Evaluation of Clerkship Learning Competencies--Autopsy Pathology (Student)
(Completed and submitted independently by student at the end of an Autopsy and/or Medical Examiner's rotation)

อีเมล *
Student Name: *
Date: *
Autopsy or Medical Examiner Site Name: *
Evaluation
Please select the response which best reflects your current performance in the following areas of competency and write a brief narrative.



*Competent = performs at the level expected of an ASCP certified Pathologists’ Assistant*
Medical Knowledge
Demonstrates competency (e.g., care, skill, efficiency, etc.) in autopsy techniques including evisceration and block dissection. *
Practice-Based Learning and Improvement
Able to resolve problems and readily adapt to new and/or changing situations and environments (e.g., labs, procedures, dictation style, etc.). *
Interpersonal and Communication Skills
Asks intelligent questions and seeks assistance when appropriate. *
Demonstrates communication and interpersonal skills that result in effective information exchange and collaboration with pathologists and other health care professionals. *
Professionalism
Recognizes the importance of appropriate appearance/attire, regular attendance, punctuality, and preparedness. *
Understands the significance of honesty, accountability, and ethical practice. *
Demonstrates a positive, supportive, and respectful attitude toward peers and colleagues. *
Displays sensitivity toward individual and cultural differences. *
Systems-Based Practice
Is prepared to serve as a steward of the profession and promote the art and science of practicing anatomic pathology. *
Safety
Practices appropriate sharps handling. *
Utilizes proper PPE. *
Narrative
Narrative *
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