Form: J

Department: Name
Instructor: Name
Course Number: No.
Section Number: No.

Completion of this questionnaire is voluntary.  You are free to leave some or all items unanswered.  All of your answers to this survey are confidential.  Your answers will not be associated with your NetID.  Print this page.

   
  Please rate the following questions.  The rating categories are Excellent, Very Good, Good, Fair, Poor, and Very Poor.
 
 
Excellent Very Poor
E VG G F P VP
1. Rotation/Studio as a whole
2. Procedures/skills taught
3. Instructor's contribution to the rotation/studio
4. Instructor's effectiveness in teaching
5. Knowledgeable and analytical
6. Clear and organized
 
Excellent Very Poor
E VG G F P VP
7. Enthusiastic and stimulating
8. Challenging 
9. Established rapport
10. Actively involved me in learning experience
11. Provided direction and feedback
12. Demonstrated clinical/professional skills and procedures
 
Excellent Very Poor
E VG G F P VP
13. Accessible
   
  14. Your involvement with the instructor was
 
Extensive
Moderate
Considerable
Slight
   
  15. On average, how many hours per week have you spent on this rotation/studio?
 
Under 2
2-3
4-5
6-7
8-9
10-11
12-13
14-15
16-17
18-19
20-21
22 or More
   
  16. From the total average hours above, how many do you consider were valuable in advancing your education?
 
Under 2
2-3
4-5
6-7
8-9
10-11
12-13
14-15
16-17
18-19
20-21
22 or More
   
  17. Year in program
 
Freshman
Second
Third
Fourth or more
   
  18. Class Composition
 
Baccalaureate Master's Ph. D.
Professinal Resident Postdoctoral fellow
Other    
   
  DEPARTMENTAL ITEMS    (Use only as directed)
 
  1 2 3 4 5 6
  1 2 3 4 5 6
  1 2 3 4 5 6
1.     6.    11.   
2.     7.    12.   
3.     8.    13.   
4.     9.    14.   
5.    10.   15.   
   
  INDIVIDUAL CLASS ITEMS    (Use only as directed)
 
  1 2 3 4 5 6
  1 2 3 4 5 6
  1 2 3 4 5 6
1.     6.    11.   
2.     7.    12.   
3.     8.    13.   
4.     9.    14.   
5.    10.   15.   

  Student Comment Sheet
  Your comments in response to the following questions will be provided to the instructor after grades are turned in.  We encourage you to respond to all questions as thoughtfully and constructively as possible.  Your comments will be used by the instructor to improve the course.  However, you are not required to answer any questions.
 

1.Was this class intellectually stimulating?  Did it stretch your thinking?
 Yes  No  Why or Why Not?

2.What aspects of this class contributed most to your learning?

3.What aspects of this class detracted from your learning?

4.What suggestions do you have for improving the class?

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