VERY DISSATISFIED DISSATISFIED  SATISFIED  VERY SATISFIED

Please rate all of the instructors involved in this rotation service by checking the appropriate category. Please fill in the name(s) of the physician(s) as well as the name(s) of any resident(s) and/or intern(s) with whom you had any meaningful contact.

Were rounds conducted on a regular basis?

 Never Occasionally Usually Always Does Not Apply

Did you have significant patient-care responsibilities assigned to you?

 Never Occasionally Usually Always Does Not Apply

Did you have opportunity to perform most procedures indicated in the Checklist of Service Objectives or Service Protocol?

 Never Occasionally Usually Always Does Not Apply

Were your work and knowledge evaluated by the physician and/or resident assigned to this service, either by oral discussion or through direct observation?

 Never Occasionally Usually Always Does Not Apply

Were specific reading assignments given to you?

 Never Occasionally Usually Always Does Not Apply

Did the physician in charge of the service contribute by giving direction and organization to your educational experience on this service?

 Never Occasionally Usually Always Does Not Apply

Was manipulative therapy ordered and given on a regular basis?

 Never Occasionally Usually Always Does Not Apply

ADDITIONAL COMMENTS: