Appendix 6 – Evaluation of Faculty by Trainee

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Appendix 6 Evaluation of Faculty by the trainee
We welcome your comments about the time you have spent training with us. Please complete the following details so that we can continue to offer the best service possible. Please pass them to the program coordinator after completion of the course.
Please place a check mark in the appropriate box for your answer.  When you are finished with this side please complete the sections located on the back of this form.

Please evaluate the faculty's performance. Select the rating which best describes faculty member's skills and abilities. Identify the major strengths and weaknesses you have observed in the faculty member's performance in the overall comments space.

1 = STRONGLY DISAGREE - Faculty member makes poor decisions or has an unsatisfactory approach to solving problems that results in poor care delivery or unacceptable behavior. Faculty member displays problems with integrity, trustworthiness, compassion, or respectfulness.Faculty member does not appear capable of understanding concepts, exercising judgment and/or demonstrating behaviors that are important to achieve competence for the element being evaluated.

2 = SOMEWHAT DISAGREE - Faculty member is governed by rules, but not capable of utilizing experience to address circumstances that are unexpected or non-typical or inconsistently uses experience to guide decisions or actions. Faculty member deals effectively with routine, repetitive or non-stressful situations but not in challenging circumstances.

3 = NEITHER AGREE OR DISAGREE - Faculty member utilizes learned principles and applies them to guide actions in usual or typical circumstances. Faculty member has developed adequate internal resources to make competent decisions in routine cases. Recognizes limitations and accesses support when needed, especially for more challenging situations.

4 = SOMEWHAT AGREE - Faculty member utilizes principles and applies them to guide actions in unusual or challenging circumstances. Is consistently trusted to deal effectively with complex problems. Faculty member has developed enough internal understanding that they can handle challenging situations.

5 = STRONGLY AGREE- Faculty member is capable of handling complex situations and is capable of effective remediation. Faculty member is a role model to follow.
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* Indicates required question
Name of the Centre *
Choose
Trivandrum Institute of Palliative Sciences, Thiruvananthapuram
MNJ Institute of Oncology, Hyderabad
Tata Memorial Hospital, Mumbai
Gujarat Cancer Research Institute, Ahmedabad
Cipla Palliative Care and Training Center, Pune
CanSupport, New Delhi
Kasturba Medical College, Manipal, Karnataka
Name of theTrainee *
Your answer
 Profession - Trainee *
Required
Name of the faculty *
Your answer
AVAILABILITY
Was prompt in availability for teaching and interactions *
STRONGLY DISAGREE
STRONGLY AGREE
Adhered to rounds and teaching schedules *
STRONGLY DISAGREE
STRONGLY AGREE
TEACHING
Stated goals of the session clearly and concisely *
STRONGLY DISAGREE
STRONGLY AGREE
Kept discussions and interactions focussed on the topic for discussion *
STRONGLY DISAGREE
STRONGLY AGREE
Asked questions in an encouraging manner *
STRONGLY DISAGREE
STRONGLY AGREE
Used bedside teaching / case studies to demonstrate history-taking and physical skills *
Choose
STRONGLY DISAGREE
Poor
Average
Good
STRONGLY AGREE
Not applicable
others
Emphasized problem-solving, (thought processes leading to decisions) *
Very Poor
STRONGLY AGREE
Integrated social/ethical aspects of medicine *
STRONGLY DISAGREE
STRONGLY AGREE
Stimulated team members to read, research, and review pertinent topics *
STRONGLY DISAGREE
STRONGLY AGREE
Accommodated teaching to actively involve all students *
STRONGLY DISAGREE
STRONGLY AGREE
PATIENT CARE AND PROFESSIONALISM
Placed high priority on the patient's interest *
STRONGLY DISAGREE
STRONGLY AGREE
Displayed sensitive, caring, respectful attitude toward patients *
STRONGLY DISAGREE
STRONGLY AGREE
Established rapport with team members *
STRONGLY DISAGREE
STRONGLY AGREE
Was enthusiastic and stimulating *
STRONGLY DISAGREE
STRONGLY AGREE
Demonstrated gender sensitivity *
STRONGLY DISAGREE
STRONGLY AGREE
MEDICAL KNOWLEDGE
Demonstrated comprehensive knowledge of concerned subject *
STRONGLY DISAGREE
STRONGLY AGREE
Used up-to-date and relevant medical/scientific literature in supporting clinical advice *
STRONGLY DISAGREE
STRONGLY AGREE
Identified and discussed important elements in case / topic under discussion *
STRONGLY DISAGREE
STRONGLY AGREE
Would you recommend that this faculty member continue to serve as an attending physician for the training program? *
To further enhance professional development, would you recommend that this faculty member receive formal training in teaching and faculty education? *
Overall comments *
Your answer
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