Longitudinal Clerkship Ambulatory Site Evaluation

Thank you for taking the time to complete this evaluation. Your comments and suggestions are very valuable to us and will help us to improve the longitudinal clerkship ambulatory sites.

Ambulatory Site Hilo Kauai Leeward-Kaiser Maui Wahiawa/Pali Momi Waimanalo

Clinics First
Blocks First

Please rate the following:

Accessibility of your site coordinator: Always easy to access Somewhat easy to access Somewhat difficult to access Always unable to access No opinion

Helpfulness of your site coordinator: Very helpful Somewhat helpful Not very helpful Did not utilize the site coordinator at all

Effectiveness of your site for learning: Very effective Somewhat effective Somewhat non-effective Very non-effective No opinion

Would you recommend this site to future students: Yes No

What did you like the most about your ambulatory site?

What did you like the least about your ambulatory site? What could help this site to improve?

Please evaluate your specific clerkship preceptors:

Family Medicine

Who was your Family Medicine Preceptor?

Effectiveness of your preceptor as a teacher: (5=Very effective; 1=Not effective at all)

1 2 3 4 5

Confidence in you preceptor as a clinician: (5=Very confident; 1=No confidence)

1 2 3 4 5

Helpfulness of the Family Medicine Clerkship Director during your ambulatory clinics: (5=Very Helpful; 1=Not helpful at all)

1 2 3 4 5

Please provide some comments regarding your Family Medicine Preceptor:

Internal Medicine

Who was your Internal Medicine Preceptor?

Effectiveness of your preceptor as a teacher: (5=Very effective; 1=Not effective at all)

1 2 3 4 5

Confidence in you preceptor as a clinician: (5=Very confident; 1=No confidence)

1 2 3 4 5

Helpfulness of the Internal Medicine Clerkship Director during your ambulatory clinics: (5=Very Helpful; 1=Not helpful at all)

1 2 3 4 5

Please provide some comments regarding your Internal Medicine Preceptor:

OB/GYN

Who was your OB/GYN Preceptor?

Effectiveness of your preceptor as a teacher: (5=Very effective; 1=Not effective at all)

1 2 3 4 5

Confidence in you preceptor as a clinician: (5=Very confident; 1=No confidence)

1 2 3 4 5

Helpfulness of the OB/GYN Clerkship Director during your ambulatory clinics: (5=Very Helpful; 1=Not helpful at all)

1 2 3 4 5

Please provide some comments regarding your OB/GYN Preceptor:

Pediatrics

Who was your Pediatrics Preceptor?

Effectiveness of your preceptor as a teacher: (5=Very effective; 1=Not effective at all)

1 2 3 4 5

Confidence in you preceptor as a clinician: (5=Very confident; 1=No confidence)

1 2 3 4 5

Helpfulness of the Pediatric Clerkship Director during your ambulatory clinics: (5=Very Helpful; 1=Not helpful at all)

1 2 3 4 5

Please provide some comments regarding your Pediatrics Preceptor:

Psychiatry

Who was your Psychiatry Preceptor?

Effectiveness of your preceptor as a teacher: (5=Very effective; 1=Not effective at all)

1 2 3 4 5

Confidence in you preceptor as a clinician: (5=Very confident; 1=No confidence)

1 2 3 4 5

Helpfulness of the Psychiatry Clerkship Director during your ambulatory clinics: (5=Very Helpful; 1=Not helpful at all)

1 2 3 4 5

Please provide some comments regarding your Psychiatry Preceptor:

Surgery

Who was your Surgery Preceptor?

Effectiveness of your preceptor as a teacher: (5=Very effective; 1=Not effective at all)

1 2 3 4 5

Confidence in you preceptor as a clinician: (5=Very confident; 1=No confidence)

1 2 3 4 5

Helpfulness of the Surgery Clerkship Director during your ambulatory clinics: (5=Very Helpful; 1=Not helpful at all)

1 2 3 4 5

Please provide some comments regarding your Surgery Preceptor: