Maastricht Clinical Teaching Questionnaire For Students

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Multisource Feedback for Clinical Supervisors: STUDENT FORM

Maastricht Clinical Teaching Questionnaire1

 

This is a TWO sided form. All responses will be collated and returned to the clinical supervisor.

 

Clinical Supervisor’s Surname: ____________________

First name: _____________________

Date: _________________

Health profession you are studying (e.g. nursing, physiotherapy, medicine etc): _______________

Your year of study: ________________

Length of time you have worked with this clinical educator: ____________ (indicate days or weeks or months)

Please indicate your level of agreement with the

following statements:

Fully                                                                                           Fully

  Disagree                                                                                    Agree

Unable to comment 

 

1

2

3

4

5

 

This clinical supervisor:

 

 

 

 

 

 

1.     consistently demonstrated how different tasks

should be performed

 

 

 

 

 

 

2.    clearly explained the important elements for the execution of a given task

 

 

 

 

 

 

3.    created sufficient opportunities for me to

observe them.

 

 

 

 

 

 

4.    was a role model as to the kind of health

professional I wish to become

 

 

 

 

 

 

This clinical supervisor:

 

 

 

 

 

 

5.    observed me multiple times during patient

encounters

 

 

 

 

 

 

6.    provided me with useful feedback during or following direct observation of patient encounters

 

 

 

 

 

 

7.     helped me understand which aspects I needed to improve

 

 

 

 

 

 

This clinical supervisor:

 

 

 

 

 

 

8.     Adjusted teaching activities to my level of experience

 

 

 

 

 

 

9.     Offered me sufficient opportunities to perform activities independently

 

 

 

 

 

 

10.  Supported me in activities I find difficult to perform

 

 

 

 

 

 

11.  Gradually reduced the support given to allow me to perform certain activities more independently

 

 

 

 

 

 

Please indicate your level of agreement with the following statements:

    Fully                                                                                                  Fully

    Disagree                                                                                         Agree          

Unable to comment 

 

1

2

3

4

5

 

This clinical supervisor:

 

 

 

 

 

 

12.    Asked me to provide a rationale for my actions

 

 

 

 

 

 

13.    Helped me to become aware of gaps in my knowledge and skills

 

 

 

 

 

 

14.    Asked me questions aimed at increasing my understanding

 

 

 

 

 

 

15.    Encouraged me to ask questions to increase my understanding

 

 

 

 

 

 

This clinical supervisor:

 

 

 

 

 

 

16.    Stimulated me to explore my strengths and weaknesses

 

 

 

 

 

 

17.    Stimulated me to consider how I might improve my strengths and weaknesses

 

 

 

 

 

 

This clinical supervisor:

 

 

 

 

 

 

18.    Encouraged me to formulate learning goals.

 

 

 

 

 

 

19.    Encouraged me to pursue my learning goals.

 

 

 

 

 

 

20.    Encouraged me to learn new things.

 

 

 

 

 

 

This clinical supervisor:

 

 

 

 

 

 

21.  Created a safe learning environment.

 

 

 

 

 

 

22.  Took sufficient time to supervise me.

 

 

 

 

 

 

23.  Was genuinely interested in me as a student.

 

 

 

 

 

 

24.  Showed me respect.

 

 

 

 

 

 

Overall, give this clinical supervisor an overall assessment (1 – 10) of their clinical teaching performance (10 =excellent):   

_______/10

 

What are the strengths of this clinical supervisor?

 

 

  

 

Which aspects of the performance of this clinical supervisor can be improved?

 

  

 

1Stalmeijer R, Dolmans D, Wolfhagen I, et al. 2010. Combined student ratings and self-assessment provide useful feedback for clinical teachers. Advances in Health Sciences Education 15(3) 315-28.


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