NEONATOLOGY FELLOWSHIP TRAINING PROGRAM
EVALUATION BY FACULTY
Name:
Year: 1
2
3
Well
Superbly 
How well do you think this program trains the fellow to:
Patient Care:
Poorly 
1. Integrate information to form a diagnosis?
1
2
3
4
5
N/A
2. Think independently?
1
2
3
4
5
N/A
3. Practice evidence-based learning?
1
2
3
4
5
N/A
4. Skillfully perform technical procedures?
1
2
3
4
5
N/A
5. Follow-up the high-risk infant?
1
2
3
4
5
N/A
1. Understand pathophysiology?
1
2
3
4
5
N/A
2. Critically review the literature?
1
2
3
4
5
N/A
1. Perform administrative procedures?
1
2
3
4
5
N/A
2. Teach audiences of varying sophistication?
1
2
3
4
5
N/A
1. Communicate with other doctors?
1
2
3
4
5
N/A
2. Communicate with support staff?
1
2
3
4
5
N/A
3. Communicate with families?
1
2
3
4
5
N/A
1. Supervise transport of critically ill neonates?
1
2
3
4
5
N/A
2. Work collaboratively with other physicians?
1
2
3
4
5
N/A
1. Understand basic research methodology?
1
2
3
4
5
N/A
2. Understand clinical research methodology?
1
2
3
4
5
N/A
3. Perform statistical analysis?
1
2
3
4
5
N/A
4. Practice life-long learning?
1
2
3
4
5
N/A
Medical Knowledge:
Practice-Based Learning:
Communication:
Systems Based Practice:
Scholarly Activities:
How do you feel about the amount of:
Too little
Just Right
Too much
1. Responsibility for patient care?
1
2
3
4
5
N/A
2. Workload and call?
1
2
3
4
5
N/A
3. Positive feedback?
1
2
3
4
5
N/A
Neonatal-Perinatal Medicine Fellowship Training Program
2016
University of Washington / Seattle Children’s Hospital
Date Revised: February 12,
NEONATOLOGY FELLOWSHIP TRAINING PROGRAM
EVALUATION BY FACULTY
4. Negative feedback?
1
2
3
Poorly 
How well did this program prepare the fellow for:
4
5
N/A
Superbly 
Well
1. A career in academic neonatology?
1
2
3
4
5
N/A
2. A career in private practice neonatology?
1
2
3
4
5
N/A
3. A career in administration?
1
2
3
4
5
N/A
Comments:
_______
Do you have adequate contact with the fellows
1. clinical ?
1
2
3
4
5
N/A
2. research?
1
2
3
4
5
N/A
3. other?
1
2
3
4
5
N/A
What do you think are the three best things about the program:
1.
2.
3.
What do you think are the three worst things about the program:
1.
2.
3.
If you were fellowship director, what one thing would you change about the program? How would you
change it?
Neonatal-Perinatal Medicine Fellowship Training Program
2016
University of Washington / Seattle Children’s Hospital
Date Revised: February 12,