PATIENT PERCEPTION SCALE

Student: SP ID:
Case Name: Date:
Record your perceptions of the student’s behavior by evaluating the following items. Your written observations
and/or suggestions will be provided to the student.

ANY GRADE EXCEPT “MEETS EXPECTATIONS” REQUIRES A

WRITTEN COMMENT AT THE END

ITEMS 1-9 ASSESS INTERPERSONAL AND COMMUNICATION SKILLS:

Does Not Meet Meets Expectations, Exceeds
Assess the Following Meets Expectations
Expectations but with Concerns Expectations
1 Aloof, rude, cold,
Warm, friendly, put you
Greeting crabby, not friendly
at ease
OR overly friendly
2 Immediately
connected with
Condescending, me; established
How he/she patronizing, “talked Treated you on the complete trust
treated you down” to you, or same level and confidence
treated you like a child within the first
few minutes of
the encounter
3 Listened
carefully, used
multiple
Let me tell my story
Letting you tell Interrupted you opened-ended
with only a few
your story frequently questions,
interruptions
redirected you
in a kind and
courteous way
4 Acted bored,
preoccupied, or
ignored what you had
Showing to say; or distracted by Did not act bored; paid
interest in you note-taking, or showed attention to what you
as a person too much interest in said
you as a person vs.
concern for reason for
visit
5 Encouraged
questions; all
answers were
Made no effort to
Answered most thorough and
encourage questions;
Asking and questions clearly; never complete;
or did not ask or
answering lectured, defers anticipates
answer questions
questions questions he/she can’t questions and
clearly; or seemed to
answer concerns that
be lecturing you
the patient may
not have thought
of
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 Does Not Meet Meets Expectations, Exceeds
Assess the Following Meets Expectations
Expectations but with Concerns Expectations
6 Used medical jargon
Using words consistently
Consistently used
you throughout encounter
understandable words
understand without attempting to
explain
7 Over-controlling or let
Moved smoothly from
patient control Flawless,
Controlling the one component of the
interview; or no seamless flow
flow of the interview to another;
summarization; or through the
interview summarized key
disorganized entire encounter
points;
8 Student was so
knowledgeable
with the
Patient Consistently used material;
Delivered instructions
education: understandable negotiated goals
in a lecture format; or
delivering language; checked for with me; you
used medical jargon;
diagnostic and my understanding; left the
did not check for my
instructional involved you in the encounter
understanding
statements process feeling
empowered to
manage your
health
9 Brought encounter
to a natural, well-
defined close
AND before
Abrupt closure; or leaving he/she
never able to bring Brought encounter to a checked if I had
Closing the
encounter to a close; natural, well-defined any other
encounter questions or if
left me hanging; did close
not finish encounter there was
anything they
missed, and told
me what the next
steps would be

ITEMS 10-16 ASSESS PHYSICAL EXAM SKILLS

10 Transferring Abrupt; did not explain
Smooth transfer;
from the what was about to
explained what was to
history to the happen; forgot hand
happen next
exam hygiene
11 Giving clear
instructions
and advance Consistently gave clear
Frequently did not tell
warning on instructions, explained
me what to do or what
what was what was happening
was next; abruptly
coming next and what you needed to
touched me without
and what you do or what to expect
warning
were supposed next
to do during
the exam
12 Avoiding Organized and
awkward Disorganized; or too
concerned about your
maneuvers and many position changes
comfort; minimal
positions, and causing unnecessary
being aware of number of positional
discomfort
your comfort changes

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Assess the Following Does Not Meet Meets Expectations Meets Expectations, but Exceeds
Expectations with Concerns Expectations
13 Made no effort to Demonstrated concern
guard your modesty; or for your modesty;
Draping you
left you uncovered draped appropriately
unnecessarily throughout exam
14 Performing the
exam without
causing undue
pain (i.e.,
during Exhibited care not to
Brusque, uncaring,
insertion of ear cause undue discomfort,
causing pain or
speculum or or forewarned when
discomfort without
insertion of discomfort could be
warning
speculum for expected
nasal exam, or
when testing
the Babinski
reflex)
15 Appropriately Appropriately paced
Rushed or performed
pacing the exam; completed
exam too slowly; or
exam comfortably in time
did not finish exam
allowed
16 Demonstrating Inspired
Struggled, appeared Performed exam steps
confidence in confidence by
uncomfortable, or had smoothly; seldom
the exam and performing ALL
difficulty with many of struggled with
its individual exam steps
the individual techniques individual techniques
techniques smoothly

ITEMS 17-18 ASSESS PROFESSIONALISM

17 Had trouble accepting
Was open to accepting
feedback,
Accepting feedback; genuinely
argumentative or
Feedback interested in how they
arrogant, discredited
could improve
value of the SP’s input
18 Overall
impression was
Overall during
so positive that
encounter, gave such a Acted professionally
Maintaining you would want
negative professional throughout encounter,
the role of a to have this
impression that you you’d probably go back
medical person as your
would not want to to this person as your
professional doctor AND
return to this person as physician
you’d refer your
a patient
friends to this
doctor

Please provide comments for any evaluation besides “meets expectations.” Also provide any other suggestions for
improving interviewing technique and professional behavior.
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