Raven EMS Education Program Manual
Skill Instructor Evaluation by Lead Instructor Form

Instructor name:

Date observed:

Observed by:

Topic of instruction:

Instructor Evaluation	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
The instruction was consistent with course content (Question required by NCOEMS).
The instructor was knowledgeable in the skill or scenario presented (Question required by NCOEMS).
The instructor was professional (Question required by NCOEMS).
The instructor was supportive of the students (Question required by NCOEMS).
The instructor demonstrated a positive attitude (Question required by NCOEMS).
The instructor allowed for a maximum use of hands-on practice during the sessions (Question required by NCOEMS).
The students were allowed to progress through the skill/scenarios uninterrupted (other than for safety reasons) (Question required by NCOEMS).

Comments and Signatures
Comments:
Skill instructor signature:
Lead instructor signature:

Change Log (3.85.250.SILI)

Date	Author	Description of Change	Citations
2023-12-13	Becker, T.Theron Jack Becker	Created this form.	(NCOEMS, 2023)NCOEMS. (2023, December 13). EMS education program manual. North Carolina Office of EMS. https://oems.nc.gov/wp-content/uploads/2024/01/NCOEMS-Education-Program-Manual-121323-2.pdf
2025-01-02	Becker, T.Theron Jack Becker	Moved online from Adobe InDesign document.

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