Relevant. Resolute. Ready.
Date:
Student name:
Faculty name:
| Behavior | Good | Fair | Needs Improvement |
|---|---|---|---|
| Integrity: Consistent honesty; trustworthy with the property of others; trustworthy with confidential information; complete and accurate documentation. | |||
| Compassion: Acts to support others who are suffering, actively listens to patients and families and demonstrates concern. | |||
| Accountability: Takes responsibility for actions, complete assignments, open to constructive feedback. | |||
| Respect: Polite to others, does not use derogatory or demeaning terms; has a manner that brings credit to the profession. | |||
| Empathy: Responds appropriately to the response of patients and family members; demonstrates respect for others; supportive and reassuring to others. | |||
| Self-Motivation: Takes initiative to complete assignments; takes initiative to improve and/or correct behavior; takes on tasks and follows through without constant supervision; shows enthusiasm for learning and improvement; consistently strives for excellence in all aspects of patient care and professional activities; accepts constructive feedback in a positive manner; takes advantage of learning opportunities. | |||
| Appearance and Personal Hygiene: Clothing and uniform is appropriate, neat, clean, and well maintained; good personal hygiene and grooming. | |||
| Self-Confidence: Demonstrates the ability to trust personal judgment, demonstrates an awareness of strengths and limitations; exercises good personal judgment. | |||
| Communications: Speaks clearly; writes legibly; listens actively; adjusts communication strategies to various situations. | |||
| Teamwork and Diplomacy: Places the success of the team above self-interest; not undermining the team; helps and supports other team members; shows respect for all team members; remains flexible and open to change; communicates with others to resolve conflict. | |||
| Patient Advocacy: Does not allow personal bias or feeling interfere with interactions with others; places the needs of patients above self-interest; protects and respects patient confidentiality and dignity. | |||
| Cultural Competency: Maintains awareness of the assumptions and biases related to cultural issues and how they may affect patients, peers and all others involved in the delivery of medical care. Seeks to learn about others’ cultural identities and looks at how one’s own background and social environment have shaped the individual. Provides culturally competent, equitable and medically appropriate care to each and every patient no matter their background. |
Additional comments:
Student signature:
Faculty signature:
| Relevant. Resolute. Ready. | |