Please complete this form to provide constructive feedback to the presenter and the residency program.
Date:
Presentation Type:
Case Conference
Journal Club
Case Presentation
Faculty Presentation
Other
Speaker:
Topic:
1. Content
- Please Select -
Mediocre (bottom 10%)
Fair (20%)
Good (40%)
Great (20%)
Outstanding (top 10%)
2. Presenters knowledge of subject
- Please Select -
Mediocre (bottom 10%)
Fair (20%)
Good (40%)
Great (20%)
Outstanding (top 10%)
3. Relevance to specialty
- Please Select -
Mediocre (bottom 10%)
Fair (20%)
Good (40%)
Great (20%)
Outstanding (top 10%)
4. Value for residents
- Please Select -
Mediocre (bottom 10%)
Fair (20%)
Good (40%)
Great (20%)
Outstanding (top 10%)
5. Professionalism of Presentation
- Please Select -
Mediocre (bottom 10%)
Fair (20%)
Good (40%)
Great (20%)
Outstanding (top 10%)
6. Scope and Depth of Coverage
- Please Select -
Mediocre (bottom 10%)
Fair (20%)
Good (40%)
Great (20%)
Outstanding (top 10%)
7. Presenter’s ability to communicate ideas and concepts
- Please Select -
Mediocre (bottom 10%)
Fair (20%)
Good (40%)
Great (20%)
Outstanding (top 10%)
8. Quality of visual presentation (i.e. PowerPoint slides)
- Please Select -
Mediocre (bottom 10%)
Fair (20%)
Good (40%)
Great (20%)
Outstanding (top 10%)
N/A
9. Presenter’s grasp of biostatistics and epidemiologic issues (e.g. journal club)
- Please Select -
Mediocre (bottom 10%)
Fair (20%)
Good (40%)
Great (20%)
Outstanding (top 10%)
N/A
10. Presenter’s knowledge of literature (e.g. journal club)
- Please Select -
Mediocre (bottom 10%)
Fair (20%)
Good (40%)
Great (20%)
Outstanding (top 10%)
N/A
11. Adequacy of Handout materials
- Please Select -
Mediocre (bottom 10%)
Fair (20%)
Good (40%)
Great (20%)
Outstanding (top 10%)
N/A
12. OVERALL IMPRESSION
- Please Select -
Mediocre (bottom 10%)
Fair (20%)
Good (40%)
Great (20%)
Outstanding (top 10%)
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