UNIVERSITY OF SANTO TOMAS

Faculty of Pharmacy
Department of Medical Technology
Principles of Medical Technology Practice 2

Performance Scoring Rubric: Familiarization with Phlebotomy Materials

Student's Name _____________________________________________ Yr. & Sec:___________ Group No:_______

CRITERIA
1. Identification of phlebotomy equipment
and supplies
2. Identification of the purpose of the
equipment and supplies needed to collect
blood
3. Identification of needle gauge and its
corresponding use based on color code
4. Identification of the parts of needle and
syringe
Excellent (5 pts)
Correctly identified 5 out of 5 phlebotomy
equipment and supplies
Correctly identified the purpose of 5 out
of 5 phlebotomy equipment and supplies
Correctly identified the gauge and use of
5 out of 5 color-coded needles
Correctly identified 5 out of 5 parts of
needle and syringe
Good (3 pts)
Correctly identified 3-4 out of 5 phlebotomy
equipment and supplies
Correctly identified the purpose of 3-4 out of
5 phlebotomy equipment and supplies
Correctly identified the gauge and use of 3-4
out of 5 color-coded needles
Correctly identified 3-4 out of 5 parts of
needle and syringe
Fair (2 pts)
Correctly identified 1-2 out of 5
phlebotomy equipment and supplies
Correctly identified the purpose of 1-2 out
of 5 phlebotomy equipment and supplies
Correctly identified the gauge and use of 1-
2 out of 5 color-coded needles
Correctly identified 1-2 out of 5 parts of
needle and syringe
Poor (1 pt) SCORE
Did not correctly identify any phlebotomy
equipment and supplies
Did not correctly identify the purpose of any
phlebotomy equipment and supplies
Did not correctly identify the gauge and use
of any color-coded needles
Did not correctly identify any parts of needle
and syringe
TOTAL
%

Transmutation table
Score % Score % Score % Score % EVALUATOR:_________________________
25 = 100% 20 = 90% 15 = 79% 8 = 65%
24 = 98% 19 = 87% 12 = 77% 7 = 61%
23 = 96% 18 = 85% 11 = 75% 6 = 58% DATE_____________________
22 = 94% 17 = 83% 10 = 72% 5 = 54%
21 = 92% 16 = 81% 9 = 68%