UNIVERSITY OF WISCONSIN – STEVENS POINT ATHLETIC TRAINING EDUCATION PROGRAM Third Year Student Clinical Rotation Evaluation Student’s Name:____________________________________ Semester/Year:________________ Clinical Rotation:_________________________________ Name of ACI: _________________ 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). Please meet with your student and then turn this form into the Clinical Coordinator. 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 ACI intervention 2(Below avg) – performs duties/skills at unsatisfactory level, constant intervention from ACI 1(Deficient) – needs remedial aid in this area prior to advancing clinical education N(Not applicable) – ACI did not observe this duty/skill, or ATS has not acquired skill yet Professional and personal qualities Communication with patients (speaks at a level Ethical practice (treats people equally, maintains and in a manner others understand, actively listens, confidentiality, adheres to NATA Code of Ethics) confident) Communication with ACI (interacts well, Professionalism (courteous, respectful, actively listens, schedules appointments in timely appropriate dress, appropriate language, appropriate manner) behavior)
Communication with coaches (speaks at a level Teamed approached to practice (works well and in a manner others understand, actively listens, with peers, willing to do extra if needed, includes confident) necessary people in decision making, teaches others)
Work ethic (strives for quality, thorough, isn’t Ability to handle stress (handles more than one always looking to leave, responsible) thing at a time, emotionally stable) Confidence level (applies skills without Advancing knowledge (eager, asks questions, hesitation, eager to demonstrate, displays practices on own, self‐motivator, uses EBP, works to appropriate level of confidence) improve)
Shows initiative (acts without being asked, stays Acceptance to constructive criticism (accepts occupied, resourceful in seeking answers)
feedback positively, used in a positive manner)
Adaptability (flexible, adjusts to changing Alert/prepared at practices and games (ready situations/settings, resourceful) to act, not distracted, knowledge of EAP)
Time management (arrives on time, efficient, prepared for practice, thinks ahead) Comments/suggestions for improvement:_________________________________________________________ ______________________________________________________________________________________________
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______________________________________________________________________________________________ Emergency Care and Prevention Skills Displays professional reaction to emergencies Works with speed and efficiency Follows blood‐borne pathogen protocols Taping and wrapping skills – upper extremity Follows emergency action plan Taping and wrapping skills – lower extremity Comments/suggestions for improvement:_________________________________________________________ ______________________________________________________________________________________________ Evaluation skills (+) attitude & interaction with patient Effectively performs thorough evaluation (hx, inspection & observation, palpation, testing) Effectively makes assessments based on findings of evaluation Effectively explains assessment to patient Comments/suggestions for improvement:_________________________________________________________ ______________________________________________________________________________________________ Modality and rehabilitation skills Knowledge and use of cryotherapy Knowledge and use of thermotherapy Knowledge and use of electrical stimulation Knowledge and use of ultrasound Effectively prescribes correct treatment for injury Effectively prescribes correct exercises for effective rehabilitation Effectively educates patient and provides feedback Effectively progresses patient as needed Uses creativity and multiple aids in exercise selection (i.e. cable column, bands, balls) Maintains accurate records of treatment, rehabilitation and patient progression Comments/suggestions for improvement:_________________________________________________________ ______________________________________________________________________________________________ Overall strengths of athletic training student: ______________________________________________________________________________________________ ______________________________________________________________________________________________
______________________________________________________________________________________________ Did the athletic training student meet his/her goals for this clinical rotation? YES NO Comments: ______________________________________________________________________________________________
______________________________________________________________________________________________ __________________________ ________________ _________________________ ____________ ATS Signature Date ACI Signature Date Student comments: