Student Progress Report

Name _Rommel Q. de Leon _ Year Level II Date November 28, 2004

I. COMPETENCIES

Rating Scale

[Use (x) - pre-/previous and

(0) - post-/present evaluation]

Where I - Incompetent

C - Competent

1. Solver of community health problem I----X+----|----+0----C

2. Physician-general surgeon I----+----X|----+0----C

2.1 Rapport I----+--X--+----+--0--C

2.1 Clinical Diagnosis I----+X----|----+0----C

2.2 Paraclinical Diagnosis I----+X----|----+0----C

2.3 Treatment I----X+----|----+0----C

2.4 Advice I---X-+----|----+-0---C

3. Emergency medicine-surgery I----+-X---|----+--0--C

4. Self-directed learner I----+---X-|----0+----C

5. Educator I----+-X---|----+-0---C

6. Researcher I----X+----|----+-0---C

7. Administrator of a health care unit I----+---X-|----+-0---C

8. Manager I----+--X--|----+0----C

9. Board Passer I----+--X--|----+--0--C

Overall Assessment for (I): S

Note: One failure is automatically FAIL. If FAIL, justify.

E - Excellent - Progressing

S - Satisfactory - Progress maintained

NI - Needs improvement - No progress

F - Fail - Backsliding

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Student Progress Report

Name Rommel Q. de Leon__ Year Level II Date November 28,2004

II. SKILLS

Assessment Remarks

(E, S, NI, F)

1. Interpersonal ____S_____ ________________

2. Communication ____NI____ ________________

2.1 Oral ____NI____ ________________

2.2 Written ____NI____ ________________

2.3 Handwriting ____S_____ ________________

3. Critical thinking/analysis ____NI____ ________________

4. Decision-making/problem solving____S_____ ________________

5. Technical ____S_____ ________________

6. Group learning ____S_____ ________________

7. Referral ____S_____ ________________

8. Others _____________________ __________ ________________

Overall Assessment for (II): S

Note: One failure is automatically FAIL. If FAIL, justify.

E - Excellent

S - Satisfactory

NI - Needs improvement

F - Fail

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Student Progress Report

Name Rommel de Leon__ Year Level II Date November 28,2004

III. ATTITUDE/TRAIT/PERSONALITY

Evaluation Remarks

(A, O, S, NI)

(A - Always; O - Often; S - Seldom; NI - Needs improvement)

1. Community-oriented ____O_____ ________________

2. Teamwork ____A______ ________________

3. Compassionate/concern ____A_____ ________________

4. Responsible ____O_____ ________________

5. Hardworking/eager to learn ____O_____ ________________

6. Resourceful/innovative ____A_____ ________________

7. Humble/accept limitation ____A_____ ________________

8. Role model ____O_____ ________________

9. Good health habits ____S_____ ________________

10. Show respect to human life ____O_____ ________________

11. Show respect to colleagues ____A_____ ________________

12. Show respect to authority ____A_____ ________________

13. Others _____________________ __________ ________________

Overall Assessment for (III): S

Note: If FAIL, justify.

E - Excellent

S - Satisfactory

NI - Needs improvement

F - Fail

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Student Progress Report

Name Rommel de Leon__ Year Level II Date November 28,2004

IV. DISCIPLINE

No. Remarks

1. Absences in work/conferences _1_ ________________________

2. Tardiness in work/conferences _2_ ________________________

3. No/late reports _2_ ________________________

4. Critical incident reports _0_ ________________________

(Describe/incorporate)

5. Others _____________________ ___ ________________________

Overall Assessment for (IV): S

Note: If FAIL, justify.

E - Excellent

S - Satisfactory

NI - Needs improvement

F - Fail

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Student Progress Report

Name Rommel de Leon__ Year Level II Date November 28,2004

V. ACADEMIC PERFORMANCE

Course/Module Assessment

No. Title (E, S, NI, F)

1. ___ Patient management process S

2. ___ MAR S

3. ___ Medical Recording NI

4. ___ Medical Photography S

5. ___ Research NI

6. ___ Surgical Curriculum S

7. ___ Disaster Preparedness Program S

8. ___ Test contructions S

9. ___ Online GS Journal S

10. ___ Medical presentation NI

Overall Assessment for V: S

Note: One failure is automatically FAIL. If FAIL, justify.

E - Excellent - Outstanding achievement of all

objectives.

S - Satisfactory - Achievement of all objectives.

NI - Needs improvement - Unsatisfactory achievement of some

objectives; incomplete achievement

of objectives.

F - Fail - No objective achieved;

unsatisfactory despite remedials.

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Student Progress Report

Name MARIA CECILIA T. LEYSON__ Year Level III Date November 25,2004

SUMMARY:

I - E S NI F

II - E S NI F

III - E S NI F

IV - E S NI F

V - E S NI F

DECISION:

Note: One failure is automatically FAIL.

( ) Needs remedials

( ) Needs improvement

( ) Eligible for promotion to ______________________________

( ) Not eligible for promotion

Remarks:

Printed Name with Signature: ___________________________

Evaluator

Date: ___________________________

Noted By:

_______________________________________

Training Officer

_______________________________________

Chairman

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