Final Eval Spring 18

5/1/2019 Georgia College Mail - Fwd: Form submission from: KINS 3122: Preceptor Evaluation of Student
adekemi adeleke <adekemi.adeleke@bobcats.gcsu.edu>
Fwd: Form submission from: KINS 3122: Preceptor Evaluation of Student

1 message
brittney hardin <brittney.hardin@gcsu.edu> Mon, Apr 16, 2018 at 3:45 PM

To: adekemi adeleke <adekemi.adeleke@bobcats.gcsu.edu>
Please see below.

Brittney Hardin, M.Ed., ATC, LAT
School of Health & Human Performance
Lecturer, Clinical Education Coordinator
Athletic Training Program
Campus Box 112
Health Science Building 325
Office: 478-445-8626
Think Independently. Lead Creatively.
Begin forwarded message:
From: Kemi Adeleke <georgia.college@gcsu.edu>

Subject: Form submission from: KINS 3122: Preceptor Evaluation of Student
Date: April 16, 2018 at 3:24:29 PM EDT
To: <brittney.hardin@gcsu.edu>
Submitted on April 16, 2018 - 3:24pm
Submitted by anonymous user: [66.210.74.161]
Submitted values are:
INSTRUCTIONS
Please fill out the evaluation below. The survey will be emailed to the email address you provided on
the survey. Please printout the email. Both the student and preceptor need to sign and date the last
page of the printout.
Student Name
Kemi Adeleke
Preceptor Name
Pranay Shah
https://mail.google.com/mail/u/2?ik=5d1700dbb6&view=pt&search=all&permthid=thread-f%3A1597933273206125893&simpl=msg-f%3A15979332732… 1/6
Preceptor Email
pshah@wesleyancollege.edu
Clinical Setting/Experience
Wesleyan College
Date
April 16, 2018
Evaluation
Final Evaluation
DIRECTIONS
Please evaluate the athletic training student objectively. Please select the appropriate response for
each item in the categories below. Select NA if you are not able to assess the student. NA = Not Able
to Assess 5 = Outstanding 4 = Good 3 = Satisfactory 2 = Improvement Needed 1 = Unacceptable
Athletic Training Knowledge
NA 5 4 3 2 1
1. Demonstrates knowledge of policies and procedures of clinical X

experience setting.
2. Demonstrates knowledge in injury prevention. X
3. Demonstrates skill in selecting and interpreting fitness/testing X

procedures to minimize risk of injury/illness.
4. Demonstrates skill in developing and implementing prevention strategies X

to minimize risk of injury/illness.
5. Demonstrates knowledge in taping/bracing techniques. X
6. Demonstrates skill in applying taping/bracing techniques. X
7. Demonstrates knowledge in injury evaluation and diagnosis. X
8. Demonstrates knowledge in providing treatment to patients/athletes. X
Interpersonal Skills
NA 5 4 3 2 1
1. Demonstrates effective written communication with preceptor. X
2. Demonstrates effective oral communication with preceptor. X
3. Demonstrates effective communication with patients/athletes. X
NA 5 4 3 2 1
4. Demonstrates effective communication with other staff/personnel. X
5. Demonstrates effective critical-thinking skills. X
6. Demonstrates effective clinical decision-making skills. X
7. Demonstrates a positive attitude in interactions with preceptor, patients, X

etc.
8. Demonstrates confidence in abilities as an athletic training student. X
Professional Responsibility
NA 5 4 3 2 1
1. Demonstrates punctuality. X
2. Demonstrates professionalism (i.e., attitude, actions, X

dress/appearance).
3. Demonstrates initiative. X
4. Demonstrates a willingness to learn. X
5. Demonstrates an awareness of limitations. X
6. Maintains confidentiality. X
DIRECTIONS
Please evaluate the athletic training student objectively. Please select the appropriate response for
each item in the categories below. Select NA if you are not able to assess the student. NA = Not Able
to Assess 5 = Outstanding 4 = Good 3 = Satisfactory 2 = Improvement Needed 1 = Unacceptable
Administrative Tasks
NA 5 4 3 2 1
1. Demonstrates an ability to multi-task efficiently and effectively. X
2. Maintains an accurate inventory of supplies. X
3. Maintains accurate documentation of injuries/illnesses and treatments X

provided.
4. Documents injuries/illnesses and treatments accurately. X
NA 5 4 3 2 1
5. Utilizes accurate and appropriate medical terminology. X
Technical Standards
NA 5 4 3 2 1
1. Demonstrates the mental capacity to assimilate, analyze, synthesize, X

integrate concepts and problem solve to formulate assessment and
therapeutic judgments.
2. Demonstrates sufficient postural and neuromuscular control, sensory X

function, and coordination to perform appropriate physical examinations
using accepted techniques.
3. Demonstrates the ability to tolerate physically taxing work loads. X
4. Demonstrates the ability to communicate effectively and sensitively with X

patients and colleagues, including individuals from different cultural and
social backgrounds.
5. Demonstrates the ability to record the physical examination results and X

a treatment plan clearly and accurately.
6. Demonstrates the capacity to maintain composure and continue to X

function well during periods of high stress.
7. Demonstrates the perseverance, diligence and commitment to complete X

the athletic training program as outlined and sequenced.
8. Demonstrates flexibility and the ability to adjust to changing situations X

and uncertainty in clinical situations.
9. Demonstrate affective skills and appropriate demeanor and rapport that X

relate to professional education and quality patient care.
Upper Extremity Assessment Skills
NA 5 4 3 2 1
1. Obtains appropriate medical history. X
2. Completes appropriate visual observation of upper extremity X

injury/condition.
3. Identifies and palpates appropriate upper extremity anatomical X

