TCC EMT Clinical Evaluation

Clinical Site

Student

Start Date of Clinical Rotation

Date

How well did this student display professional attitudes and behaviors expected of an EMS provider?

Did this student arrive on time for the scheduled clinical / field activity, in full Weatherford College clinical uniform? (Late arrivals and students out of uniform should not be permitted to stay for the clinical experience)

How well did this student display the knowledge expected of an Emergency Medical Technician Student?

How well did this student perform the skills and competencies expected of an Emergency Medical Technician Student?

Preceptor

Please enter the preceptors name

Preceptor ID Number

Please enter the preceptors ID (badge) number

Signature

Please enter an Email address if you would like to be contacted about this student

Email address is only required if you would like us to contact you about this students clinical activity.

Comments

Please enter any comments you have about this students performance, or anything that may be helpful in improving the EMS Education Program at Weatherford College.

Emergency Medical Technician Clinical Evaluation

Affective Evaluation

Cognitive Evaluation

Psychomotor Evaluation

Thank you.