceptor provided opportunities to review information or skills; assisted student with performance weaknesses; supported EMS Education Faculty’s educational process.
Demonstrated a professional attitude towards the student’s learning experience.
Including, but not limited to: consistently honest; demonstrated ability to be trusted with the property of others or confidential information; completely and accurately documented patient care and learning activities.
Including, but not limited to: showed compassion for others; responded appropriately to the emotional response of patients, family members, and students; demonstrated respect for others; demonstrated a calm, compassionate, and helpful demeanor toward those in need; was supportive and reassuring to others.
Clothing and uniform was appropriate, neat, clean, & well maintained; exhibited good personal hygiene and grooming.
Demonstrated the ability to trust personal judgment; displayed an awareness of strengths and limitations; exercised good personal judgment.
Examples included, but were not limited to: listened actively; provided constructive criticism & discussion with student regarding expectations, performance, remediation, & positive reinforcement; adjusted communication strategies to various situations.
Consistently punctual; rapid response times.
Placed patient care above all else; helped and supported students; showed respect for all team members; remained flexible and open to change; communicated with students/fire department personnel to resolve problems.
Was polite to others; did not use derogatory or demeaning terms; behaved in a manner that brought credit to the profession.
Did not allow personal bias or feelings interfere with patient care or the student’s educational process; provided accurate evaluation of student performance in order to provide a highly effective learning environment; protected and respected patient/student confidentiality and dignity.
Demonstrated mastery of skills/knowledge; exhibited ability to use resources to find information; displayed a thorough knowledge of local protocols and ambulance operations; followed policies, procedures and physician/medical command orders.

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