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This evaluation is in regards to OBRC's Pathway 3 Trainee.
Your Name / Mentor's Name
How many days have you worked with the trainee?
<2 days
2-4
5 or more
Please answer the following based on your knowledge of the Trainee's current experience level.
History Taking
Not Applicable to my time with the P3
Needs Further Education
Competent/Needs Minimal Assistance
Independent/Proficient
Maternal Assessments
Not Applicable to my time with the P3
Needs Further Education
Competent/Needs Minimal Assistance
Independent/Proficient
Infant Assessments
Not Applicable to my time with the P3
Needs Further Education
Competent/Needs Minimal Assistance
Independent/Proficient
Feeding Assessments
Not Applicable to my time with the P3
Needs Further Education
Competent/Needs Minimal Assistance
Independent/Proficient
Plans of Care
Not Applicable to my time with the P3
Needs Further Education
Competent/Needs Minimal Assistance
Independent/Proficient
Charting
Not Applicable to my time with the P3
Needs Further Education
Competent/Needs Minimal Assistance
Independent/Proficient
Follow-ups
Not Applicable to my time with the P3
Needs Further Education
Competent/Needs Minimal Assistance
Independent/Proficient
Counseling Skills
Not Applicable to my time with the P3
Needs Further Education
Competent/Needs Minimal Assistance
Independent/Proficient
Professionalism
Poor
Good
Excellent
Please list the Trainee's strengths
Please list the Trainee's weaknesses
Any suggestions of improvement the Trainee?
Additional comments?
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