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  • To The Supervisor: Ismaildr@kb - Usm.my Reeny@kck - Usm.my

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    The document contains a letter from the Elective Secretariat at the School of Medical Sciences, Universiti Sains Malaysia requesting that supervisors complete an assessment form evaluating USM medical students who completed clinical electives at their institutions. The letter provides contact information for the secretariat. It is followed by an assessment form asking supervisors to rate students on a scale of 1 to 4 in areas such as clinical and practical skills, knowledge acquisition, participation, ethics, punctuality, and attitude. Supervisors are asked to provide an overall performance judgment and any additional comments. The form is to be completed, signed, and returned with the student to the USM academic office.

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    lampiran_klinikal_Part3

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    The document contains a letter from the Elective Secretariat at the School of Medical Sciences, Universiti Sains Malaysia requesting that supervisors complete an assessment form evaluating USM medical students who completed clinical electives at their institutions. The letter provides contact information for the secretariat. It is followed by an assessment form asking supervisors to rate students on a scale of 1 to 4 in areas such as clinical and practical skills, knowledge acquisition, participation, ethics, punctuality, and attitude. Supervisors are asked to provide an overall performance judgment and any additional comments. The form is to be completed, signed, and returned with the student to the USM academic office.

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    28 views2 pages

    To The Supervisor: Ismaildr@kb - Usm.my Reeny@kck - Usm.my

    Uploaded by

    Law You
    The document contains a letter from the Elective Secretariat at the School of Medical Sciences, Universiti Sains Malaysia requesting that supervisors complete an assessment form evaluating USM medical students who completed clinical electives at their institutions. The letter provides contact information for the secretariat. It is followed by an assessment form asking supervisors to rate students on a scale of 1 to 4 in areas such as clinical and practical skills, knowledge acquisition, participation, ethics, punctuality, and attitude. Supervisors are asked to provide an overall performance judgment and any additional comments. The form is to be completed, signed, and returned with the student to the USM academic office.

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    © All Rights Reserved
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    of 2

    Lampiran 3 [PPSP/MD/ELEKTIF_4/CP1/L3]

    School of Medical Sciences,


    USM Health Campus
    Kelantan,16150 Malaysia

    To the supervisor
    of medical students
    from USM, Health Campus

    Dear Supervisor,
    Thank you very much for supervising our student during her / his elective at your
    institution. We would be most grateful if you could fill out the attached
    assessment form.
    Please kindly hand the student the completed form. The student will bring with
    her/ him to the academic office of School of Medical Sciences USM.

    Yours sincerely
    Elective Secretariat
    Academic Office
    School of Medical Sciences
    USM, Health campus
    16150 Kubang Kerian
    Kelantan, Malaysia
    Phone:609-7676045 / 6046
    Fax: 609-7653370
    Email: ismaildr@kb.usm.my
    reeny@kck.usm.my

    ASSESSMENT CLINICAL ELECTIVE FORM


    Dear Supervisor
    Below are the statements addressing the performance of a student from school of Medical Sciences USM
    when working under your supervision.

    Name of student:..

    Date:

    Please kindly circle the number for each statement based on the scale given:
    Very good 4

    Good 3

    Satisfactory 2

    The statements
    How well the student prepared for the programme conducted under
    your supervision with respect to basic science knowledge?

    Unsatisfactory - 1
    Scale
    4

    How well the student prepared for the programme conducted under
    your supervision with respect to clinical knowledge?

    How well the student prepared for the programme conducted under
    your supervision with respect to communication skill?

    How well the student prepared for the programme conducted under
    your supervision with respect to practical skill?

    How did the student progress when working under your supervision
    with respect to acquisition of relevant knowledge?

    How did the student progress when working under your supervision
    with respect to participation in department activities?

    How did the student progress when working under your supervision
    with respect to issues in medical ethics?

    How did the student progress when working under your supervision
    with respect to punctuality and attendances?

    How was the students attitude when interacting with patients, faculty
    and colleagues?

    What is your overall judgment on the students performance?

    Additional comments (if any)


    ..

    Supervisors name:

    Signature & official stamp:

    Thank you very much for your cooperation.


    Fn/elektif/PPSPassessment/nrra/2010

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