"*Required field" required fields indicator

Stage 1 out of 4

25%

Health Professions—Assessment of Student Performance in Clinical Training in Occupational Therapy

Student Information

Student's Name*Required field

First Name Last Name

ID Card*Required field

Guide Name*Required field

Training Program*Required field

Date of Midterm Assessment

Date of Final Evaluation

Year of Training*Required field

Training*Required field

First

Second

Third

Cell Phone*Required field

Email*Required field

Chapter 1: Professional Ethics

1. Midterm Evaluation: Upholds and Respects Medical Confidentiality

Fetus

Doesn't go through

(Midterm Evaluation)

1. Final Assessment: Upholds and Respects Medical Confidentiality

Fetus

Doesn't go through

(Final Assessment)

2. Midterm Evaluation: Respecting Clients/Patients

Fetus

Doesn't go through

(Midterm Evaluation)

2. Final Evaluation: Respecting Clients/Patients

Fetus

Doesn't go through

(Final Assessment)

3. Midterm Evaluation: Conducted Safely

Fetus

Doesn't go through

(Midterm Evaluation)

3. Final Assessment: Conducted Safely

Fetus

Doesn't go through

(Final Assessment)

4. Midterm Evaluation: Works collaboratively and transparently with the client/patient

Fetus

Doesn't go through

(Midterm Evaluation)

4. Final Evaluation: Works collaboratively and transparently with the client/patient

Fetus

Doesn't go through

(Final Assessment)

5. Midterm Evaluation: He makes a point of presenting himself as a student rather than as a professional

Fetus

Doesn't go through

(Midterm Evaluation)

5. Final Evaluation: Makes a point of presenting himself as a student rather than a professional

Fetus

Doesn't go through

(Final Assessment)

6. Midterm Evaluation: Acting Within the Scope of His Authority

Fetus

Doesn't go through

(Midterm Evaluation)

6. Final Evaluation: Acts within the scope of his or her authority

Fetus

Doesn't go through

(Final Assessment)

7. Midterm Evaluation: Preparing for the Tasks Required of Him

Fetus

Doesn't go through

(Midterm Evaluation)

7. Final Assessment: Preparing for the tasks required of him

Fetus

Doesn't go through

(Final Assessment)

8. Midterm Evaluation: Meets the training requirements as defined in the training procedures and by the training site

Fetus

Doesn't go through

(Midterm Evaluation)

8. Final Evaluation: Meets the training requirements as defined in the training procedures and by the training site

Fetus

Doesn't go through

(Final Assessment)

9. Midterm Evaluation: Acts in a reliable and honest manner (provides accurate reports)

Fetus

Doesn't go through

(Midterm Evaluation)

9. Final Evaluation: Acts in a reliable and honest manner (provides accurate reports)

Fetus

Doesn't go through

(Final Assessment)

If any of the sections receives a "Fail" grade, please describe in detail the events that led to this decision:

A student who went above and beyond what was expected as part of the training program can also be described in the following sections:

Chapter 2: Evaluation of Professional Conduct

1. Behavior and Interpersonal Communication

Verbal Assessment

Components of the Assessment

Check the box next to each relevant statement.

Midterm Evaluation: Understands and acts in accordance with the hierarchy of roles within the framework

Not applicable

(Midterm Evaluation)

Final Assessment: Understands and acts in accordance with the hierarchy of roles within the framework

Not applicable

(Final Assessment)

Midterm Evaluation: Ensures that his appearance is appropriate for the workplace

Not applicable

(Midterm Evaluation)

Final Evaluation: Maintains an appearance appropriate for driving

Not applicable

(Final Assessment)

Midterm Evaluation: Fosters Positive and Respectful Communication

Not applicable

(Midterm Evaluation)

Final Assessment: Fosters Positive and Respectful Communication

Not applicable

(Final Assessment)

Midterm Evaluation: Listens to the needs and wishes of clients/patients and responds to them with respect

Not applicable

(Midterm Evaluation)

Final Assessment: Attentive to the needs and wishes of clients/patients and responds to them with respect

Not applicable

(Final Assessment)

Midterm Evaluation: Handles disagreements in a pleasant and attentive manner

Not applicable

(Midterm Evaluation)

Final Evaluation: Handles disagreements in a pleasant and attentive manner

Not applicable

(Final Assessment)

