= e 3 © GRAND CANYON, Universit 1 Feedback Form Daily C (Cinical Faculty i to provide formative feock onthe sides clinical perfomance the end of cach iia day and seus with tent. Any measure marked with an“N,"indstng "Nests Ingrovemen," egies a comment on th second page of the for Both cliniian and stadent must sgn the form ach ‘linia day afer reviewing in posconference. ‘Students responsible fer seanning and pling the completed form tthe designated drop bo nthe LoudClod classroom atthe endothe lnc rotaton ‘Students who donot have ter frm sigh each clink day wil ot seve the al ois for submission athe end ofthe ration. Student: ructor;_Kely Seta ‘Mrxstns Bay) Day [ay [Day [ay [Day [Day [Day [Diy [Dax Key: _S= Meets or Is Developing _N = Needs Improvement Ce ee T._ Demeonsrtes appropriate infection control practices” sis iS lisis is ls [s Is [s | Demonstate appropri fey pases” s [sls 3 fs [s_[s [ss | ss eects eae pone vied h uerscios sober’ $ als (sas (Sms 5. Demonte aprons develope’ of eeted poner sii stele lets [5 3 [ss] 5 Dense oping oN oT aT aR TE els sls ls Wel, laws a 5 7s prepared ancl an eg wa yma stele [s [5s bets bets Takes espns Tr eng SP RTS RIT os PSs REN) se Ee ' 9 Panipat TEES wl PROTEC TTS aa) s (als Al s els 10- Resonances WISN CSN Ts Ca I, Sle bol See 5 es “Measures are related tothe competencies evaluated on the midterm and fal Clinical Evaluation Tool (CET). Measures marked by an (*) are ‘essential Competencies that i unmet by the end ofthe clinical rotation wil esult in student failure of elinical. © 2018, Grand Canyon University, All Rights Reserv,© 6 & Day/Date | Measure ere Comments Tasiracior Siadcat —] 7 SiqnatureDate | Signature/Date a * Gud Hy bes tartlt a latllt z a4 ie aay 5 ve by Lait ana 7 yt wis altamz ws : e Ww : vy wes | ols! wh wt | wand ra oe poe : ANTS sts ns Kita Tastracors 7 Velly y—Schaqeg 3ie 7 yo Ww we = wes wr yr et