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Peer Assessment Tools Medicine

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Mini-PAT (Peer Assessment Tool)

This is a PILOT EVALUATION being tested by KCUMB with MSIII students and healthcare professionals who observe
students during training. Students are asked to request multisource feedback from members of the healthcare team in areas
reflecting Good Medical Practice. Please complete the information and Fax the form to 816-460-0559. Students will receive
credit for submission of the form.

Name: ____________________________________________________________________________________________

Site (City/State): ___________________________________________________________Date: ____________________

Assessor’s Physician Resident Preceptor Other Please


Position: Specify _____________________________

Below
Borderline for Meets expectations Above expectation
expectation for
How do you rate this student in their: MSIII for MSIII for MSIII U/C*
MSIII
completion completion completion
completion
Good Clinical Care:
1. Ability to interpret patient problems

2. Ability to formulate appropriate


management plans
3. Awareness of their own limitations

4. Ability to recognize psychosocial


aspects of illness
5. Utilize appropriate resources e.g.
ordering investigations
Good Medical Practice
6. Ability to manage time
effectively/prioritize
7. Technical skills appropriate to current
clerkship
Relationship with Patients
8. Communication with patients

9. Communication with caregivers


and/or family
10. Respect for patients and their right to
confidentiality
Working with Healthcare Team
11. Verbal communication with
colleagues
12. Written communication with
colleagues
13. Ability to recognize and value the
contribution of others

14. Accessibility / Reliability

15. Overall, how do you rate this doctor


compared to a doctor ready to
complete MSIII
Do you have any concerns about this student’s professionalism Yes No
If yes please state your concerns:

KANSAS CITY UNIVERSITY OF MEDICINE AND BIOSCIENCES • DEPARTMENT OF CURRICULUM & EDUCATION AND
COMMUNITY CLINICAL EDUCATION • 1750 INDEPENDENCE AVENUE • KANSAS CITY, MISSOURI 64106-1453 • PLEASE FAX
TO: (816) 460-0559

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