pro
Behavior
Example Actions Observed
Points
0= Never
0.25= Rarely
0.5= Occasionally
1 = Always
Comments
Provide examples of how you demonstrate these behaviors.
Accountability
Student accepts consequences of own actions
Student adheres to FNUs Student Code of Ethics
Actively seeks feedback regarding progress
Communicates with Faculty in a timely manner regarding concerns or errors
Completes all assignments in a timely manner
1
Attendance
Student attends all mandatory class sessions
Student is punctual
Professional Interactions
Demonstrates respect for peers, instructors and volunteers
Values input from others
Contributes to team activities and projects
Demonstrates Ability to balance own needs with the needs of peers, instructors, volunteers and patients.
Demonstrates active listening skills and follows instructions provided by faculty carefully and consistently in all areas.
Appearance
Student comes to class in required uniform and identification.
Duty
Student is committed to meeting obligations
Student is cognizant of safety and confidentiality
Integrity
Adheres to institutional policies and procedures
Demonstrates honesty and trustworthiness
Communication
Address program faculty appropriately
Speaks respectfully to the Institutions faculty and staff
Uses respectful language
Always = 100% of the time; occasionally = Greater than 50% of the time but less than 100%;
Rarely = 50% of the time or less; Never = 0% of the time.
Identify at least 3 areas with room for growth:
1. _________________________________________________________________________________________________________
2. _________________________________________________________________________________________________________
3. _________________________________________________________________________________________________________
Goals to improve professional behavior: related to identified areas above.
1.
2.
3.
4.
5.
Plan of action to achieve goals:
1. ________________________________________________________________________________________________________________________________________________________________________________________________________________________
2. ________________________________________________________________________________________________________________________________________________________________________________________________________________________
3. ________________________________________________________________________________________________________________________________________________________________________________________________________________________
4. ________________________________________________________________________________________________________________________________________________________________________________________________________________________
5. ________________________________________________________________________________________________________________________________________________________________________________________________________________________
Student Signature:
**Student must complete ALL sections to receive full 5 points.
