Introduction to Medical Interviewing and History Taking Course Evaluation
Social Security Number (XXX-XX-XXXX)
Date (MM/DD/YY)
Group Instructor
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Alexander, Gwen
Anderson, Robert
Bieliauskas, Linas
Dillon, James
Fitzgerald, Tom
Gillard, Mary Lou
Giordani, Bruno
Glick, Rachel
Gruppen, Larry
Jibson, Michael
Riba, Michelle
Robins, Lynne
Romano, Sam
Sheets, Kent
Wisdom, Kimberlydawn
Group Site
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Bortz Health Care
Brookhaven Manor
Chelsea United Methodist Home
Gilbert Residence
Glacier Hills
Hidden Pond
Northfield Place
Plymouth Inn
Plymouth Towne
Riverview
Saline Evangelical
Whitehall Convalescent Center
We would like your help in improving this course. Please respond as honestly as you can to the following questions.
Directions:
On a scale of 1 (ineffective/not helpful) to 10 (effective/helpful), rate each of the following components of this course by indicating your response with the pull-down menus accompanying each question.
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1. Large Group Sessions (overall).
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2. Viewing & rating of videotaped patient interview (large group session).
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3. Use of Medical Interview Assessment Scale for rating interviewing effectiveness.
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4. Patient case presentation (videotaped) & discussion.
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5. Self evaluation of patient interviews.
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6. Peer evaluation of patient interviews.
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7. Interviews at nursing homes or residential sites.
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8. Small group practice and discussion sessions (prior to and during site visits).
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9. Syllabus (Introduction to Medical Interviewing).
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10. Textbook (The Medical Interview: The Three-Function Approach).
Directions:
Please rate the following by selecting the appropriate letter
(A=very much; E=very little).
11. How well did this course meet your needs in learning to interview individuals in a medical context?
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E
12. How well did you like your small group instructor?
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13. How well did you like the course?
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14. How well did your small group instructor present the content of the course?
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15. What do you believe were the major strengths of the course?
16. What do you believe could be improved?
17. Other comments?
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