Health Professions Survey: Clinical
Please fill out the form below
Which Program are you enrolled in?
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Practical Nursing
Pharmacy Technician
Nursing Assistant
Medical Assistant
Surgical Technologist
Were you with an instructor?
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Yes
No
Name of Instructor
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Baum, Mindee
Birchell, Andrelee
Bird, Bailee
Christensen, Eric
Dean, Jaime
Ellingford, Lindsey
Horrocks, Terri
Howcroft, Taryn
Leishman, Kasaundra
Lloyd, Leigh
Luck, Jeanie
Massey, Tera
Morrisson, Heather
Priebe, Kayti
Rockwood, Adam
Thompson, Angala
Webster, Alicia
Clinical Site Name
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Clinical objectives clearly explained?
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1
2
3
Does Not Meet Expectation
Exceeds Expectation
1 is Does Not Meet Expectation, 3 is Exceeds Expectation
So far, this clinical site has met the defined objectives.
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1
2
3
Does Not Meet Expectation
Exceeds Expectation
1 is Does Not Meet Expectation, 3 is Exceeds Expectation
Clinical environment was favorable for learning.
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1
2
3
Does Not Meet Expectation
Exceeds Expectation
1 is Does Not Meet Expectation, 3 is Exceeds Expectation
Clinical equipment was well organized and easy to use.
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1
2
3
Does Not Meet Expectation
Exceeds Expectation
1 is Does Not Meet Expectation, 3 is Exceeds Expectation
This clinical experience has helped build my confidence in entering the workforce.
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1
2
3
Does Not Meet Expectation
Exceeds Expectation
1 is Does Not Meet Expectation, 3 is Exceeds Expectation
Instructor demonstrated thorough knowledge of the subject.
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1
2
3
Does Not Meet Expectation
Exceeds Expectation
1 is Does Not Meet Expectation, 3 is Exceeds Expectation
Instructor provided useful, real world examples.
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1
2
3
Does Not Meet Expectation
Exceeds Expectation
1 is Does Not Meet Expectation, 3 is Exceeds Expectation
Instructor involved participants in activities and discussions.
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1
2
3
Does Not Meet Expectation
Exceeds Expectation
1 is Does Not Meet Expectation, 3 is Exceeds Expectation
Instructor presented information in a clear, understandable manner.
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1
2
3
Does Not Meet Expectation
Exceeds Expectation
1 is Does Not Meet Expectation, 3 is Exceeds Expectation
Instructor explained the certificate program associated with this course.
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1
2
3
Does Not Meet Expectation
Exceeds Expectation
1 is Does Not Meet Expectation, 3 is Exceeds Expectation
I would take another course from this instructor.
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1
2
3
Does Not Meet Expectation
Exceeds Expectation
1 is Does Not Meet Expectation, 3 is Exceeds Expectation
I plan to complete the program in which I am enrolled.
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1
2
3
Does Not Meet Expectation
Exceeds Expectation
1 is Does Not Meet Expectation, 3 is Exceeds Expectation
Final Thoughts?
Please include what was most valuable about this course, did the time allotted meet the course objectives, any suggestions for improvements, etc.
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