Resident Neurology Clerkship Evaluation Form
Student Name:
Neurology Rotation/Location:
Rotation Dates:
Clerkship
Competencies
CONSISTENTLY
exceeds
expectations for
level of training
SOMETIMES
exceeds
expectations for
level of training
MEETS basic
expectations
for level of
training
DOES NOT MEET
expectations for level
of training
1. Data Acquisition
Elicits focused and thorough Neurological
History
Performs complete and appropriate
Neurologic Examination
2. Data Interpretation
Generates a pertinent Differential
Diagnosis
Proposes diagnostic and therapeutic plan
for each patient
3. Communication
Clearly and accurately presents patient
findings to team members
4. Medical Knowledge
Integrates basic sciences knowledge with
clinical aspects of medicine
Shows an eagerness to learn, identifying
their own questions and reviewing the
literature concerning their patients
problems
4. Professionalism
Arrives on time and leaves only when work
is done or for didactic sessions
Brings appropriate medical equipment
Reliably fulfills patient care responsibilities
without frequent reminders
Name of person providing this evaluation:
Date: ___________