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PSYCHIATRY CLERKSHIP

Mid-Point Formative Evaluation


SATISFACTORY NEEDS WORK CATEGORY

Fund of Knowledge Written History Physical Exam Oral Presentation Documentation Accuracy Documentation: Timeliness Integration Synthesizing Skills Clinical Judgment Professional Integrity Commitment to Learning Interpersonal Skills with Patients, Colleagues, and Others Professional Behavior and Responsibility Professional Demeanor and Appearance Mental Status Exam Patient Safety Factors Medical Student Name:_______________________________ Please print

_______________________
(Student Signature)

_________________________
(Attending Signature) / Date

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