Peer Feedback Form for Clinical Placement

Section 1: Peer Details

Name of Peer: ____Gabriel Taneza for Yeung Tsang_____________________________________

Date of Feedback: _______11/29/2024______________________________

Clinical Placement Area: _____Sills 4 CCC__________________________

Section 2: Professionalism

1. Did they demonstrate professionalism in their interactions with patients, staff, and team members?

Comments: ______Yeung always introduces himself to patients and staff in a respectful and professional manner. ______________________________________

2. Punctuality and preparedness:

Comments: ___Yeung comes to placement on time and has patient research prepared prior to placement. _________________________________________

Section 3: Clinical Skills

1. How well did they perform clinical tasks and procedures? (E.g., accuracy, technique, adherence to protocols)

Strengths: ____Yeung demonstrated proper sterile technique while providing wound care. He prepared all the needed materials for care and followed the direction of the nurse assisting him. ________________________________________

Areas for Improvement: ____Work on ringing out your gauzes when needing to clean the affected area. You can always use both tweezers as long as you maintain a sterile technique. ___________________________

2. Did they show confidence and competence when managing patient care?

Comments: ___Yeung demonstrated confidence and competency when providing wound care for his assigned patient. _________________________________________

Section 4: Communication Skills

1. Effectiveness of communication with patients, families, and colleagues:

Strengths: ____Yeung provided thorough research on providing patient education on hypertension. Yeung summarized and had patient repeat what he taught them. __________________________________

Areas for Improvement: ____Provide some helpful illustrations to deepen further your understanding of hypertension or whatever you’re trying to teach about (as much as possible). ___________________________

2. Ability to explain clinical concepts clearly and accurately:

Comments: ____Yeung demonstrated competency in providing wound care. __________________________________

Section 5: Teamwork and Collaboration

1. How well did they contribute to the team dynamic?

Comments: __________Yeung collaborates well with others and understands whatever role he’s assigned in. __________________________________

2. Did they seek and respond to feedback appropriately?

Comments: ______Yeung responds to feedback appropriately and acknowledges whenever he makes mistakes. ______________________________________

Section 6: Strengths and Areas for Development

1. Key strengths observed during the placement:

_____Preparedness, punctuality, willingness to help. _________________________

2. Key areas for growth or improvement:

______Continuous communication(ask questions whenever you don’t know it’s okay). Infection control(remember to remove your gloves after seeing your patient). ______________________________________

Section 7: Additional Comments

Use this section to add any other relevant feedback or observations:

________No additional comments. ____________________________________

Instructions for the Reviewer

1. Be specific: Use concrete examples to support your feedback.

2. Be constructive: Focus on improvement and development rather than criticism.

3. Be honest: Provide balanced feedback, highlighting strengths and growth areas.