EVALUATION REPORT
ROTATION: ___________________________ INCLUSIVE DATE: _______________
CLINICAL AREA: ______________________ TIME/SHIFT: ____________________
NAME OF STUDENT: __________________________
GRADING SYSTEM RATING OBTAINED REMARKS
WARD PERFORMANCE (80%)
KNOWLWDGE (35%)
Quizzes 15%
Written Reports/Case Studies,
Journal Readings/ Health Teaching 10%
Knowledge of Principles of
Underlying Care 10%
SKILLS (35%)
Actual Patient Care 10%
Performance of Procedures/ Manipulation
& Care of Equipment and Supplies 10%
Organizational Ability 5%
Communication 10%
ATTITUDE (30%)
Punctuality 10%
Relationship with co-workers 10%
Professional Decorum/Composure 10%
VALIDATING EXAMINATION (20%)
TOTAL
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SIGNATURE OVER PRINTED NAME OF C.I.
Conforme:
__________________________________
STUDENT’S SIGNATURE