Student: Marisa Diehl

Clinical Facility:

AUTO

Date: 3-6-2015

Gateway Technical COU~

Surgical Technology P:r _
Clinical Evaluati
512-135-3KIA Clini
Scoring for Clinical Evaluation
4 = Excellent
3 = Good
2 = Acceptable
Professional

Competency

3.5 = Very Good

2.5 = Average
o = Unacceptable [Below 2]
Characteristics

Comments

I 3.5

2.5

1. Adheres to dress code

I 3.5

2.5

2. Demonstrates Dependability ~.

I 3.5

2.5

3. Communicates effectively

13.5

3 2.5 2

I 3.5

2.5

A. Accept Responsibility for Own

Experiences.

4. Demonstrates professional
interpersonal relationship behavior