EXERCISE SCIENCE STUDENT (ESS) EVALUATION OF APPROVED CLINICAL INSTRUCTOR Survey

It is very important to the Exercise Science Program that we receive your input on each of your clinical practicum experiences and each of the Clinical Sites in which you have been placed. Your information will be shared with the Clinical Instructors to help them improve their clinical site and their teaching methods while educating the students in the Exercise Science.

1

*Please answer the following:

Please answer the following: Clinical Instructor
Your Name
Date

The Following Questions Focus upon Professional Attitudes and Actions

2

*My Clinical Instructor (CI) is well respected by the Exercise Scientist.

No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent
*My Clinical Instructor (CI) is well respected by the Exercise Scientist. No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent

3

*My CI demonstrates self-respect.

No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent
*My CI demonstrates self-respect. No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent

4

*My CI anticipates respect from others.

No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent
*My CI anticipates respect from others. No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent

5

*My CI is a positive professional role model for students.

No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent
*My CI is a positive professional role model for students. No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent

6

*My CI demonstrates self-confidence as a professional.

No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent
*My CI demonstrates self-confidence as a professional. No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent

7

*My CI cares about student learning in the clinical setting.

No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent
*My CI cares about student learning in the clinical setting. No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent

8

*My CI verbally and actively promotes the Exercise Science profession.

No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent
*My CI verbally and actively promotes the Exercise Science profession. No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent

9

*My CI assists students in understanding their professional responsibility.

No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent
*My CI assists students in understanding their professional responsibility. No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent

The Following Questions Focus upon Characteristics Of Effective Leaders

10

*My CI is in control of Exercise Science situations.

No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent
*My CI is in control of Exercise Science situations. No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent

11

*My CI reviews goals with me and uses these goals to plan activities.

No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent
*My CI reviews goals with me and uses these goals to plan activities. No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent

The following questions focus upon Communication Skills

12

*My CI provides feedback to students in a timely manner.

No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent
*My CI provides feedback to students in a timely manner. No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent

13

*My CI actively promotes clinical discussion with students.

No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent
*My CI actively promotes clinical discussion with students. No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent

14

*My CI corrects students tactfully in an appropriate location/place.

No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent
*My CI corrects students tactfully in an appropriate location/place. No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent

15

*My CI deals with conflict in a professional manner.

No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent
*My CI deals with conflict in a professional manner. No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent

16

*My CI provides a clear orientation during first day(s) of rotation.

No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent
*My CI provides a clear orientation during first day(s) of rotation. No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent

17

*My CI provides on-going communication for student expectations.

No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent
*My CI provides on-going communication for student expectations. No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent

18

*My CI encourages students to ask questions.

No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent
*My CI encourages students to ask questions. No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent

19

*My CI is an active listener.

No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent
*My CI is an active listener. No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent

20

*My CI encouraged interaction with Allied Health Professional at this site.

No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent
*My CI encouraged interaction with Allied Health Professional at this site. No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent

21

*My CI performed and discussed a mid rotation and end of rotation evaluation with me

No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent
*My CI performed and discussed a mid rotation and end of rotation evaluation with me No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent

The following questions focus upon Teaching Abilities And Attitudes

22

*My CI provides stimulating activities for students to learn.

No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent
*My CI provides stimulating activities for students to learn. No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent

23

*My CI promotes critical thinking skills in his/her teaching to foster learning.

No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent
*My CI promotes critical thinking skills in his/her teaching to foster learning. No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent

24

*My CI admits to students when he/she does not have the necessary information at hand to adequately address to a question.

No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent
*My CI admits to students when he/she does not have the necessary information at hand to adequately address to a question. No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent

25

*My CI actively investigates further knowledge to fully address questions.

No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent
*My CI actively investigates further knowledge to fully address questions. No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent

26

*My CI keeps up with current information within Exercise Science.

No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent
*My CI keeps up with current information within Exercise Science. No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent

27

*My CI takes time to learn to know Exercise Science students personally.

No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent
*My CI takes time to learn to know Exercise Science students personally. No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent

28

*My CI understands my current level of academic competency level in assigning academic tasks

No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent
*My CI understands my current level of academic competency level in assigning academic tasks No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent

29

*My CI initiates academic and clinical discussions.

No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent
*My CI initiates academic and clinical discussions. No Basis to Evaluate	Poor	Below Average	Average	Good	Excellent