Midterm Evaluation: Setting Boundaries with Clients/Patients

Not applicable

(Midterm Evaluation)

Final Assessment: Setting Boundaries with Clients/Patients

Not applicable

(Final Assessment)

Midterm Evaluation: Presents his opinions in a professional manner

Not applicable

(Midterm Evaluation)

Final Evaluation: Presents his opinions in a professional manner

Not applicable

(Final Assessment)

Midterm Evaluation: Maintains open and respectful communication with the client/patient

Not applicable

(Midterm Evaluation)

Final Assessment: Maintains open and respectful communication with the client/patient

Not applicable

(Final Assessment)

Midterm Evaluation: Considers the needs of others on the team

Not applicable

(Midterm Evaluation)

Final Evaluation: Considers the needs of others on the team

Not applicable

(Final Assessment)

Mid-Year Evaluation: Works effectively as part of a team (plans and carries out tasks assigned by others)

Not applicable

(Midterm Evaluation)

Final Evaluation: Works effectively as part of a team (plans and carries out tasks together with others)

Not applicable

(Final Assessment)

Midterm Evaluation: Shares Concerns and Expresses a Position

Not applicable

(Midterm Evaluation)

Final Assessment: Shares his concerns and expresses his opinion

Not applicable

(Final Assessment)

Midterm Evaluation: Presenting a Professional and Well-Organized Report at a Staff Meeting

Not applicable

(Midterm Evaluation)

Final Evaluation: Presents a professional and well-organized report at a staff meeting

Not applicable

(Final Assessment)

Interpersonal Skills and Communication—Midterm Evaluation: Other

(Midterm Evaluation)

Interpersonal Skills and Communication—Final Assessment: Other

(Final Assessment)

Examples and Notes

2. Personal Responsibility

Verbal Assessment

Components of the Assessment

Midterm Evaluation: Demonstrates Motivation for Professional Development

Not applicable

(Midterm Evaluation)

Final Evaluation: Demonstrates Motivation for Professional Development

Not applicable

(Final Assessment)

Midterm Evaluation: Demonstrates personal responsibility for learning

Not applicable

(Midterm Evaluation)

Final Assessment: Demonstrates personal responsibility for learning

Not applicable

(Final Assessment)

Midterm Evaluation: Asks questions, seeks advice, and brings up concerns during coaching sessions

Not applicable

(Midterm Evaluation)

Final Assessment: Asks questions, seeks advice, and brings up concerns during coaching sessions

Not applicable

(Final Assessment)

Midterm Evaluation: Receives positive feedback and strives for improvement

Not applicable

(Midterm Evaluation)

Final Evaluation: Receives positive feedback and strives for improvement

Not applicable

(Final Assessment)

Midterm Evaluation: Assesses his strengths and weaknesses in training

Not applicable

(Midterm Evaluation)

Final Evaluation: Addresses his strengths and weaknesses in training

Not applicable

(Final Assessment)

Midterm Evaluation: Meeting Deadlines with Patients, Staff, and External Parties

Not applicable

(Midterm Evaluation)

Final Evaluation: Meets deadlines with patients, staff, and external parties

Not applicable

(Final Assessment)

Midterm Evaluation: Takes responsibility for tasks and carries them out to completion

Not applicable

(Midterm Evaluation)

Final Evaluation: Takes responsibility for tasks and carries them out to completion

Not applicable

(Final Assessment)

Midterm Evaluation: Takes the initiative and offers ideas/suggestions

Not applicable

(Midterm Evaluation)

Final Evaluation: Takes the initiative and offers ideas/suggestions

Not applicable

(Final Assessment)

Midterm Evaluation: Volunteer for Tasks and Roles

Not applicable

(Midterm Evaluation)

Final Evaluation: Volunteer for Tasks and Roles

Not applicable

(Final Assessment)

Midterm Evaluation: Makes sure to prepare for and plan the session with the client/patient

Not applicable

(Midterm Evaluation)

Final Evaluation: Takes care to prepare for and plan the session with the client/patient

Not applicable

(Final Assessment)

Mid-Year Evaluation: Adaptable and able to cope with changes in job requirements

Not applicable

(Midterm Evaluation)

Final Evaluation: Adaptable and able to cope with changes in job requirements

Not applicable

(Final Assessment)

