Real Time Assessment Evaluation Form

Note to Clinicians:
Completion of three real-time assessments (RTAs) are required for graduation for the Class of 2017. RTAs are intended to provide immediate and useful feedback to students on their mastery of a variety of clinical skills. Agree to complete this form only if you agree to give immediate feedback to the student directly following completion of the case. In addition, the student must request an RTA be completed prior to start of a case. If this does not happen, do not agree to perform the RTA.
Student Name
Your answer
Date RTA Took Place
MM
/
DD
/
YYYY
Case number
Your answer
RTA type disease
Species
Your answer
Competencies
1 Unsatisfactory performance

2 Performs below the level expected for a 4th year veterinary
student; significant improvement needed

3 Acceptable performance, but significant improvement needed to be practice ready

4 Performs at, or near, the level expected for an entry level new graduate

5 Performs at a level expected of a competent graduate veterinarian


Note: If any scores of 1 or 2 are given, the evaluator must provide written comments explaining the reasons for the score given.

Comprehensive patient diagnosis
1
2
3
4
5
N/A
Patient assessment skills
Appropriate use of diagnostic testing
Record management
Comprehensive treatment planning
1
2
3
4
5
N/A
Development of a treatment plan
Appropriate use of patient referral
Record Management
Patient Welfare
1
2
3
4
5
N/A
Anesthesia management
Pain management
Patient care
Surgery skills
1
2
3
4
5
N/A
Surgical knowledge
Surgical skills
Medicine skills
1
2
3
4
5
N/A
Medicine knowledge
Medicine skills
Emergency and intensive care
1
2
3
4
5
N/A
Knowledge of emergency medicine
Emergency medicine skills
Knowledge of intensive care medicine
Intensive care skills
Health promotion and disease prevention
1
2
3
4
5
N/A
Knowledge of disease prevention
Knowledge of zoonotic disease
Knowledge of food safety
Professionalism and conduct
1
2
3
4
5
N/A
Professionalism
Communication with clients
Communication with the healthcare team
Ethical conduct
Critical analysis of new information
1
2
3
4
5
N/A
Knowledge of veterinary literature - general
Knowledge of veterinary journals and research
Comments
Please provide constructive comments that will improve the student's clinical competency.
Your answer
I have discussed this assessment and provided suggestions for further development of this student’s clinical skills.
Please sign your name below.
Your answer
Date
MM
/
DD
/
YYYY
Student copy of Real Time Assessment
Prior to submission of this RTA form:

- Go to menu bar in your browser: FILE>PRINT
- Either save as a PDF or print a paper copy of the RTA for review with the student and provide student a copy

- Once the "Submit" button is clicked, the form data is sent to the Office of the Dean and is no longer retrievable to review with the student.

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