UMaine Athletic Training Education Program
Clinical Site Evaluation
Clinical Instructor Evaluation


Student _______________________________ Current Date ___________________________


Clinical Site ___________________________ Clinical Instructor _________________________


Studentís Assignment(s) and Dates_________________________________________________



Purpose: To receive input from you, the student, regarding the effectiveness of this clinical site and clinical instructor. Your comments and scoring will remain completely anonymous, but will be shared with the clinical instructor as a method of making this site and their teaching skills the best they can be for this Athletic Training Education Program.


Clinical Instructor Evaluation

Your clinical instructor was helpful and responsive to your learning objectives.


1 was not responsive or helpful regarding my learning objectives
2 at times was responsive, but did not show much interest in helping me learn
3 was very responsive and helpful to my learning objectives
4 went above and above his/her responsibilities of helping me achieve my learning objectives


Your clinical instructor was professional in appearance and attitude.


1 frequently dressed and/or acted unprofessionally
2 sometimes dressed and/or acted unprofessionally
3 rarely dressed and/or acted unprofessionally
4 never dressed and/or acted unprofessionally


Your clinical instructor was respectful of you and those around him/her.


1 did not respect me as an ATS nor those around him/her
2 occasionally showed disrespect to me and/or to those we worked with
3 was respectful of me and those we worked with
4 put the needs of me and those we worked with above him/herself


Your clinical instructor is well respected by his/her peers, his/her physicians, his/her administration, his/her patients and his/her students.


1 not respected at all
2 is not respected by some of those in contact with the CI
3 respected by all
4 respected and seen as a leader by those in contact with the CI


Your clinical instructor is using current skills, techniques and protocols.


1 not consistent with my current coursework
2 sometimes is inconsistent with my current coursework
3 uses current skills, techniques and protocols consistent with my coursework
4 uses current and cutting edge skills, techniques and protocols



Your clinical instructor is personally and professionally motivated and carries that over to those around him/her.


1 disagree
2 is sometimes motivated personally and professionally
3 is frequently motivated to improve professionally and/or personally
4 is always looking for ways to improve personally and professionally and shares it with those around


Your clinical instructor cares about making this clinical experience a true learning environment for you.


1 does not take much interest in making this a learning environment
2 takes some time to make this experience educational, but it is not a high priority
3 takes a great deal of time to make this an educational experience
4 has made me a part of his/her priority in daily patient care


Your clinical instructor gives timely, appropriate feedback.


1 never gives feedback
2 rarely gives feedback
3 gives feedback through evaluation forms
4 gives timely feedback on a situation to situation basis


Your clinical instructor takes the time to know you, your learning methods, your strengths, and your weaknesses.


1 my clinical instructor has made no effort to get to know me or my AT abilities
2 my clinical instructor has helped me as an ATS, but does not know me other than that
3 my clinical instructor has taken the time and made efforts to know me personally and to know my AT abilities
4 my clinical instructor has taken the time to work with me enough to help me to strengthen my weaknesses


Your clinical instructor encourages you to think critically, to work to your abilities and listens to suggestions and new opportunities.


1 never
2 rarely ever
3 frequently
4 always takes the time to listen and encourage me