Beruflich Dokumente
Kultur Dokumente
U-~~CU
~O~S
Clinical Facility~~~
(~1~G
\ ~
Date:
0-\ \J-\
\~I
Clinical Evaluation
512-133 Clinical 2
Scoring for Clinical Evaluation 4 = Excellent 3.5 = Very Good 2.5 = Average 2 = Acceptable
Comments
4@
.-
2.5
2 2 2
8)3.5
3 2.5
- 2. Demonstrates Dependability
Missed daysft
8
~
I
3.5 312.5
I
I
3. Communicates effectively
(8)3.5 3 2.5 2
0
..:
3.5 3 2.5
B. PerformsAssigned
'.
Duties.
;-'
.4
'.
~)
]3.5
3.5
3 2.5 .2
I
o
0
.'
1. Acknowledges the S-T's limits of individual responsibility: self, profession and employer. 2. Adheres to legal responsibilities
31 2.5 2
0)3.5
2.5
8
4.5
3.5 3
2.5
V"
.
- -
3 2.5 2 2,5 2
;
{v 3.5
..
Demonstrate
needed for tIre surgical procedure using preference card. 2. Scrubs, gowns and gloves self fo]]owmg site routine.
3. Sets up sterile table with instruments, supplies, equipment
{V3.5
2.5
(8)3.5 3 2.5 2 0
4 3.5G 2.5 2 0
and medicatine/soluaons
for the procedure.
needed
4
the circulator prior to the procedure and before the incision is closed.
5. Gowns and gloves team.
3'D
3
2.5
~3.5 4 3.5
2.5
2 2
0 0
G) 2.5
4 3.502.5
surgeon's requests 10. Sequences surgical procedures 11. Passes sutnre safely. 12. Initiates
GOIIJIts
3.5(})
2.5 2
2
0 0 0
at needed times
2.5 2
during procedures.
4J~
~
p..5
20
3 2.5 2 0
Ins~\~ctO!r"':s Comments;
\\U~'10CL -IJ,
~0lL~~'
.. mO,\0J'I'j ~o::\~'o~c::ht\QS
\A'P( v.
~~'J
()-\\ "v'NL
\0 \..sL
o-b
~'N--
5.-\'Llt fUQds -to uA\lL \'?t 'SU u)o J}Sn c.~ 03Jl-d s O/t, '-\1."-90 I'- "* ~
jX~d LO"~-\o
Evaluat~
Student's Signature:
l-'6\
_____________ Date: