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EVALUATION SHEET Flattened

This document contains an evaluation sheet for medical interns at the Remedios Trinidad Romualdez Medical Foundation. It outlines the criteria and scoring system that will be used to evaluate interns technically and behaviorally during their clinical practicum. The technical evaluation, worth 40% of the practicum grade, will assess an intern's preparedness, technique, accuracy, speed, neatness, and theoretical knowledge in laboratory work. The behavioral evaluation, worth 30% of the grade, will evaluate personal qualities, work ethic, relationships, and responsibility. Interns will receive individual scores in these areas from staff and instructors after each section rotation.

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Reah Jayzel Alkuino
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39 views2 pages

EVALUATION SHEET Flattened

This document contains an evaluation sheet for medical interns at the Remedios Trinidad Romualdez Medical Foundation. It outlines the criteria and scoring system that will be used to evaluate interns technically and behaviorally during their clinical practicum. The technical evaluation, worth 40% of the practicum grade, will assess an intern's preparedness, technique, accuracy, speed, neatness, and theoretical knowledge in laboratory work. The behavioral evaluation, worth 30% of the grade, will evaluate personal qualities, work ethic, relationships, and responsibility. Interns will receive individual scores in these areas from staff and instructors after each section rotation.

Uploaded by

Reah Jayzel Alkuino
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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REMEDIOS TRINIDAD ROMUALDEZ MEDICAL FOUNDATION

CALANIPAWAN ROAD, TACLOBAN CITY

EVALUATION SHEET

NAME OF INTERN: ALKUINO,


DURAN,REAH JAYZEL G.
DANIELLE R.
AFFILIATED LABORATORY: ____________________________________________
SECTION ASSIGNMENT: ________________________________________________
TECHNICAL EVALUATION

The intern will be evaluated by the following: Staff Medical Technologist of each section,
the Clinical Instructor and by the Chief Medical Technologist using the technical evaluation
form with criteria stipulated therein on a scale of 1 – 5.

The average rating / score on these criteria will be the technical evaluation grade of the
intern and will be equivalent to 40% of the practicum grade.

Technical Evaluation Criteria

A. Preparedness
- knows immediately what to do with the assigned work. 5 4 3 2 1 NA
B. Organization
- works in an organized manner 5 4 3 2 1 NA
C. Technique
- follows the right / proper technique such as:
counting, culturing, pipetting, smearing, etc. 5 4 3 2 1 NA
- careful and cautious in his / her work 5 4 3 2 1 NA
D. Accuracy and Precison
- obtains values close to that of the true value 5 4 3 2 1 NA
- obtains test values that are close to one another
using the same sample and same 5 4 3 2 1 NA

- accurate in reporting laboratory results 5 4 3 2 1 NA


E. Speed
- has the ability to follow instructions immediately 5 4 3 2 1 NA
- fast in finishing his/ her work 5 4 3 2 1 NA
F. Neatness
- keeps his / her working area clean and organized at all times 5 4 3 2 1 NA
G. Equipment and Apparatus Care
- knows how to handle the equipment and apparatus with 5 4 3 2 1 NA
outmost care
H. Self – Confidence
- trusts his / her abilities in doing assigned tasks right 5 4 3 2 1 NA
away
I. Apparent Theoretical Knowledge
- knows the theory behind his/ her work 5 4 3 2 1 NA

J. Application 5 4 3 2 1 NA
- knows how to make use of theoretical knowledge in
his / her practical work
BEHAVIORAL EVALUATION CRITERIA:

Behavioral evaluation of each intern will be done using the evaluation form following the criteria
stipulated on a scale of 1 – 5.
The average rating / score on these criteria will be the evaluation grade of the intern and will be
equivalent to 30% of the practicum grade.
A. Personal Grooming / Appearance 5 4 3 2 1 NA
B. Interest in his / her work 5 4 3 2 1 NA
C. Initiative 5 4 3 2 1 NA
D. Willingness to work beyond the call of duty 5 4 3 2 1 NA
E. Punctuality 5 4 3 2 1 NA
F. Honesty 5 4 3 2 1 NA
G. Willingness to accept criticisms 5 4 3 2 1 NA
H. Willingness to accept challenge 5 4 3 2 1 NA
I. General manner in dealing with patients 5 4 3 2 1 NA
J. General attitude towards work 5 4 3 2 1 NA
K. Responsibility towards work 5 4 3 2 1 NA
L. Dependability 5 4 3 2 1 NA
M. Helpfulness towards others 5 4 3 2 1 NA
N. Relationship staff and co – interns 5 4 3 2 1 NA
O. Cooperation with co – interns 5 4 3 2 1 NA
P. Ability to make use of vacant time usefully 5 4 3 2 1 NA
Q. Maintenance of laboratory supplies 5 4 3 2 1 NA
R. Economy with laboratory supplies 5 4 3 2 1 NA
S. Emotional balance 5 4 3 2 1 NA
T. Leadership ability 5 4 3 2 1 NA
Interpretation

5- Most Desirable = 95%


4- Very Desirable = 90%
3- Desirable = 85 %
2- Less Desirable = 75%
1- Least Desirable = 70%
NA- Not Applicable
Note: Evaluation on both technical and behavioral aspects will be done after each rotation of the
intern in a particular section.
Technical Score :_______________ Behavioral Score :__________
Evaluated by :__________________
CI in charge: ___________________

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