Midterm Evaluation: Adjusting Behavior Based on Feedback

Not applicable

(Midterm Evaluation)

Final Assessment: Adjusting Behavior Based on Feedback

Not applicable

(Final Assessment)

Midterm Evaluation: Adapts to Different Clients/Patients

Not applicable

(Midterm Evaluation)

Final Assessment: Adapting to Different Clients/Patients

Not applicable

(Final Assessment)

Midterm Assessment: Reveals an Understanding of the Discrepancies Between What Is Taught in Academia and What Is Observed in the Field

Not applicable

(Midterm Evaluation)

Final Assessment: Demonstrates an understanding of the gaps between what is taught in academia and what is observed in the field

Not applicable

(Final Assessment)

Midterm Evaluation: Coping with Stressors in Positive and Effective Ways

Not applicable

(Midterm Evaluation)

Final Assessment: Copes with stressors in positive and effective ways

Not applicable

(Final Assessment)

Midterm Evaluation: Adheres to Hygiene Rules

Not applicable

(Midterm Evaluation)

Final Assessment: Adheres to hygiene rules

Not applicable

(Final Assessment)

Mid-term Evaluation: Maintains an organized and clean work environment

Not applicable

(Midterm Evaluation)

Final Evaluation: Maintains an organized and clean work environment

Not applicable

(Final Assessment)

Personal Responsibility—Midterm Evaluation: Other

(Midterm Evaluation)

Personal Responsibility—Final Assessment: Other

(Final Assessment)

Examples and Notes

Chapter 3: Assessment of Required Skills and Knowledge

3. Gathering information about the client/patient and their needs

Verbal Assessment

Components of the Assessment

Mid-term Assessment: Gathering Information from Staff Members, Personal Files, Primary Caregivers, and External Sources

Not applicable

(Midterm Evaluation)

Final Assessment: Gathering information from staff members, personal files, primary caregivers, and external sources

Not applicable

(Final Assessment)

Midterm Assessment: Structured Observation Exercise

Not applicable

(Midterm Evaluation)

Final Assessment: Structured Observation Exercise

Not applicable

(Final Assessment)

Midterm Evaluation: Demonstrates the ability to listen actively

Not applicable

(Midterm Evaluation)

Final Assessment: Demonstrates active listening skills

Not applicable

(Final Assessment)

Midterm Evaluation: Conducting an Introductory Interview

Not applicable

(Midterm Evaluation)

Final Evaluation: Conducting an Introductory Interview

Not applicable

(Final Assessment)

Midterm Assessment: Uses information sources (literature, articles)

Not applicable

(Midterm Evaluation)

Final Assessment: Uses information sources (literature, articles)

Not applicable

(Final Assessment)

Midterm Evaluation: Describes the information collected using professional terminology (terminology relevant to the context)

Not applicable

(Midterm Evaluation)

Final Assessment: Describes the information collected using professional terminology (terminology relevant to the context)

Not applicable

(Final Assessment)

Midterm Assessment: Selects assessment tools appropriate for the patient and the professional rationale within the framework of

Not applicable

(Midterm Evaluation)

End-of-Treatment Assessment: Selects appropriate assessment tools for the patient and in accordance with professional rationale within the framework of

Not applicable

(Final Assessment)

Midterm Evaluation: Conducts an assessment in accordance with the guidelines booklet and the instructor’s instructions

Not applicable

(Midterm Evaluation)

Final Assessment: Conducts an assessment in accordance with the guidelines booklet and the instructor’s instructions

Not applicable

(Final Assessment)

Midterm Evaluation: Actively participates in analyzing the results and is able to explain them to other team members

Not applicable

(Midterm Evaluation)

Final Assessment: Actively participates in analyzing the results and is able to explain them to other team members

Not applicable

(Final Assessment)

Mid-term Evaluation: Explains the findings of the diagnosis and evaluation to the client/patient

Not applicable

(Midterm Evaluation)

Final Evaluation: Explains the findings of the diagnosis and evaluation to the client/patient

Not applicable

(Final Assessment)

Midterm Evaluation: Writes a summary of the assessment findings in clear and precise language

Not applicable

(Midterm Evaluation)

Final Assessment: Writes a summary of the assessment findings in clear and precise language

Not applicable

(Final Assessment)

Gathering Information About the Client/Patient and Their Needs—Midterm Assessment: Other

(Midterm Evaluation)

Gathering information about the client/patient and their needs—Final assessment: Other

(Final Assessment)

Examples and Notes

4. Planning and Implementing an Intervention

Verbal Assessment

Components of the Assessment

Midterm Assessment: Setting Goals That Are Relevant to the Client/Patient and in Collaboration with Them

Not applicable

(Midterm Evaluation)

Final Assessment: Setting goals that are relevant to the client/patient and in collaboration with them

Not applicable

(Final Assessment)

Midterm Evaluation: Uses Appropriate Intervention Approaches

Not applicable

(Midterm Evaluation)

Final Assessment: Uses Appropriate Intervention Approaches

Not applicable

(Final Assessment)

Midterm Evaluation: Setting Priorities for Intervention

Not applicable

(Midterm Evaluation)

Final Assessment: Setting Priorities for Intervention

Not applicable

(Final Assessment)

Midterm Evaluation: Can adjust the intervention goals in response to changes in the situation

Not applicable

(Midterm Evaluation)

Final Assessment: Can adjust the intervention goals in response to changes in the situation

Not applicable

(Final Assessment)

Midterm Assessment: Integrating Knowledge and Theory into Practice

Not applicable

(Midterm Evaluation)

Final Assessment: Integrating Knowledge and Theory into Practice

Not applicable

(Final Assessment)

Midterm Evaluation: Activity Analysis

Not applicable

(Midterm Evaluation)

Final Assessment: Activity Analysis Exercise

Not applicable

(Final Assessment)

Midterm Evaluation: Organizing the Therapeutic Environment

Not applicable

(Midterm Evaluation)

End-of-Treatment Assessment: Organizing the Therapeutic Environment

Not applicable

(Final Assessment)

Midterm Evaluation: Selecting Appropriate Intervention Measures

Not applicable

(Midterm Evaluation)

Final Assessment: Selecting Appropriate Intervention Strategies

Not applicable

(Final Assessment)

Midterm Evaluation: Managing Intervention Time Effectively

Not applicable

(Midterm Evaluation)

Final Assessment: Manages the intervention time effectively

Not applicable

(Final Assessment)

Midterm Evaluation: Plans the intervention in accordance with the established goals

Not applicable

(Midterm Evaluation)

Final Evaluation: Plans the intervention in accordance with the established goals

Not applicable

(Final Assessment)

Midterm Evaluation: Use touch as needed

Not applicable

(Midterm Evaluation)

Final Assessment: Uses touch when necessary

Not applicable

(Final Assessment)

Mid-process assessment: The manager communicates with the patient about what is being done as the procedure is underway

Not applicable

(Midterm Evaluation)

Final Assessment: Communicate with the patient about what is being done as the procedure is performed

Not applicable

(Final Assessment)

Midterm Evaluation: Reporting and Record-Keeping

Not applicable

(Midterm Evaluation)

Final Assessment: Reporting and Record-Keeping

Not applicable

(Final Assessment)

Intervention Design and Implementation—Midterm Evaluation: Other

(Midterm Evaluation)

Intervention Design and Implementation—Final Evaluation: Other

(Final Assessment)

Examples and Notes

5. Recommended Experiences – Training and Group Facilitation

Verbal Assessment

Examples and Notes

Components of the Assessment

Midterm Assessment: Patient Education Session

Not applicable

(Midterm Evaluation)

Final Assessment: Patient Education Session

Not applicable

(Final Assessment)

Midterm Evaluation: Training Program for Primary Care Providers

Not applicable

(Midterm Evaluation)

Final Evaluation: Training Program for Primary Care Providers

Not applicable

(Final Assessment)

Mid-term Assessment: Exchanging Relevant Information with Other Care Providers in the Community

Not applicable

(Midterm Evaluation)

Discharge Assessment: Sharing Relevant Information with Other Community Care Providers

Not applicable

(Final Assessment)

Midterm Evaluation: A Guide and Source of Information for Other Staff Members

Not applicable

(Midterm Evaluation)

Final Evaluation: A Guide and Source of Information for Other Staff Members

Not applicable

(Final Assessment)

Midterm Assessment: Design a group or a subset of a group based on the population and objectives

Not applicable

(Midterm Evaluation)

Final Assessment: Design a group or a subset of a group based on the population and objectives

Not applicable

(Final Assessment)

Midterm Evaluation: Active Participant in Group Facilitation

Not applicable

(Midterm Evaluation)

Final Evaluation: Active Participant in Group Facilitation

Not applicable

(Final Assessment)

Midterm Evaluation: Documents the group's progress in clear, professional language

Not applicable

(Midterm Evaluation)

Final Evaluation: Documents the group's progress in clear, professional language

Not applicable

(Final Assessment)

Recommended Experiences – Group Instruction and Facilitation – Midterm Evaluation: Other

(Midterm Evaluation)

Recommended Experiences – Group Instruction and Facilitation – Final Evaluation: Other

(Final Assessment)

Chapter 4 – Verbal Assessment

After completing the form, select up to 3 items to maintain and up to 3 items for improvement, for which the instructor and the student will jointly define goals for the future (even in the case of a final evaluation). The goals must be quantitatively measurable, clearly defined, and time-bound. For example: The student will continue to write reports in the personal file of the patient with whom they are working (maintenance). The student will meet with the patient to select a goal for the next two weeks in the intervention process, while ensuring respect for the patient’s aspirations (improvement).

Defining Conservation Behaviors

Defining Behaviors for Retention - 1

Midterm Assessment: Defining Behaviors to Retain - 1

Not applicable

(Midterm Evaluation)

Final Assessment: Defining Behaviors to Be Retained - 1

Not applicable

(Final Assessment)

Defining Behaviors for Retention - 2

Midterm Assessment: Defining Behaviors to Retain - 2

Not applicable

(Midterm Evaluation)

Final Assessment: Defining Behaviors to Retain - 2

Not applicable

(Final Assessment)

Defining Behaviors for Retention - 3

Midterm Assessment: Defining Behaviors to Retain - 3

Not applicable

(Midterm Evaluation)

Final Assessment: Defining Behaviors to Retain - 3

Not applicable

(Final Assessment)

Defining Behaviors for Improvement - 1

Midterm Evaluation: Identifying Behaviors for Improvement - 1

Not applicable

(Midterm Evaluation)

Final Assessment: Identifying Behaviors for Improvement - 1

Not applicable

(Final Assessment)

Defining Behaviors for Improvement - 2

Midterm Assessment: Identifying Behaviors for Improvement - 2

Not applicable

(Midterm Evaluation)

Final Assessment: Identifying Behaviors for Improvement - 2

Not applicable

(Final Assessment)

Defining Behaviors for Improvement - 3

Midterm Assessment: Identifying Behaviors for Improvement - 3

Not applicable

(Midterm Evaluation)

Final Assessment: Identifying Behaviors for Improvement - 3

Not applicable

(Final Assessment)

Final Evaluation

1. Defining Additional Behaviors to Preserve

2. Defining Additional Behaviors to Preserve

3. Defining Additional Behaviors to Preserve

1. Defining Additional Behaviors for Improvement

2. Defining Additional Behaviors for Improvement

3. Defining Additional Behaviors for Improvement

General Evaluation of the Student (To be completed only at the end of the training period)

* The written summary in this chapter will be provided to the student and may serve as a recommendation if the student wishes to use it.

Comments (To be filled out only at the end of the training period)

Midterm Evaluation

Date (mid)

Student's Signature

(Midterm Evaluation)

The Instructor's Signature

(Midterm Evaluation)

Final Evaluation

Date (End)

Student's Signature

(Final Assessment)

The Instructor's Signature

(Final Assessment)

Accessibility at Ono Academic College

Health Professions—Assessment of Student Performance in Clinical Training in Occupational Therapy

Student Information

Chapter 1: Professional Ethics

Chapter 2: Evaluation of Professional Conduct

1. Behavior and Interpersonal Communication

Components of the Assessment

2. Personal Responsibility

Components of the Assessment

Chapter 3: Assessment of Required Skills and Knowledge

3. Gathering information about the client/patient and their needs

Components of the Assessment

4. Planning and Implementing an Intervention

Components of the Assessment

5. Recommended Experiences – Training and Group Facilitation

Components of the Assessment

Chapter 4 – Verbal Assessment

Defining Conservation Behaviors

Final Evaluation

Midterm Evaluation

Final Evaluation

CV