Resident Professionalism Assessment Form - Always Events
Resident Professionalism Assessment Form - Always Events
Resident Professionalism Assessment Form - Always Events
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The University of California Irvine Medical Center<br />
Department of Anesthesiology & Perioperative Care<br />
HUMANISM IN THE PERIOPERATIVE ENVIRONMENT<br />
<strong>Resident</strong> <strong>Professionalism</strong> <strong>Assessment</strong><br />
Instructions: We would like to know how much you agree or disagree with each of the following statements about your physician<br />
named below. Please use the following scale and mark the box for each statement to indicate your response.<br />
Dr. (<strong>Resident</strong> physician involved in your perioperative care at UCI Medical Center): ___________________________________<br />
Strongly<br />
Disagree<br />
Strongly<br />
Agree<br />
1 2 3 4 5 6 7<br />
Demonstrated compassion, integrity and honesty<br />
Was ethical in his/her interactions with me<br />
Demonstrated sensitivity toward diversity<br />
Was professional in his/her interactions with me
The University of California Irvine Medical Center<br />
Department of Anesthesiology & Perioperative Care<br />
Strongly Strongly<br />
Disagree<br />
Agree<br />
1 2 3 4 5 6 7<br />
Responded to my questions and provided appropriate information<br />
Considered my needs and the needs of my family<br />
Was reliable, dependable and trustworthy
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