In order to give effective feedback, a physician needs to develop a sound teacher-student relationship. During the first month, the preceptor should observe the student daily doing interviews and examinations in order to gauge the student’s level of competence and to instruct him/her in areas that need improvement. Evaluation methods and instruments are designed to enhance the student’s learning experience, not just measure performance. Verbal feedback and evaluations are an integral part of the clerkship experience. A lack of direction and ongoing feedback are the most significant shortcomings identified by students during the clinical portion of their training--hallway discussion and off-handed feedback are not as powerful as sitting down and having a private dialogue with the student.

One tool that is helpful is the Daily Feedback Card. Keep it handy and try to note something each day to discuss with the student. Then use it at the end of the rotation to do the final evaluation on the student.

It is suggested that there be weekly meetings between the preceptor and the student; organized discussion and feedback will give the student the opportunity to talk about particular patients and present one or more cases to the preceptor for critique. Additionally, the feedback sessions are a great opportunity for the physician preceptor to review the student’s professional progress (charts, records and activity data), discuss strengths and areas that need improvement, make suggestions for additional study and talk about any personal problems the student may be dealing with. See the WRITE Progress Report and Feedback Summary Form, due in to your WWAMI Regional Dean at the end of each month.

The following Weekly Feedback & Evaluation Reference List was developed to aid the preceptor in evaluating the student’s progress and in offering feedback:

Communication Skills:

• Interactions with patients
• Clinic and hospital staff relations
• Interaction with consultants
• Community relations

Clinical Skills:

• History taking skills & physical exam techniques, both clinic and hospital based
• Procedural skills

Knowledge base:

• Differential diagnosis
• Treatment plans
• Hospital progress notes & orders

Overall experience:

• Data entries in the student's Patient Visit Log should indicate that the student is getting a variety of experiences

Self-discipline and level of satisfaction:

• Attitude regarding assigned responsibilities - how are things going from the student’s perspective?
• Timeliness - efficient use of time?
• Use of personal time - are there any needs?
• Use of reading time

Evaluations using E*Value

Evaluations are accomplished using the online E*Value evaluation program. In May, a direct link will be sent to the primary preceptor to access the system. It is a good idea to print out the old evaluation forms and distribute those to all preceptors who have worked with a student in a significant way in either FM, IM, Peds, or Psych, collect those preceptor evaluations, and then create a summary of comments and ranking BEFORE sitting down to do the online evaluation. When the four-week clinical elective in FM is complete, another link will be sent out to the primary preceptor to do an evaluation for that clerkship experience (keeping in mind that the performance of the student at that point should be as a fourth year sub-I student).

It is important to do a "good" evaluation: Please be sure that the grading anchors match the comments about student performance AND that the comments are specific, descriptive, and substantive.

Comment Examples: "the Good, the Bad and the Ugly"

• The Ugly: Jenny was a great student.
• The Bad: Jenny was a hard working student, got along well with others, and was always prepared.
• The Good: Jenny was intellectually curious, thoroughly researched her patient's diagnosis, and went the extra mile. Staff and patients commented on how much they enjoyed working with her. She developed outstanding rapport with her patients and took ownership for their care.