Raven EMS Education Program Manual
Clinical Student Evaluation Form

During Field Internship, each shift needs a Shift Evaluation (this form) AND a Team Lead Evaluation (if ALS student) for every patient contact.

Thank you for being a preceptor for a Raven clinical student. For the student to get credit for completing this clinical, a Shift Evaluation must be completed by the preceptor.

Student type:

Change Log (3.85.188.CSEF)

DateAuthorDescription of ChangeCitations
2024-05-28Becker, T.Theron Jack BeckerAdded clinical student eval, team lead eval, & mentor approval forms.(Becker, 2023)Becker, T. (2023). CMH education manual. OzarksEMS. https://ozarksems.com/edman.php
2024-08-27Becker, T.Theron Jack BeckerMoved the clinical eval form to Google Drive Forms
2025-01-02Becker, T.Theron Jack BeckerMoved online from Adobe InDesign document. Fully built out a dynamic form that will email results of submitted evaluations and store in an online database.
Relevant. Resolute. Ready.
Raven EMS Education Manual - Table of Contents
BeckerTeam (main page)