Medical Practical Exam Evaluation Form
Use this form to evaluate a candidate's performance during a medical practical exam. Please complete all sections accurately and objectively.
Evaluator Full Name
*
First Name
Last Name
Candidate Full Name
*
First Name
Last Name
Exam Station or Scenario
*
Date of Evaluation
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Clinical Knowledge (Rate the candidate's understanding of clinical concepts)
*
1
2
3
4
5
Technical Skills (Rate the candidate's ability to perform procedures)
*
1
2
3
4
5
Communication Skills (Rate the candidate's ability to communicate with patient and team)
*
1
2
3
4
5
Professionalism (Rate the candidate's adherence to professional standards)
*
1
2
3
4
5
Overall Performance (Select the most appropriate level)
*
Excellent
Good
Satisfactory
Needs Improvement
Unsatisfactory
Evaluator Comments (Provide any additional feedback or observations)
Submit Evaluation
Should be Empty: