Penn Med SP Training and Performance Check-in
Penn Med SP Training and Performance Check-in
Please take 5 minutes to complete this evaluation. All your responses will remain anonymous.
Name (optional)
Name (optional)
First
Last
Program Date
Program Date
*
/
MM
/
DD
YYYY
Program/Case
*
*
1- Strongly Disagree
2 - Disagree
3 - Agree
4 - Strongly Agree
The training for this program was effective.
The training for this program was effective.
1- Strongly Disagree
The training for this program was effective.
2 - Disagree
The training for this program was effective.
3 - Agree
The training for this program was effective.
4 - Strongly Agree
The program assistant/trainer was organized.
The program assistant/trainer was organized.
1- Strongly Disagree
The program assistant/trainer was organized.
2 - Disagree
The program assistant/trainer was organized.
3 - Agree
The program assistant/trainer was organized.
4 - Strongly Agree
Today's session was collaborative.
Today's session was collaborative.
1- Strongly Disagree
Today's session was collaborative.
2 - Disagree
Today's session was collaborative.
3 - Agree
Today's session was collaborative.
4 - Strongly Agree
I feel confident about my ability to perform in this program.
I feel confident about my ability to perform in this program.
1- Strongly Disagree
I feel confident about my ability to perform in this program.
2 - Disagree
I feel confident about my ability to perform in this program.
3 - Agree
I feel confident about my ability to perform in this program.
4 - Strongly Agree
What was the best part of today's experience?
*
Name at least one thing that would improve today's experience.
*
Would you like a PENN MED SP PROGRAM staff member to follow-up with you? If yes, please include your name at the top of this form, or feel free to contact us directly.
*
Would you like a PENN MED SP PROGRAM staff member to follow-up with you? If yes, please include your name at the top of this form, or feel free to contact us directly.
Yes
No
Additional comments.
OPTIONAL FEEDBACK REQUEST (for sessions that are video-recorded). Provide name of student and/or encounter number that you’d like a trainer or staff to review, or we can select a random encounter. Is there a specific skill you're working on or feedback you want? We will contact you to arrange a 1:1 coaching session.