From: mandy jarriel mandy.jarriel@gcsu.

edu
Subject: Fw: Form submission from: KINS 3102: Preceptor Evaluation of Student
Date: December 7, 2017 at 1:37 PM
To: kayla brockway kayla.brockway@bobcats.gcsu.edu

Mandy Jarriel PhD, ATC, LAT, CHES

School of Health and Human Performance
Associate Professor, Program Director
Athletic Training Program
Campus Box 112
Health Sciences Building 330
478-445-2136

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From: Kayla Brockway <georgia.college@gcsu.edu>

Sent: Thursday, December 7, 2017 1:28 PM
To: mandy jarriel
Subject: Form submission from: KINS 3102: Preceptor EvaluaPon of Student

Submitted on December 7, 2017 - 1:28pm

Submitted by anonymous user: [71.86.100.26]

Submitted values are:

INSTRUCTIONS

Please fill out the evaluation below. The survey will be emailed to the email address you provided
on the survey. Please printout the email. Both the student and preceptor need to sign and date
 the last page of the printout.

Student Name
Kayla Brockway

Preceptor Name
Caitlin Moeller

Preceptor Email
caitlin.moeller@gcsu.edu

Clinical Setting/Experience
GCSU RecSports

Date
December 7, 2017

Evaluation
Final Evaluation

DIRECTIONS

Please evaluate the athletic training student objectively. Please select the appropriate response
for each item in the categories below. Select NA if you are not able to assess the student. NA =
Not Able to Assess 5 = Outstanding 4 = Good 3 = Satisfactory 2 = Improvement Needed 1 =
Unacceptable

Athletic Training Knowledge

NA 5 4 3 2 1

1. Demonstrates knowledge of policies and procedures of clinical experience X

setting.

2. Demonstrates knowledge in injury prevention. X

3. Demonstrates skill in selecting and interpreting fitness/testing procedures X

to minimize risk of injury/illness.

4. Demonstrates skill in developing and implementing prevention strategies to X

minimize risk of injury/illness.
 5. Demonstrates knowledge in taping/bracing techniques. X

6.Demonstrates skill in applying taping/bracing techniques. X

7. Demonstrates knowledge in injury evaluation and diagnosis. X

8. Demonstrates knowledge in providing treatment to patients/athletes. X

Interpersonal Skills

NA 5 4 3 2 1

1. Demonstrates effective written communication with preceptor. X

2. Demonstrates effective oral communication with preceptor. X

3. Demonstrates effective communication with patients/athletes. X

4. Demonstrates effective communication with other staff/personnel. X

5. Demonstrates effective critical-thinking skills. X

6. Demonstrates effective clinical decision-making skills. X

7. Demonstrates a positive attitude in interactions with preceptor, patients, X

etc.

8. Demonstrates confidence in abilities as an athletic training student. X

Professional Responsibility

NA 5 4 3 2 1

1. Demonstrates punctuality. X

2. Demonstrates professionalism (i.e., attitude, actions, dress/appearance). X

3. Demonstrates initiative. X

4. Demonstrates a willingness to learn. X

5. Demonstrates an awareness of limitations. X

6. Maintains confidentiality. X

DIRECTIONS

Please evaluate the athletic training student objectively. Please select the appropriate response
for each item in the categories below. Select NA if you are not able to assess the student. NA =
Not Able to Assess 5 = Outstanding 4 = Good 3 = Satisfactory 2 = Improvement Needed 1 =
Not Able to Assess 5 = Outstanding 4 = Good 3 = Satisfactory 2 = Improvement Needed 1 =
Unacceptable

Administrative Tasks

NA 5 4 3 2 1

1. Demonstrates an ability to multi-task efficiently and effectively. X

2. Maintains an accurate inventory of supplies. X

3. Maintains accurate documentation of injuries/illnesses and treatments X

provided.

4. Documents injuries/illnesses and treatments accurately. X

5. Utilizes accurate and appropriate medical terminology. X

Technical Standards

NA 5 4 3 2 1

1. Demonstrates the mental capacity to assimilate, analyze, synthesize, X

integrate concepts and problem solve to formulate assessment and
therapeutic judgments.

