UTMB 3rd Year Pediatric Clerkship Evaluations
At the end of each student's rotation, we will ask you to complete an evaluation form. You will receive an email reminder to log into UTMB's New Innovations system to complete the evaluation forms. If you have any questions about completing
the evaluation form, please contact the Pediatric Clerkship Coordinator, Tiffany Swain. She will send you the UTMB username and password that you will
use to log into New Innovations.
UTMB 3rd Year Pediatric Clerkship Form
This .pdf version of the evaluation form is only used as an example so you know what areas you will be evaluating while a student is in your clinic. The actual evaluation form is completed online. Instructions on how to log into the New Innovations system
and complete the evaluation form
Online Evaluation Instructions
Please follow these instructions when completing your online evaluation of your Pediatric Clerkship students. We will be using the attached form for all clinical evaluations. It will be sent to you via New Innovations for AY 21-22. Please note that this
form does not have a Final Assessment ( Honors, HP and P etc.) .
The Faculty Clinical Evaluations will be converted to grades using the following Rubric:
| ||Numeric Grade|
|1. All components Competent (C) and 7 or more Outstanding (O)||100|
|2. All components C and 5-6 components O||95|
|3. All components C and 3-4 components O||93|
|4. All components C and 1-2 components O||90|
|5. All components C (Anchor)||85|
|6. One component with Needs Improvement (NI), and all other components C||80|
|7. Two components with NI and all other components C||75|
|8. Three components NI and all other components C||70|
|9. *Four components with NI and all other components C||65|
|10. One component with NI, one or more components with O, and the rest competent||85|
|11. Two components with NI, one or more components O, and the rest competent||80|
*Please note that if you assign a student with four (4) needs improvements , that will be considered a Fail of the clinical assignment. This will trigger an automatic review of all clinical evaluations by the Undergraduate Medical Education Committee of Pediatrics
and a final Grade for the overall Clinical Component will be assigned based on the students overall performance/your comments over the 6 weeks. If you feel a student is performing poorly, please provide the student with detailed feedback. Also please
inform Melissa Smith-Phillips and myself, so that we can provide additional feedback. If a student gets 4 or more NI, Please make sure to write detailed comments about the students’ performance in the feedback area.
As we are assigning Honors , HP etc., you are no longer required to do Above and Beyond Nominations for the AY21-22.
If you have any questions regarding this evaluation form and grading, please email or call me.
Gayani P. Silva MD, FAAP
Professor (Clinical )
University of Texas Medical Branch Galveston, Texas.