| Student: |
| Period/Site: |
| Preceptors: |
| |
Student's Pre-questionnaire |
| |
Student's Post-questionnaire |
| |
Student's Nomination for Outstanding Teaching Award - optional |
| |
Patient Data Record-PDA entries |
| |
Student's Evaluation of Preceptors-General Psychiatry (Fargo: IP, PHP, CL and VA) |
| |
Student's Evaluation of Preceptor-SATP |
| |
Student's Evaluation of Preceptor-Child/Ward Bismarck & GF |
| |
Student's Evaluation of Preceptor-Neurology |
| |
Student's Overall Evaluation of Psychiatry Third Year Clerkship |
| |
Student's Didactic Evaluation Forms - Fargo: 1. OL:Psych Eval. & MSE, 2. OL:Psychopharmacology, 3. Mid-term Vignettes, 4. CC: Anxiety Disorders, 5. CC: Geropsychiatry, 6. Biopsychosocial Approach to Solving Clinical Problems, 7. Child Lectures, 8. Grand Rounds
Bismarck: 1. OL: Psych Eval. & MSE, 2. Psychopharmacology, 3. Mid-term Vignettes
Grand Forks: 1. OL:Psych Eval. & MSE, 2. Psychopharmacology, 3. Mid-term Vignettes |
| |
4 Patient write-ups |
| |
Student's Evaluation of Case Presentations |
| |
Glen Gabbard Psychotherapy Module |
| |
---- The following for coordinator use only ---- |
| |
Final Vignette |
| |
Preceptor's Evaluation of Student-General Psychiatry (Fargo: IP, PHP, CL and VA) |
| |
Preceptor's Evaluation of Student-SATP |
| |
Preceptor's Evaluation of Student-Child/Ward Bismarck & GF |
| |
Preceptor's Evaluation of Student-Neurology |
| |
NBME Score |
