End of Rotation/Exit Evaluation Form srudentName: GTA CY CLC Facility: LA Wy Long ievm Core Please rate the student’s performance based on the seale belo S--Satisfactory NI-—Needs Improvement NA--Not applicable or could not be assessed adequately at this time _ Student was adequately prepared for rotation site 5_ Student had knowledge of the subject matter required for tasks _S Student treated others with dignity and respect _5_ Student demonstrated adequate level of enthusiasm 5 Student demonstrated good interpersonal relationship with patients and employees __S_ Student complied w/the Code of Ethics/Standards of Care for dietetic professionals 5 Student was resourceful _S Student demonstrated initiative __5 Student responded adequately to feedback and followed through on suggestions __S Student had the ability to adapt to change _ Student projected confidence _S Student demonstrated good oral communication skills __5 Student demonstrated good written communication skills _-S Student planned, organized, and made efficient use of time Student was adequately productive _5_ Student had the ability to follow through _5__ Student was detail oriented when necessary __S Student demonstrated leadership skills 5 Student had good judgment and decision making 5 Student established, communicated and executed goals Student had good supervisory and/or management skills NA Student trained and instructed others well Cy Student has the ability to evaluate others Student’s Strengihs: Wet Clermca® Sli00n weed wrensthorad Go she aos d Van edcg ee Chenich) Rekadooos | Fdvca en ae LIT /RRalo Packer . Areas needing development: _ OWE Gow Audorin\ 2D0 Ua) Al2slis a Site Supervisor's Signature Date