PLUS Observation Form
Fall 2011
Observer: ________________________
Preceptors: _______________________________________________________________________________________
Date & Time: _____________________ Location: ___________________
Preceptor |
SCORE (1-4) |
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Interpersonal Skills |
Embracing Program Philosophy |
Facilitation Skills |
Time Organization |
Uses Effective Questioning Techniques |
Problem Solving Skills |
Individual TOTALS |
OVERALL GROUP SCORE (1-4) |
Name: |
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Name: |
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Name: |
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Quick Comments |
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Comments:
Please make specific notes about each preceptor/ how well they worked together/ and the group time as a whole