New Trainer being evaluated:

Faculty Evaluator:

Number of training sessions observed:


In addition to meeting the criteria for competency as an abortion provider, a trainer must be able to:

Training Skills Beginner Developing Competence Competent Did not experience
Assesses trainee’s skills and learning needs
Engages trainee in learning experience
States objectives for each training day
Encourages trainee to ask questions
Answers questions clearly and completely
Demonstrates strong knowledge of subject matter
Gives appropriate evidence and resources
Uses variety of teaching methods including cases, role plays, “what if” scenarios, didactics
Discusses various approaches to the procedure
Demonstrates knowledge of site specific protocols
Reviews chart and informed consent
Reviews / interprets US, labs, and medical history with trainee
Demonstrates establishing rapport with the patient
Demonstrates non-judgmental attitude towards the patient
Demonstrates clear communication with the patient regarding procedure and management
Allows trainee to solicit and answers patient questions
Confirms physical exam findings
Gives feedback about no touch technique
Gives feedback about trainee’s attention to patient comfort during procedure
Can take over a case when appropriate without disturbing the patient or undermining the trainee
Provides feedback to the trainee after each procedure, and at the end of session
Reviews elements of tissue exam with trainee
Reviews appropriate post operative orders with the trainee
Reviews patient’s contraceptive needs (including EC) and contraindications with trainee
Models respectful attitude towards staff
Is receptive to feedback from trainee / peers
Models and teaches trainee attention to clinic flow

Further Comments:

Evaluation by Trainer:
[ ] Approved  [ ] Further orientation and observation suggested

SIGNATURE OF EVALUATOR: ___________________________________

DATE: ___________


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