CP121 2019 SOAP NOTE EVALUATION FORM

Student:_____________________________________ Examiner :______________________________

If you feel the experience with the examinee (student) meet your expectation, choose “Meet expectation (ME)”.
If you are slightly dissatisfied with the experience OR are not sure whether the examinee accomplished the objective
of the item OR you disliked what the examinee (student) did enough to flag their behavior, choose “Marginally meet
expectation (MME).”
If you feel anything in the encounter with the examinee (student) negatively impacted
the patient significantly enough for you to want the examinee to get remedial help,
choose “Does not meet expectation (DNME)”.
Please check the appropriate Box. Expectation
Meet Marginally Does Not
meet meet
1. Format – The SOAP note has Subjective, Objective, Assessment/Plan
sections. Each section contains corresponding information and/or data.
* If the SOAP note does not have student name, or does not have the
correct file name, then give MME or lower grade.

2. Clarity – The SOAP note is clear to understand and easy to follow.

3. Accuracy – The SOAP note contains accurate patient information

including but not limited to demographics, past medical history, social
history, family history, allergies, medication history, vitals and laboratory
test results.

4. Conciseness – The SOAP note is concise and not wordy. The SOAP
note is no more than 1 page long (maximum limit of word count: 450).

5. Content – The SOAP note contains relevant and important

information. The SOAP note is organized based on priority of the patient
problems.

6. Appropriateness of the assessment/plan section – The SOAP

note
1) identifies the most likely etiology of the problem
2) assesses the current therapy or need for therapy
3) provides therapeutic plans with patient-specific reasons
4) sets patient-specific goals and monitoring parameters
5) documents patient education provided, and
6) provides a timely follow up plan.

OVERALL IMPRESSION

Adapted from East Tennessee State University & UCSF SOM Rating Form
101809 , 102809, 010410