landmarks.
4. Assesses upper extremity range of motion appropriately. X
5. Performs upper extremity manual muscle test(s) appropriately. X
NA 5 4 3 2 1
6. Selects appropriate diagnostic/special tests pertinent to injury/condition. X
7. Performs upper extremity diagnostic/special tests accurately. X
8. Differentiates between normal and abnormal patient physical findings. X
9. Performs appropriate upper extremity neurological circulatory X

assessment.
10. Documents evaluation and diagnosis appropriately. X
Therapeutic Rehabilitation Skills
NA 5 4 3 2 1
1. Selects appropriate goals for patients. X
2. Inspects therapeutic rehabilitation equipment prior to use for safety. X
3. Utilizes appropriate therapeutic exercises based on patient goals. X
4. Demonstrates proper technique of rehabilitative exercises. X
5. Utilizes functional progression and functional testing appropriately. X
6. Documents rehabilitation goals and functional progression appropriately. X
GLOBAL ASSESSMENT
In the space below, please assess the athletic training in each of the following areas:
Willingness to accept role as a health care provider:

Yes accepts role as health care provider. Show great initiative.
Utilization of evidence-based medicine techniques in patient care:

N/A
Strengths of the athletic training student:

Easy to get a long with. Works well with people. Decent at identifying abnormalities in posture/gait etc.
Areas for the athletic training student to improve:

Rehab progression in the sense of what to do with the information gathered in the eval. Have greater
confidence in knowledge. Being able to be tested under pressure. Better knowledge of anatomy, but
everything stated will come with time.
Additional comments:
Do you feel students under your supervision engage in a sufficient number of real-time clinical
evaluations? Why or Why Not?
Yes. Given class schedule and clinical site practices, she is available and shows up if there are no conflicts.
Signature
__________________________________________ Student Signature / Date
The results of this submission may be viewed at:
https://intranet.gcsu.edu/node/1603/submission/14548

Final Eval Spring 18

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5/1/2019 Georgia College Mail - Fwd: Form submission from: KINS 3122: Preceptor Evaluation of Student

adekemi adeleke <adekemi.adeleke@bobcats.gcsu.edu>

Fwd: Form submission from: KINS 3122: Preceptor Evaluation of Student

brittney hardin <brittney.hardin@gcsu.edu> Mon, Apr 16, 2018 at 3:45 PM

Please see below.

Think Independently. Lead Creatively.

Begin forwarded message:

From: Kemi Adeleke <georgia.college@gcsu.edu>

Submitted on April 16, 2018 - 3:24pm

Submitted by anonymous user: [66.210.74.161]

Submitted values are:

Athletic Training Knowledge

1. Demonstrates knowledge of policies and procedures of clinical X

2. Demonstrates knowledge in injury prevention. X

3. Demonstrates skill in selecting and interpreting fitness/testing X

4. Demonstrates skill in developing and implementing prevention strategies X

5. Demonstrates knowledge in taping/bracing techniques. X

6. Demonstrates skill in applying taping/bracing techniques. X

7. Demonstrates knowledge in injury evaluation and diagnosis. X

8. Demonstrates knowledge in providing treatment to patients/athletes. X

1. Demonstrates effective written communication with preceptor. X

2. Demonstrates effective oral communication with preceptor. X

3. Demonstrates effective communication with patients/athletes. X

4. Demonstrates effective communication with other staff/personnel. X

5. Demonstrates effective critical-thinking skills. X

6. Demonstrates effective clinical decision-making skills. X

7. Demonstrates a positive attitude in interactions with preceptor, patients, X

8. Demonstrates confidence in abilities as an athletic training student. X

2. Demonstrates professionalism (i.e., attitude, actions, X

4. Demonstrates a willingness to learn. X

5. Demonstrates an awareness of limitations. X

1. Demonstrates an ability to multi-task efficiently and effectively. X

2. Maintains an accurate inventory of supplies. X

3. Maintains accurate documentation of injuries/illnesses and treatments X

4. Documents injuries/illnesses and treatments accurately. X

5. Utilizes accurate and appropriate medical terminology. X

1. Demonstrates the mental capacity to assimilate, analyze, synthesize, X

2. Demonstrates sufficient postural and neuromuscular control, sensory X

3. Demonstrates the ability to tolerate physically taxing work loads. X

4. Demonstrates the ability to communicate effectively and sensitively with X

5. Demonstrates the ability to record the physical examination results and X

6. Demonstrates the capacity to maintain composure and continue to X

7. Demonstrates the perseverance, diligence and commitment to complete X

8. Demonstrates flexibility and the ability to adjust to changing situations X

9. Demonstrate affective skills and appropriate demeanor and rapport that X

Upper Extremity Assessment Skills

1. Obtains appropriate medical history. X

2. Completes appropriate visual observation of upper extremity X

3. Identifies and palpates appropriate upper extremity anatomical X

4. Assesses upper extremity range of motion appropriately. X

5. Performs upper extremity manual muscle test(s) appropriately. X

6. Selects appropriate diagnostic/special tests pertinent to injury/condition. X

7. Performs upper extremity diagnostic/special tests accurately. X

8. Differentiates between normal and abnormal patient physical findings. X

9. Performs appropriate upper extremity neurological circulatory X

10. Documents evaluation and diagnosis appropriately. X

Therapeutic Rehabilitation Skills

1. Selects appropriate goals for patients. X

2. Inspects therapeutic rehabilitation equipment prior to use for safety. X

3. Utilizes appropriate therapeutic exercises based on patient goals. X

4. Demonstrates proper technique of rehabilitative exercises. X

5. Utilizes functional progression and functional testing appropriately. X

6. Documents rehabilitation goals and functional progression appropriately. X