SOUTHWESTERN OKLAHOMA STATE UNIVERSITY
SCHOOL OF NURSING & ALLIED HEALTH SCIENCES
ATHLETIC TRAINING PROGRAM
SELF-EVALUATION OF ATHLETIC TRAINING STUDENT

Student:
Adhikari, Bivek
Fulton, Catherine
Johnson, Kayla
Rauschenberg, Jessica
Blevins, Hailey
Hamilton, Kaylee
Lantz, Aaron
Self, Sydney
Bonnewell, Reagan
Heinen, Emmalee
Massey, Brooke
Spence, Kaci
Brown, Austin
Henricks, Colton
Nicklas, Emily
Stuart, Andrew
Castleberry, Randa
Hill, Benjamin
Nyhan, Darolyn
Vanderwerff, Taylor
Fischer, Jennifer
Hoffman, Tiffany
Ocenar, Andrea
Weir, Jasmine
Floyd, Karen
Houchin, Ali
Peters, Kayla
Willcox, Devon
Foster, Caitlin
Hudson, Taylor
Platt, Hailee
Wright, Walter

Preceptor:
Aneshansley, Shane
Hamlin, John
Long, Travis
Rose, Susan
Badgett, Blake
Harms, Meghan
Mahlock, Kris
Sage, David
Blakeburn, Robert
Hart Wolfe, Chris
McCurry, Lauren
Smith, Laura
Bolin, Kelly
Hatton, Jeremy
McKenzie, Ernest
Spencer, Breanna
Cox, Leah
Hill, Paul
Moses, Jeff
Steinkraus, Tammy
Crampton, Derrick
Hollandsworth, Randa
Oliver, Kalyp
Walker, Leander
Cruse, Anthony
Holley, Dr.
Raines, Rob
Warford, Travis
Detweiler, Edwin
Jones, Daniel
Rickey, Jody
Young, Jessica
Foster, Dain
Kiehn, Michael
Rideau, Cesiley

Clinical Site:
Badgett, Dr. Blake
Regeneration Physical Therapy
Clinton High School
SWOSU Athletics
Human Performance Center--PT
SWOSU Student Health Services
Integris Clinton Regional Hospital
Southwest Orthopaedic & Reconstructive Specialists
Integris Clinton Regional Hospital, Outpatient PT
Weatherford High School
Orthopedic Associates
Yukon High School
Current semester in the program:
Start Date of Rotation (Month, Day, & Year)
End Date of Rotation (Month, Day, & Year)

Rating Scale:
5 = Excellent skills for this level.  Consistently performs above expectations.
4 = Good skills for this level.  Occasionally performs above expectations.
3 = Average skills for this level.  Performs at minimum level of expectations.
2 = Below Average skills for this level.  Occasionally performs below expectations.
1 = Poor skills for this level.  Consistently performs below expectations.
No Score (No Reply) = Clinical Instructor feels unable to rate student on specific item. Do not calculate "No Scores" into average.

UNIVERSAL TRAITS / PERSONAL TRAITS
Attendance
5
4
3
2
1
No Reply
1. Punctual in reporting to daily assignments
2. Hours completed were appropriate

INSTRUCTIONS:  Click the button below to calculate the average rating for attendance.

Average Rating for Attendance: 

Comments

Professionalism
5
4
3
2
1
No Reply
3. Develops/maintains profesional relationships with peers, supervisors, coaches, & athletes
4. Professional demeanor
5. Demonstrates professional & ethical behavior consistent with other allied health professionals & appropriate to the profession of athletic training
6. Demonstrates effective coping skills in regards to physical & mental stress
7. Demonstrates appropriate emotional maturity
8. Dresses professionally & appropriately
9. Responds appropriately & implements constructive criticism to benefit his/her educations as an athletic trainer

INSTRUCTIONS:  Click the button below to calculate the average rating for professionalism.

Average Rating for Professionalism: 

Comments

Communication
5
4
3
2
1
No Reply
10. Effective communication with ACI, AT staff, coaches, athletes
11. Develops appropriate rapport with coaches, athletes, patients, AT staff, peers

INSTRUCTIONS:  Click the button below to calculate the average rating for communication.

Average Rating for Communication: 

Comments

Quality of Work
5
4
3
2
1
No Reply
12. Follows directions
13. Completes task assigned
14. Demonstrates reliability & dependability
15. Follows policies & procedures
16. Skillfully performs required tasks

INSTRUCTIONS:  Click the button below to calculate the average rating for quality of work.

Average Rating for Quality of Work: 

Comments

Initiative
5
4
3
2
1
No Reply
17. Demonstrates initiative to learn
18. Demonstrates initiative in clinical setting
19. Asks questions in timely manner
20. Performs responsibilities in an independent fashion
21. Organizes time effectively to achieve maximum productivity

INSTRUCTIONS:  Click the button below to calculate the average rating for initiative.

Average Rating for Initiative: 

Comments

Cooperative
5
4
3
2
1
No Reply
22. Works well with others
23. Shows cooperation & appropriate relationships with staff
24. Shows respect for the opinions of others.

INSTRUCTIONS:  Click the button below to calculate the average rating for cooperative.

Average Rating for Cooperative: 

Comments

Attitude
5
4
3
2
1
No Reply
25. Positive attitude
26. Consistently demonstrates professional attitude
27. Sets good examples for peers
28. Demonstrates confidence in his/her own ability as an Athletic Trainer
29. Provides proper encouragement & learning environment to peers

INSTRUCTIONS:  Click the button below to calculate the average rating for attitude.

Average Rating for Attitude: 

Comments

Interest
5
4
3
2
1
No Reply
30. Shows interest in athlete's well being
31. Shows interest in the profession of athletic training
32. Shows interest in learning
33. Has put forth ALL EFFORTS to gain a valuable clinical experience

INSTRUCTIONS:  Click the button below to calculate the average rating for interest.

Average Rating for Interest: 

Comments

INSTRUCTIONS:  Click the button below to calculate the average of all ratings.

Average Rating for All: 

34. Identify your strengths (Characteristics that will enhance your ability as an Athletic Trainer.  Include behavior qualities as well as work knowledge.)
35. Identify areas you need to improve on through the remainder of the clinical assignment (Suggestions for improvement will  enhance your ability as an athletic trainer.  Include behavior qualities as well as work knowledge.  Be specific.)
36. List any goals you may have for the remainder of the clinical rotation.


 
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