Peer Professionalism Evaluation Form

Peer Professionalism Evaluation Form

1. Respect

a. Polite and respectful to faculty, staff, peers, and patients/SPs (when applicable)

b. Minor lapse in behaving in a polite, respectful manner

c. Lack of consideration and/or respect *

2. Honesty

a. No issues arose to question this student’s honesty

b. Minor or single lapse in honesty (e.g. signing in for someone who was not present in class)

c. More serious lapse in honesty (e.g. cheating, plagiarism)*

3. Timeliness

a. Routinely arrived on time and/or completed assigned responsibilities on time

b. Occasional lapse in timeliness

c. Repeatedly was late to class and/or in completed assigned responsibilities

d. Unable to assess

4. Preparation

a. Routinely prepared for class, lab, and/or small group

b. Occasionally unprepared but responded well to feedback

c. Repeatedly unprepared *

d. Unable to assess

5. Collaboration

a. Actively helpful, enhanced team dynamic when working in a group

b. Reliable when working in a team, helpful when asked

c. Tended to rely on others to complete team assignments and/or not responsive to requests for help

d. Hindered learning and/or team effectiveness

6. Listening Skills

a. Engaged, interested, listened to others

b. Sometimes distracted (e.g. texting, talking off topic, using laptop off task)

c. Seemed disengaged (e.g. dozing off, frequent texting, reading the paper, goofing off)

7. Response to feedback

a. Responds well to feedback and applies it

b. Seems to respond well to feedback but does not apply it

c. Tends to argue and rationalize in the face of constructive feedback

d. Unable to assess

*Comment required

Comments: __________________________________________________________________________________