New Hire Preceptorship Experience Feedback Survey

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* 1. New Hire (Your) Full Name:

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* 2. Preceptor's Full Name:

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* 3. Did you feel the amount of time it took to complete preceptorship was appropriate?

Enough Time

Too Much Time

Too little Time

Please Explain Briefly:

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* 4. What part of preceptorship did you like most or find most useful?
Please Explain Briefly:

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* 5. What did you like least about your orientation or preceptorship experience?

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* 6. Overall, how would you rate your preceptor:

Poor

Fair

Skilled

Very Skilled

Can you help us understand why?

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* 7. Please rank your Preceptor in the following areas

	Exceptional	Very Good	Fair	Needs Improvement
Makes good decisions	Makes good decisions Exceptional	Makes good decisions Very Good	Makes good decisions Fair	Makes good decisions Needs Improvement
Has good problem solving skills	Has good problem solving skills Exceptional	Has good problem solving skills Very Good	Has good problem solving skills Fair	Has good problem solving skills Needs Improvement
Can think critically	Can think critically Exceptional	Can think critically Very Good	Can think critically Fair	Can think critically Needs Improvement
Competent and knowledgeable about the job	Competent and knowledgeable about the job Exceptional	Competent and knowledgeable about the job Very Good	Competent and knowledgeable about the job Fair	Competent and knowledgeable about the job Needs Improvement
Manages time effectively	Manages time effectively Exceptional	Manages time effectively Very Good	Manages time effectively Fair	Manages time effectively Needs Improvement
Effectively informs of important information	Effectively informs of important information Exceptional	Effectively informs of important information Very Good	Effectively informs of important information Fair	Effectively informs of important information Needs Improvement
Patient	Patient Exceptional	Patient Very Good	Patient Fair	Patient Needs Improvement
Trusting and compassionate	Trusting and compassionate Exceptional	Trusting and compassionate Very Good	Trusting and compassionate Fair	Trusting and compassionate Needs Improvement
Good communicator/listener	Good communicator/listener Exceptional	Good communicator/listener Very Good	Good communicator/listener Fair	Good communicator/listener Needs Improvement
Manages conflict well	Manages conflict well Exceptional	Manages conflict well Very Good	Manages conflict well Fair	Manages conflict well Needs Improvement

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* 8. Overall, how would you rate your preceptor(s) during your preceptorship:

Poor

Fair

Skilled

Very Skilled

Can you help us understand why?

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* 9. Please rank your preceptor(s) in the following areas

	Exceptional	Very Good	Fair	Needs Improvement
Makes good decisions	Makes good decisions Exceptional	Makes good decisions Very Good	Makes good decisions Fair	Makes good decisions Needs Improvement
Has good problem solving skills	Has good problem solving skills Exceptional	Has good problem solving skills Very Good	Has good problem solving skills Fair	Has good problem solving skills Needs Improvement
Can think critically	Can think critically Exceptional	Can think critically Very Good	Can think critically Fair	Can think critically Needs Improvement
Competent and knowledgeable about the job	Competent and knowledgeable about the job Exceptional	Competent and knowledgeable about the job Very Good	Competent and knowledgeable about the job Fair	Competent and knowledgeable about the job Needs Improvement
Manages time effectively	Manages time effectively Exceptional	Manages time effectively Very Good	Manages time effectively Fair	Manages time effectively Needs Improvement
Effectively informs of important information	Effectively informs of important information Exceptional	Effectively informs of important information Very Good	Effectively informs of important information Fair	Effectively informs of important information Needs Improvement
Patient	Patient Exceptional	Patient Very Good	Patient Fair	Patient Needs Improvement
Trusting and compassionate	Trusting and compassionate Exceptional	Trusting and compassionate Very Good	Trusting and compassionate Fair	Trusting and compassionate Needs Improvement
Good communicator/listener	Good communicator/listener Exceptional	Good communicator/listener Very Good	Good communicator/listener Fair	Good communicator/listener Needs Improvement
Manages conflict well	Manages conflict well Exceptional	Manages conflict well Very Good	Manages conflict well Fair	Manages conflict well Needs Improvement

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* 10. What can Circle of Care do to improve the preceptorship experience?

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* 11. Please identify any other areas you would like support in as a new PSW with circle of care

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* 12. Rate how confident you feel about working as a PSW with Circle of Care after completing preceptorship.

Very Confident

Confident

Somewhat Confident

Not Confident

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* 13. Rate your overall enjoyment of orientation and preceptorship:

Did Not Enjoy

Enjoyed

Enjoyed Very Much

Can you provide us with some other comments or suggestions to improve your experience?

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* 1. New Hire (Your) Full Name:

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* 2. Preceptor's Full Name:

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* 3. Did you feel the amount of time it took to complete preceptorship was appropriate?

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* 4. What part of preceptorship did you like most or find most useful?Please Explain Briefly:

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* 5. What did you like least about your orientation or preceptorship experience?

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* 6. Overall, how would you rate your preceptor:

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* 7. Please rank your Preceptor in the following areas

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* 8. Overall, how would you rate your preceptor(s) during your preceptorship:

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* 9. Please rank your preceptor(s) in the following areas

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* 10. What can Circle of Care do to improve the preceptorship experience?

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* 11. Please identify any other areas you would like support in as a new PSW with circle of care

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* 12. Rate how confident you feel about working as a PSW with Circle of Care after completing preceptorship.

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* 13. Rate your overall enjoyment of orientation and preceptorship:

* 4. What part of preceptorship did you like most or find most useful?
Please Explain Briefly: