ASM Student Self Evaluation and Preceptor Evaluation

Please rate your performance as a student based on the following measures. Feel free to add comments in the blank text boxes provided. It would be helpful to hear specifics about the ways in which you're achieving success so that we can garner wisdom from your accomplishments. Knowing about your struggles will also inform our ability to offer more targeted support to you in the areas where you are facing challenges.

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* 1. Student Name

Name

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* 2. Preceptor Name (please complete a separate evaluation for each of your preceptors)

Name

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* 3. Date

Date

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* 4. This evaluation is to cover the work done in the following trimester:

	Trimester	Year
Evaluation Period:	Evaluation Period: Trimester menu	Evaluation Period: Year menu

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* 5. I clearly identify and communicate to my preceptor my goals for learning.

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Fair

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Good

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Clinical and academic expectations and goals will need to be clarified prior to working together but also throughout the duration of the apprenticeship by a process of dialogue and documentation. Meetings between student and preceptor which are scheduled on a regular basis can provide opportunity for adjusting expected learning outcomes as the student progresses through different stages of her apprenticeship. It is also important to consciously seek out and recognize potential learning opportunities during a clinic day or during the course of a labor/birth. This way you can clearly communicate to your student what specific skills she might acquire or refine during that particular clinical experience. It’s also vital that the student be encouraged to continually seek out learning opportunities so that she can then communicate clearly to you what she is ready to self initiate.

Filling out a "Plan of Completion" with your student prior to starting work together clarifies the timeframe and expectations of progress throughout the program. This form can be found at http://midwiferycollege.org/AcademicProgram/Downloads/ASM/ASMPlanofCompletionForm.pdf

For Academic courses, the student is expected to be able to answer the Learning Objective questions, and to complete course content and credit requirements. They are also expected to be able to utilize this information as it corresponds to the practice of midwifery. The student should be able to apply the information to clinical and real-world practice.

In terms of clinical and NARM skills, the student is expected to be able to competently and confidently perform all skills when appropriate and demonstrate all clinical skills to mastery level prior to being signed off on Clinical Record Forms.

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* 6. I have identified my learning style and am able to develop a strategy to match it.

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Fair

Satisfactory

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Identifying your individual learning style can help you succeed as a student. It is strongly recommended that you take the VARK questionnaire at the beginning of your apprenticeship. The questionnaire will provide you with a profile of your learning preferences, or in other words will identify how you want to take in and give out information. The questionnaire also provides strategies and suggestions for meeting different learning styles, so can help you learn how to get your needs met. The results of this questionnaire and the corresponding strategies should be discussed between you and your preceptor and then reevaluated on a regular basis.

http://vark-learn.com/the-vark-questionnaire/

There is also a document on the NCM website entitled Teach to Students' Learning Styles
by Judie Haynes. It can be found at: http://midwiferycollege.org/AcademicProgram/Downloads/Learning%20Styles.pdf

If you have any type of learning difference, it is of utmost importance that you learn to advocate for yourself. Here are a few resources we hope will help:

CLD (The Council for Learning Differences) promotes and disseminates evidence-based research and practices related to the education of individuals with learning disabilities.
http://www.council-for-learning-disabilities.org/

AHEAD (Association on Higher Education and Disability) is a professional association committed to the full participation of persons with disabilities in postsecondary education. Their website includes links to informative webinars and articles.
https://www.ahead.org

The Understood website, although designed for parents of children with learning differences, can serve as an incredible asset for preceptors as well. The site provides resources designed to help us uncover the potential strengths of those with learning differences.
www.understood.org

Learning Ally is a non-profit that provides resources for parents, teachers and community to empower dyslexic, blind or visually impaired students to succeed.
http://learningally.org/

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* 7. I identify and address any resistance or obstacles to my learning & I maximize my special talents.

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Fair

Satisfactory

Good

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Here is a list of strengths and ways that you can work to embody these qualities to maximize your special talents and overcome obstacles:
Creativity: Think of new and interesting ways to conceptualize ideas and develop innovative ways of learning.
Curiosity: Show interest in exploring and discovering new things. Ask questions freely and explore fresh ideas.
Humility: Be willing to say when you don't know the answer to a question and apologize when you make a mistake.
Open-Mindedness: Entertain new ideas without judgement or shame, consider multiple ways to think about an idea.
Perspective: Try to bring a sense of clarity to complex situations and provide well rounded, balanced advice.
Courage: Embrace challenges and act appropriately even when you feel afraid or think that no one has your back.
Persistence: Always finish what you start regardless of what road blocks arise.
Kindness: Approach situations with genuine sensitivity and compassion to the needs of others.
Optimism: Look at each challenge as an opportunity and find ways to exhibit resilience by turning a bad situation right side up.
Discipline: Create structures, rituals and routines that promote efficiency and organization.
Independence: Self initiate and to take responsibility where you are capable.
Collaboration: Consider yourself a valuable member of your team by participating and helping in any areas where you are able.
Reliability: Follow through on your commitments.
Humor: Humor helps solidify your learning! Take time to recognize the absurd and inject some levity into your clinical experiences. You'll increase the chance that you will not only enjoy what you are learning but that you will retain it on a deeper level.
Patience: Have patience with your own obstacles and with your preceptor's abilities to meet them.
Honesty: Be willing to express yourself with honesty, especially when it comes to your own challenges and any observations or insights you may have about your preceptor's.

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* 8. I am completing academic, clinical and skills requirements in a timely fashion.

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Fair

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Since NCM offers a largely self paced program, please measure this based on the goals you have set for for yourself and agreed upon with your preceptor.

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* 9. I identify and address issues/disagreements with my preceptor. I take the time to discuss the Student-Preceptor Evaluation results with my preceptor each trimester, take needed actions based on these evaluations, and ask for help from my community and/or NCM staff when issues arise that I am unable to address myself.

Poor

Fair

Satisfactory

Good

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Student and preceptor evaluations are submitted separately to allow an opportunity for students and preceptors to express themselves in confidentiality when needed. However, we strongly urge you to share both your self evaluation and your preceptor evaluation with your preceptor and to use it as a tool to reflect and to articulate areas of strength and weakness.

Student and preceptor evaluation are meant not to be punitive but rather to bring to light ways in which students and preceptors need help in improving on their skills. NCM staff is always available to offer support. If there is an evaluation measure where you are struggling to achieve excellence, please let us know and we will do our best to provide insight and resources to help you.

Often, consciously striving towards excellence in all of the evaluation measures listed above will prevent unnecessary conflict or misunderstanding. However, true disagreements can present a unique opportunity for growth and deeper insight. When issues do start to brew, it is best to address them as soon as possible. The earlier you confront an issue, the less layered the solutions will be and the sooner you'll be able to reap the benefits of improved understanding.

An excellent resource for conflict resolution can be found at https://www.cnvc.org/

While NCM encourages preceptors and students to make all attempts at resolving their disagreements directly, we do offer mediation services and follow a grievance policy when necessary.

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* 10. I have sent the following forms to NCM for this trimester:

Academic Grade Sheet

Updated Clinical Record Sheets

Updated NARM Skills Form

Services & Policies Evaluation Form (Complete this if you have any Services and Policies recommendations for NCM)

Curriculum Evaluation Form (Complete this if you have any recommendations for the NCM courses)

Information Change Form (Complete this if there are any changes to your contact info, name, etc.)

Comments Form (Complete this if you have additional comments or suggestions)

Other (please specify)

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* 11. Please use the space provided to outline your goals for the upcoming trimester. This must match the goals outlined on the preceptor's evaluation form so please communicate with your preceptor before filling out this section.

Academic Courses or Modules

Practical NARM Skills

Clinical Experiences

For MSM & PhD Students please briefly outline your plans for the next trimester: