UNM Medical Student Evaluation

UNM Medical Student Evaluation

This form is for UNM Non-Catalog, Research, Teaching, or Away Electives

EVALUATIONS ARE DUE WITHIN TWO WEEKS OF THE ROTATION END DATE.

Evaluations may be entered directly into this form.

Additional information or host school evaluations may be uploaded where noted.

Student Information

STUDENT First Name*

Please enter the first name of the STUDENT being evaluated.

STUDENT Last Name*

Please enter the last name of the STUDENT being evaluated.

UNM Student ID

Helpful if known. Included on automated reminders. (No dashes, please).

Course Information

Was this rotation done at the University of New Mexico?*

YES

UNM Course Title*

PLEASE SELECT THE UNM COURSE.

Please select or type the course as listed in the emailed reminder.

Select or enter value

Institution of Rotation*

Course Title (Non-UNM)

Please enter the course number and title as listed in visiting student materials.

Rotation Start Date*

Rotation End Date*

Course Type

Clinical Elective

Non-Clinical Elective

Sub-Internship

ICU

Evaluation

In addition to the narrative, ALL EVALUATIONS MUST INCLUDE A GRADE OR GRADE EQUIVALENT OF (Outstanding, Good, Satisfactory, Fail) OR Credit/No Credit.

Do you have a COMPLETED evaluation form from your institution ready for upload?*

PLEASE CHECK ONE OF THE FOLLOWING:

NO - the remainder of this evaluation form will appear for direct entry.

YES - please drag the completed PDF or Word doc to the Document Upload section below.

Document Upload

Any additional supporting documentation (i.e institutional evaluations with narratives) may be uploaded here.

Drag and drop files here or

OVERALL EVALUATION*

(REQUIRED)

Please select one grade (Outstanding, Good, Satisfactory, or Fail) from the dropdown list below to describe this student's overall performance on the rotation.

Select

Credit/No Credit*

"Credit" has been selected by default to account for those rotations that only offer Credit/No Credit. Please change if the overall grade was 69% or lower.

CREDIT (70% or higher)

Professionalism Score

Demonstrates respect, compassion, and integrity
Is reliable, trustworthy, and responsible
Demonstrates sensitivity and responsiveness that supersedes self-interest
Demonstrates commitment to excellence, self-improvement, and adaptability
Arrives punctually

Select

Reporter Score

Collects relevant and reliable (accurate) patient data
Develops a trusting relationship with patients in the collection of data
Communicates data orally and in writing in a complete, organized, and logical manner

Select

Interpreter Score

Recognizes normal and abnormal
Interprets abnormal findings and tests
Identifies and prioritizes problems
Summarizes relevant info from the history, physical exam, and labs and then develops an appropriate assessment using semantic qualifiers (e.g. acute/chronic, bilateral/unilateral, local/systemic).
Creates, ranks, and justifies differential diagnoses
Modifies assessment based on new information
Considers population health issues in developing differential diagnoses
Incorporates psychosocial issues and patient’s understanding in patient assessment

Select

Manager Score

Chooses and justifies appropriate diagnostic tests and treatment plans
Modifies plans based on results and response to treatment
Incorporates patient preferences/needs in negotiating a mutually acceptable treatment plan
Demonstrates competency in performing procedures (if required by clerkship)
Interacts with other providers and systems to provide continuity of care

Select

Educator Score

Identifies knowledge gaps for patient, self, and team and addresses them
Shares new information with others
Evaluates the quality of evidence found
Accepts responsibility for the education of self and the team
Provides clear explanations to patient with verification of understanding

Select

Narrative Evaluation*

(REQUIRED)

Please be as detailed as possible in your narrative, as this will be included in the student's MSPE (Dean's Letter). Explain "above" or "below" expectations; cite the student's strengths.

Please do not include recommendations in this section.

Recommended Suggestions for Improvement*

Amount of Contact*

Select

Evaluator Information

Evaluating Faculty or Department Coordinator Email*

Please list a valid email address for any questions related to this evaluation.

Evaluating Faculty Name and Title*

I certify that I am authorized to submit an evaluation for this student.

Evaluating Faculty Institution

Evaluation Date*

Please click "Submit" at the bottom of this form.

Thank You

We greatly appreciate the time spent evaluating our students. If you have any questions or comments, please do not hesitate to reach out to our office.

University of New Mexico School of Medicine

Office of Medical Student Affairs

hsc-omsa@salud.unm.edu

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