SRI RAMACHANDRA

INSTITUTE OF HIGHER EDUCATION & RESEARCH

(Deemed to be University)
Sri Ramachandra Medical College & Research Institute

POST GRADUATE -FEEDBACK FORM

A. GENERAL INFORMATION:
A1. ID No (Optional):
A2. Date :
A3. Name of the respondent (Optional):
A4. Name of the course: ____________
A5. Year of study:1 I year 2 II year 3 III year
A6. Age: _____ years
A7. Sex: 1 Male 2 Female
A8. Are you a? :1Hosteller 2Day scholar
A9. Have you done under-graduation from SRMC & RI? 1 yes 2 No
A9. Nationality: 1 Indian 2 Others, Please specify ____________
A10. Mobile number (Optional):
A11. E-mail ID (Optional):
We appreciate your active participation in evaluating our PG program. Please indicate your rating of the PG
program in the categories below by ticking the appropriate box, using a scale of 1 (Strongly disagree) to 5
(Strongly agree). Please fill out all the components of this form. Your responses will be maintained strictly
confidential.

1 3 5
2 4
B. ORIENTATION PROGRAM Strongly No Strongly
Disagree Agree
disagree comments agree
B1. At the start of the first year I was oriented
to the objectives of the Post Graduate (PG)
program
B2. I was sensitized about the MCI norms and
tasks to be completed at the end of PG as
per MCI norms
C. ACADEMICS ( Structured academic schedule by the Department)
C1. Structured academic schedule by the
departments was useful in planning my
learning on a daily basis
C2. Structured academic schedule by the
departments was available to me well in
advance
C3. Timing of the sessions and format of the
structured academic schedule addressed
all my learning needs
D. TEACHING – LEARNING METHODS ( Practical/Clinical - whichever applicable)
D1. Adequate resources
(patients/equipments/opportunities)
were available to obtain clinical/practical
skills
D2. Faculty guided/trained me adequately to
obtain clinical/practical skills
 D3. Appropriate teaching-learning methods
were used by the faculty to obtain
clinical/practical skills
E. RESEARCH ( Thesis / Oral / poster presentation)
E1. Faculty helped me in planning, execution
and submission of my thesis work
E2. Faculty trained me to do oral / poster
presentation in conferences
E3. Faculty supported / motivated me to take
up additional research opportunities
F. MONTHLY FEEDBACK ( Formative assessment)
F1. Monthly feedback given by the faculty was
very beneficial for improving my learning
outcomes
F2. Faculty gave friendly and constructive
feedback
G. COMMON INTERNAL ASSESSMENT
G1. Common internal assessment at regular
intervals improved my confidence towards
final exams
G2. I was informed about the structured
internal assessment schedule well in
advance enabling me to prepare well
G3. The timing and format of the structured
internal assessment was appropriate for
my course
H. INFRASTRUCTURE
H1. PG training and infrastructure was
adequate to achieve what I wanted to
learn
H2. The infrastructure enabled me to be
confident of skills and procedures that
makes me a better professional in my
chosen field
H3. Facilities for stay, food and library were
adequate and appropriate
H4. I had the opportunity to participate in
quality improvement processes
I. PROFESSIONALISM ( non-scholastic skills)
I1. I had a good team to work with
I2. Faculty, staff and other members had a
cordial working relationship with me and
were always willing and available to help
I3. I have been empowered to effectively
manage time and meet workload demands
J. What were the top three things that facilitated your PG training? (Lectures/ small group
discussions/research/hands on training/regular assessment with feedback/any other)

K. What were the three things that did not facilitate your PG training? (Lectures/ small group
discussions/research/hands on training/regular assessment with feedback/any other)

L. Kindly give suggestions for improvement, if any

SIGNATURE (Optional):
NAME (Optional): DATE: