User ID Number: {6 digits required}
Rotation Starting Date: {Please use (mm/yyyy) format}

The following questions pertain to the teaching methods that were utilized during the Disaster Medicine Rotation. Use the following number rating scale to answer questions 1 thru 32. After answering all the questions in this evaluation, please remember to click on the SUBMIT button at the bottom of the form.

Excellent = 5 Very Good = 4 Good = 3 Fair = 2 Poor = 1 Not Applicable = 0


Reading Material			Didactic Sessions
1.) Quantity of material :			5.) Quality of interaction :
2.) Quality of material :			6,) Organization:
3.) Scope of topics covered :			7.) Scope of topics :
4.) Overall rating :			8.) Overall rating :


Facilities			ADLS
9.) Comfort :			13.) Usefulness :
10.) Ease for learning :			14.) Organization :
11.) Audio/visual effectiveness:			15.) Scope :
12.) Overall rating :			16.) Overall rating :


ACLS			ICS
17.) Usefulness :			21.) Usefulness :
18.) Organization :			22.) Organization :
19.) Scope:			23.) Scope :
20.) Overall rating :			24.) Overall rating :


Practical Sessions/ Field Trips
25.) Airway Obstacle Course :			29.) International Relief Medicine Table Top:
26.) Splinting & Extrication :			30.) Shooting at things aka Tactical EMS:
27.) Canine Search & Rescue :			31.) Eco Resus Challenge:
28.) Confined Space:			32.) Ropes Sessions With Andy:

33.) How do you rate the teaching methods used in this rotation? In what way did this instruction contribute to your knowledge, skills and professional growth?

34.) What did you think of the Disaster Medicine staff with respect to their knowledge, teaching ability, interest in residents, and strengths/weaknesses? Please make specific comments on each of the following.

Dr. Rimple

Dr. Greenberg

Dr. Webb

Dr. Macias

Dr. Gnauck

Joe Alcock

Others (Please specify)

35.) What did you find was the most productive use of your time?

36.) What did you find was the least productive use of your time?


37.) Would you recommend this course to others?
Yes:		No:

38.) Please provide any additional comments about this rotation.

Before submitting your evaluation, please be sure you have entered the rotation starting date at the top of the evaluation and then type in the field "yes":
	type yes
At this time, please click on the SUBMIT button below. Before exiting this page, be sure you get a confirmation of submission, and Thank You for taking the time to complete the evaluation.