Professionalism Assessment Tool

School of Medicine Edition

Version 7 12/27/12
©

Name__________________________ Date______________________________________ Faculty/Evaluator__________________________

Rotation/Course________________________

Please indicate the appropriate score for each of the following standards of professionalism.

Honesty/Integrity Not Observed_____

60 65 70 75 80 85 90 95 100 95 90 85 80 75 70 65 60

Untruthful; misrepresents Exhibits forthrightness and Truthful to the point of

position or status; misuses truthfulness; trustworthy; blatant insensitivity;
resources; falsifies data, identifies status and position tactless
plagiarizes or cheats appropriately; displays honesty
at all times

Written communication Not Observed_____

60 65 70 75 80 85 90 95 100 95 90 85 80 75 70 65 60

Writing illegible; grammar Writes in a clear, concise Verbose; writing is overly

poor; ideas not well manner; thoughts well- detailed or redundant
expressed expressed and unambiguous.

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 Verbal communication Not Observed_____
60 65 70 75 80 85 90 95 100 95 90 85 80 75 70 65 60

Inarticulate; poorly Speaks clearly and effectively Dominates conversations;

spoken loud or indiscreet

Punctuality Not Observed_____

60 65 70 75 80 85 90 95 100 95 90 85 80 75 70 65 60

Exhibits a consistent Punctual; meets deadlines Values timeliness over

lack of punctuality; quality
does not adhere to
deadlines

Appearance Not Observed_____

60 65 70 75 80 85 90 95 100 95 90 85 80 75 70 65 60

Poor hygiene; sloppy, Appropriately groomed and Extremes of dress;

clothes unkempt clean provocative or
inappropriate

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Confidentiality Not Observed____
60 65 70 75 80 85 90 95 100 95 90 85 80 75 70 65 60

Disregards patients’ Demonstrates and maintains Inappropriately upholds

confidentiality sensitivity to confidential patients’ right to
patient information confidentiality, thereby
putting them and others at
risk for adverse
` consequences, e.g., suicide,
sexual assault, child abuse,
and reportable diseases

Team work Not Observed_____

60 65 70 75 80 85 90 95 100 95 90 85 80 75 70 65 60

Non-participatory, does Works well with others and Dominant and

not contribute team members authoritarian;
uncooperative; overbearing

Respect for patients Not Observed_____

60 65 70 75 80 85 90 95 100 95 90 `85 80 75 70 65 60

Disrespectful to patients; Demonstrates sensitivity to Accepting of all patients’

insensitive to their beliefs, patients; beliefs opinions, behaviors, regardless of
opinions, gender, race, gender, race, culture, sexual, their status;
culture, religion, sexual orientation, and status inappropriately deferential
orientation, or status to patients’ behaviors,
regardless of their
consequence

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Responsibility Not Observed_____
60 65 70 75 80 85 90 95 100 95 90 85 80 75 70 65 60

Makes excuses; displaces Admits errors; responsibility Afraid to act for fear of
blame for actions making errors; assumes
blame inappropriately;
overly obsessive

Respect for Colleagues Not Observed_____

60 65 70 75 80 85 90 95 100 95 90 85 80 75 70 65 60

Concern for self supersedes Shows appropriate concern for Excessively deferential;
concern for others; self- others; goes the extra mile overextends self to own
centered; selfish, unwilling without thought of reward detriment
to extend self

Self-Confidence Not Observed_____

60 65 70 75 80 85 90 95 100 95 90 85 80 75 70 65 60

Always insecure; unable to Appropriately confident; asks Overconfident; does not

act independently for help when necessary recognize own limitations

PAT_SOM Ver 1 07.16.12

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