Student Self-Assessment of Competencies

None of this data has any influence on your grades. This is a tool for us to help you meet your competencies.

All fields marked with an * are required:

Student ID*
Course*	PC Lab III (4331) PC Lab V (5322) 1st Semester Rotations 2nd Semester Rotations
Semester*	Fall Spring Summer
Year*	2008 2009 2010
Age
Gender*	Male Female

Please rank the completed competencies as follows: 0=Not applicable   1=No confidence   2=Less than confident   3=Confident   4=Extremely confident
Comp 1 (Communicate effectively)*	0 1 2 3 4
Comp 2 (Think critically)*	0 1 2 3 4
Comp 3 (Demonstrates social interactions, skills, citizenship, leadership & professionalism)*	0 1 2 3 4
Comp 4 (Manage information)*	0 1 2 3 4
Comp 5 (Prepare, distribute, administer medications)*	0 1 2 3 4
Comp 6 (Manage systems)*	0 1 2 3 4
Comp 7 (Manage patients)*	0 1 2 3 4
Comp 8 (Make pharmacotherapeutic decisions)*	0 1 2 3 4
Comp 9 (Drug therapy evaluation)*	0 1 2 3 4
Comp 10 (Develop pharmaceutical care plan)*	0 1 2 3 4
Comments, etc.

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