UAB Nurse Anesthesia Program
School of Health Related Professions
The University of Alabama at Birmingham
- Annual Clinical Faculty Self-Evaluation Name of Clinical Faculty:
Rarely
1
Affiliate:
Occasionally
Area of Assessment
Provides consistent, objective
assessment of SRNAs.
Pursues reading the literature to
remain current with clinical
knowledge.
Encourages SRNA autonomy
when appropriate circumstances
permit.
(e.g., pushing own drugs)
Completes daily evaluations and
provides verbal feedback for
SRNAs
Provides timely feedback to the
Clinical Resident Manager
regarding SRNA performance
Serves as professional role
model in dealing with surgeons,
anesthesiologists, SRNAs, and
patients.
1
2
2
Commonly
Date:
3
Clinical Faculty’s Comments
3
Clinical Strengths:
Areas Needing Improvement:
Areas Needing Improvement
Areas Needing Improvement
Improvement in clinical performance
enhanced via (e.g., attended workshops):
OVERALL EVALUATION
Check here
if a conference between Clinical Faculty & Nurse Anesthesia Resident Manager is requested.
This form is to be kept at the clinical site, completed once a year and reviewed (as needed) by the Nurse Anesthesia Resident Manager and UAB
Director of Clinical Education
07/26/00