The primary goal of a Medical Assisting Education program is to prepare each graduate to function as a competent Medical Assistant. This survey is designed to help program faculty determine their program's strengths and those areas that need improvement. All data will be kept confidential and will be used for program evaluation purposes only. We request that this survey be completed by the graduate's immediate supervisor.

* 1. Name of graduate (optional)

* 2. Length of employment at time of survey

* 3. Place of Employment

Instructions: Consider each item separately and rate each item independent of all others. Check the rating that indicates the extent to which you agree with each statement. Please do not skip any of them.
5 = Strongly Agree 4 = Agree 3 = Neutral (Acceptable) 2 = Disagree 1 = Strongly Disagree
Cognitive Domain - The graduate

* 4. Has medical assissting knowledge appropriate to his/her training

Psychomotor Domain - The Graduate

* 5. Is able to collect pertinent data accurately from charts and patients.

* 6. Is able to perform appropriate diagnostic and medical procedure as directed.

Affective Domain - The Program

* 7. Uses good judgement while functioning in the ambulatory healthcare setting.

* 8. Communicates effectively in the healthcare setting.

* 9. Conducts himself/herself in an ethical and professional manner.

* 10. Functions effectively as a member of the healthcare team.

* 11. Accepts supervision and works effectively with supervisory personnel.

* 12. Is self-directed and responsible for his/her actions.

* 13. Arrives to work prepared and on time.

* 14. Contributes to a positive environment in the department.

* 15. Overall, is this graduate a well prepared employee?

* 16. Comments: What qualities or skills did you expect of the graduate upon employment that he/she DID NOT possess?

* 17. Please provide comments and suggestions that would help this program to better prepare future graduates.

* 18. What are the strengths of the graduate(s) of this program?

Evaluator Information

* 19. Name

* 20. Title:

* 21. Telephone Number:

Thank you in advance!