2. Demonstrates sufficient postural and neuromuscular control, sensory X

function, and coordination to perform appropriate physical examinations using
accepted techniques.

3. Demonstrates the ability to tolerate physically taxing work loads. X

4. Demonstrates the ability to communicate effectively and sensitively with X

patients and colleagues, including individuals from different cultural and social
backgrounds.

5. Demonstrates the ability to record the physical examination results and a X

treatment plan clearly and accurately.

6. Demonstrates the capacity to maintain composure and continue to function X

well during periods of high stress.

7. Demonstrates the perseverance, diligence and commitment to complete X

the athletic training program as outlined and sequenced.

8. Demonstrates flexibility and the ability to adjust to changing situatins and X

uncertainty in clinical situations.

9. Demonstrate affective skills and appropriate demeanor and rapport that X

relate to professonal education and quality patient care.

Lower Extremity Assessment Skills

NA 5 4 3 2 1

1. Obtains appropriate medical history. X

 X

2. Completes appropriate visual observation of lower extremity X

injury/condition.

3. Identifies and palpates appropriate lower extremity anatomical landmarks. X

4. Assesses lower extremity range of motion appropriately. X

5. Performs lower extremity manual muscle test(s) appropriately. X

6. Selects appropriate diagnostic/special tests pertinent to injury/condition. X

7. Performs lower extremity diagnostic/special tests accurately. X

8. Differentiates between normal and abnormal patient physical findings. X

9. Performs appropriate lower extremity neurological circulatory assessment. X

10. Documents evaluation and diagnosis appropriately. X

Therapeutic Modalities Skills

NA 5 4 3 2 1

1. Selects appropriate modality based on desired patient outcomes. X

2. Inspects modality prior to use to ensure safety. X

3. Utilizes proper patient positioning during treatments. X

4. Identifies indications and contraindications for modality use. X

5. Utilizes appropriate parameters for modality use. X

6. Utilizes correct procedures for modality application and use. X

7. Documents treatment appropriately. X

GLOBAL ASSESSMENT

In the space below, please assess the athletic training in each of the following areas:

Willingness to accept role as a health care provider

Kayla is very aware of her future role as a health care provider, and often speaks to how she looks
forward to learning more to become a better provider.

Utilization of evidence-based medicine techniques in patient care

Utilization of evidence-based medicine techniques in patient care
We only use evidence-based medicine techniques in patient care in RecSports.

Strengths of the athletic training student

One of Kayla's biggest strengths is her eagerness to learn more. She never shies away from a
challenge, and often seeks them out. Her work ethic, drive, and positive attitude are noticeable by all.
She interacts well with both patients and RecSports staff.

Areas for the athletic training student to improve

The main thing Kayla needs to improve is her confidence in her own knowledge and abilities. She
often knows the correct answer, but may doubt, or overthink it. We have discussed this, and she has
improved on it throughout the semester.

Do you feel students under your supervision engage in a sufficient number of real-time
clinical evaluations? Why or Why Not?
I do feel that the students engage in a sufficient number of real-time evaluations based on their
knowledge base. I try to give them the opportunity to take the lead when it is appropriate, then I fill in
the blanks for them and the patient afterwards. Sometimes this isn't possible due to the nature of the
injury (example: shoulder injury, and they haven't taken upper extremity yet), but I think it's important
for them to get as much hands-on experience as possible.

Additional comments
Kayla improved very well throughout this semester, and was an absolute pleasure to work with the
entire time. She successfully maintained the balance between being a student-athlete and an athletic
training student, despite the difficulties associated with this. Not once did she slack off in regards to
her clinical responsibilities. I wish I could have offered her more experience in regards to
treatment/rehab, but her time was limited in that area. I do feel that she is exactly where she needs to
be at the end of her first semester, and she will have no trouble continuing to improve throughout her
time in this program.

Signature
__________________________________________ Student Signature / Date

The results of this submission may be viewed at:

https://intranet.gcsu.edu/node/1606/submission/14058