University of Manitoba
Department of Obstetrics & Gynecology
Clerkship Gyn Clinic Eval Period 7 Dr. Sett |
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 | Name of Clerk | |
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 | Name of Evaluator | |
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 | Evaluation Date | |
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Criteria -
(For the following questions, any responses that are marked with an * must have a rationale for the rating.)
1* - Unsatisfactory -Does not meet the standard. 2 - Satisfactory - Meets the standard. 3 - Excellent - Exceeds the standard. |
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 | Interpersonal and Communication |
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| Rationale for Rating - Interpersonal and Communication Skills: |
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 | Patient Care |
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| Rationale for Rating - Patient Care: |
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 | Dependability / Responsibility |
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| Rationale for Rating - Dependability / Responsibility: |
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 | Student Strengths |
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 | Areas for Improvement |
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