Form
Practice Managers Feedback on GP Registrar
Registrar Name:
Registrars Training Term:
Practice Name:
Practice Manager:
This feedback form has been developed to gain your valuable feedback on how a registrar is progressing in your practice. Please consult other practice staff (e.g. nurses, allied health staff and receptionists) to gather a whole of practice view on the registrars performance. Your answers should reflect the registrars overall performance during this training term taking into account their current level of training experience. Note: your feedback should be discussed with the registrar.
Communication Skills
/Strongly Agree
/Agree
/Neutral
/Disagree
/Strongly Disagree
Demonstrated effective and appropriate communication with:
Administration Staff
Fellow GP’s
Patients and Family
Demonstrated good communication with other professionals:
Nurses
Allied Health
Asked clear questions when unsure of something
Listened appropriately to other staff
Listened actively to understand others points of view
Overall Comments (if you have indicated Disagree of Strongly Disagree please elaborate):
Time Management
/Strongly Agree
/Agree
/Neutral
/Disagree
/Strongly Disagree
Managed interruptions throughout the day
Demonstrated overall organisational skills in order to effectively manage their work and training requirements
Arrived to work on time and started sessions on time
Completed required administration ‘paperwork’ including checking of results in timely fashion
Overall Comments (if you have indicated Disagree of Strongly Disagree please elaborate):
Professionalism
/Strongly Agree
/Agree
/Neutral
/Disagree
/Strongly Disagree
Projected a positive image
Treated others in a respectful and supportive manner
Has been reliable and met deadlines
Maintained confidentiality of patient information
Appropriate dress, grooming & hygiene
Has been non-judgmental of others
Overall Comments (if you have indicated Disagree of Strongly Disagree please elaborate):
Work Ethic
/Strongly Agree
/Agree
/Neutral
/Disagree
/Strongly Disagree
Demonstrated a positive attitude in the workplace
Worked cooperatively with other staff
Respected other staff members
Managed conflict and criticism appropriately
Taken responsibility for their own actions
Overall Comments (if you have indicated Disagree of Strongly Disagree please elaborate):
Workplace Procedures
/Strongly Agree
/Agree
/Neutral
/Disagree
/Strongly Disagree
Followed work health & safety policies and procedures
Billed appropriately in accordance with practice policies and procedures
Responded to emergency situations in the practice in accordance with policies and procedures
Participated in after hours work in accordance with practice policies and procedures
Overall Comments (if you have indicated Disagree of Strongly Disagree please elaborate):
Teamwork
/Strongly Agree
/Agree
/Neutral
/Disagree
/Strongly Disagree
Worked well as part of a team
Demonstrated flexibility and compromises when needed
Shared information and resources with team
Showed care & respect to colleagues
Overall Comments (if you have indicated Disagree of Strongly Disagree please elaborate):
Feedback Summary:
Keep Doing:Do More of:
Do Less of:
Stop Doing:
During this training term, have you had complaints from staff or patients about this registrar?
Yes / NoIf Yes, please add comments:
From your perspective (Practice Manager), is this registrar demonstrating behavior appropriate for their current level of training?
Please notify your Education & Training Coordinator with any issues to ensure early intervention
Yes / NoIf No, please add comments:
Have you discussed any of the above directly with your registrar?
Yes / No
If Yes, please add comments:
Name:
Position
Date: / / /
Practice Managers Feedback on GP Registrar v4.0 31.08.2015.doc
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