University of Wisconsin-Stevens Point Athletic Training Education Program
Athletic Training Student Self-Evaluation (Complete at the end of rotation)
Please write the appropriate scale number next to each item based on the student’s performance and
professional qualities. Explain any item which falls below average (3). Compare your selfevaluation to the evaluation completed by your CP.
Scale:
5(Excellent) – performs duties/skills extremely well, very professional
4(Above avg) – performs duties/skills better than average in a professional manner
3(Avg) – performs duties/skills as well as expected at this level, minimum CP intervention
2(Below avg) – performs duties/skills at unsatisfactory level, constant intervention from CP
1(Deficient) – needs remedial aid in this area prior to advancing clinical education
N(Not applicable) – CP did not observe this duty/skill, or ATS has not acquired skill yet
Professional qualities
Communication with patients
Communication with CP
Communication with coaches
Follows instructions & carries out tasks
Ability to act in calm demeanor
Professional appearance
Behaves ethically and morally
Encourages mature behavior from patient
Alert/prepared at practices and games
Maintains patient confidentiality
Resourceful
Good rapport with athletes/coaches/staff
Comments:__________________________________________________________________________
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Quality of work and personal qualities
Shows initiative in daily duties
Eager and enthusiastic about learning
Displays appropriate confidence level
Maintains clean working environment
Demonstrates proficiency in skills at
current level
Was diligent in completing proficiencies
Acceptance to constructive criticism
Is responsible
Is punctual
Cooperates with staff/students
Effectively balances academics & clinical
rotations
Putting best effort into education/learning
Comments:__________________________________________________________________________
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Did you accomplish your goals this rotation? Yes/No and Why?
List three athletic training/personal areas which you could improve on.
List three positive experiences you have been involved in this past clinical rotation.
Additional Comments:
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Student Signature
Date
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Clinical Preceptor Signature
Date