MedEd IQ Student Survey

First Name:

Last Name:

Tell us about the learning opportunities that were available at the clinical site.

	Strongly Disagree	Disagree	Mildly Disagree	Mildly Agree	Agree	Strongly Agree
1. Performance of problem-focused history and physical exam
2. The opportunities were too diverse, preventing me from developing proficiency.
3. My experiences were repetitive and offered few new learning experiences.
4. I increased my independence in caring for patients.
5. I improved my communication skills.
6. I became more proficient in the skills of clinical medicine because of opportunities in this experience.

Please comment on what aspects of this experience you found particularly positive or negative:

Tell us about the experiences in the clinical site:

	Strongly Disagree	Disagree	Mildly Disagree	Mildly Agree	Agree	Strongly Agree
1. Things moved too fast for me to really learn anything.
2. I felt like my time in the office was wasted.
3. The site functioned so that I could easily join in patient care.
4. I did not feel like a useful member of the health care team.
5. The health care team was not supportive of my learning.
6. I had adequate resources available to me, which facilitated my learning (e.g., reference materials).

Please comment on what aspects of this experience you found particularly positive or negative:

Participation: In general, how would you characterize your involvement in the following activities?

	No Exposure	Involved hardly at all	Involved to a small degree	Involved to a moderate degree	Involved to a considerable degree	Involved to a high degree
1. Taking patient histories.
2. Performing exams.
3. Interpreting laboratory tests.
4. Assessing the use of radiology services.
5. Explaining causes or pathophysiology of problems.
6. Discussing assessment and diagnosis.
7. Planning treatment and patient education.

Please comment on what aspects of this experience you found particularly positive or negative:

Please tell us about your experiences with your preceptor:

	Strongly Disagree	Disagree	Mildly Disagree	Mildly Agree	Agree	Strongly Agree
1. Established an active role for me in the office.
2. Failed to prepare me for patient encounters (e.g. reviewing patient history, prioritizing pertinent issues, demonstrating strategies).
3. Gave me specific information that helped me improve my skills.
4. Instructed me at my own level of expertise.
5. Did not actively listen to me.
6. Brought to my attention physical findings that I had previously not seen.
7. Made every patient encounter a learning experience.
8. Created an environment in which I felt comfortable accepting challenges, even at the risk of making mistakes.
9. Improved my understanding of clinical practice (such as physical exams, medical decision making, treatment options, etc.).
10. Discouraged me from taking risks or trying new things.
11. Did not check my work.
12. Demonstrated the value of respecting patient preferences even when they differed from my own.
13. Encouraged me to become increasingly independent over time.
14. Criticized me without offering suggestions for improvement.

Please comment on what aspects of this experience you found particularly positive or negative:

I would be willing to participate in a student focus group regarding evaluation of effective clinical teaching to benefit future PA students: Yes No

This form was modified with permission from Dr. Paul James, Carver College of Medicine, Iowa.City, Iowa.