Division of Geriatric Medicine
Department of Internal Medicine
University of South Florida College of Medicine
Faculty Evaluation Form
To improve and maintain the quality of the Geriatric Medicine attending staff, a frank evaluation by the Geriatric Medicine Fellows is necessary.
*
1. Name of Attending
2. Rotation
AMBULATORY
BPVAH
JAHVAH
TGH
USF CLINIC
LIFEPATH HOSPICE
FALLS CLINIC
ELECTIVE
Other:
*
3. Period
4. Period (year)
Select:
2000
2001
2002
2003
2004
2005
2006
2007
2008
5. Objectives of rotation met:
Yes
No
Other:
*
6. Average # work hours per week (excluding on-call):
Excellent
Good
Fair
Poor
Scientific knowledge
Clinical judgment
Attendance and promptness at scheduled rounds
Empathy with patients
Ability to communicate
Enthusiasm for teaching
Bedside examination and teaching
Writing chart staff notes
Availability for advice other than rounds
8. Please enter any additional comments you may have.