Elective:
Dates:
Course Number:
Student Name:
Location:

For each of the following statements, click the response that most accurately indicates the extent to which you are in agreement with the statement using the following scale:
1=Strongly Disagree, 2=Disagree, 3=Neutral, 4=Agree, 5=Strongly Agree, N/A= Not Applicable.

The Elective was well organized
1 2 3 4 5 N/A

The instructor(s) was/were prepared for formal presenations.
1 2 3 4 5 N/A

The elective time was well spent
1 2 3 4 5 N/A

I understood the goals/objectives of the elective.
1 2 3 4 5 N/A

The goals/objectives were met
1 2 3 4 5 N/A

The faculty were available for consultation and assistance.
1 2 3 4 5 N/A

I found adequate assistance with difficulties.
1 2 3 4 5 N/A

I felt included as a part of the healthcare team.
1 2 3 4 5 N/A

Nursing and technical people were helpful.
1 2 3 4 5 N/A

The workload was appropriate.
1 2 3 4 5 N/A

The content was understandable.
1 2 3 4 5 N/A

The knowledge and skills learned in the M1/M2introduction course in this specialty integrated well into this elective.
1 2 3 4 5 N/A

I understood how my performance was to be evaluated.
1 2 3 4 5 N/A

I learned a great deal.
1 2 3 4 5 N/A

I felt stimulated to learn more.
1 2 3 4 5 N/A

The overall length of the elective was adequate.
1 2 3 4 5 N/A

The overall quality of the faculty was good.
1 2 3 4 5 N/A

The overall quality of the course was good.
1 2 3 4 5 N/A

There was appropriate integration of the course with other basic and clinical sciences.
1 2 3 4 5 N/A

Multiple teaching methods (lecture, group discussions, case studies, etc.) and learning resources (audio visuals, LRC, etc.) were effectively utilized.
1 2 3 4 5 N/A

Opportunities were available to apply my core knowledge and concepts in scientific and clinical reasoning and problem solving.
1 2 3 4 5 N/A

The conferences (grand rounds, core curriculum, etc.) were beneficial experiences.
1 2 3 4 5 N/A

The faculty modeled and encouraged self-directed and career-long learning.
1 2 3 4 5 N/A

The elective appropriately incorporated the use of computer-based programs and simulations.
1 2 3 4 5 N/A

The elective promoted the acquisition of professional attitudes and behaviours such as communication skills, compassion, humanities, law and the respect for human values.
1 2 3 4 5 N/A

The elective promoted the development of leadership skills.
1 2 3 4 5 N/A

Student participation in the determination of elective activities was adequate.
1 2 3 4 5 N/A

The time available for learning experiences, apart from repetitive clinical duties, was adequate.
1 2 3 4 5 N/A

The level of supervision provided by attending physicians and house staff was appropriate.
1 2 3 4 5 N/A

Suitable sites were used for clinical learning experiences.
1 2 3 4 5 N/A

The numbers and mix of patients were adequate.
1 2 3 4 5 N/A

This elective has been valuable in my career decision-making.
1 2 3 4 5 N/A

Please Grade the Teaching By Specific Faculty (1-100):

Name:
Grade:
Comments:
Name:
Grade:
Comments:
Name:
Grade:
Comments:

Please Grade the Teaching By Specific Residents (1-100):

Name:
Grade:
Comments:
Name:
Grade:
Comments:
Name:
Grade:
Comments:

Please provide general comments related to your overall impression and provide specific comments related to any items you rated "strongly disagree and/or "strongly agree":