Communication Assessment Tool - McGaw Medical Center
Form R
Professionalism Assessment Tool
Professionalism is a very important part of quality medical care. We would like to know how you feel about the most recent experience with your resident physician. Your answers are completely confidential, so please be as open and honest as you can. Thank you very much.
1 2 3 4 5
poor fair good very good excellent
Please use this scale to rate professionalism during the most recent experience with your resident physician. Circle your answer for each item below.
The doctor poor excellent
1. Is approachable 1 2 3 4 5
2. Takes a genuine interest in the patient’s health 1 2 3 4 5
3. Explores patient’s needs and concerns 1 2 3 4 5
4. Listens carefully 1 2 3 4 5
5. Answers questions from patients and families 1 2 3 4 5
6. Communicates clearly and effectively 1 2 3 4 5
7. Maintains patient’s privacy during exams 1 2 3 4 5
8. Shows compassion and care 1 2 3 4 5
9. Shows respect for patients and families 1 2 3 4 5
10. Involves patient and/or family in decision making process 1 2 3 4 5
11. Maintains appropriate behavior with patients and families 1 2 3 4 5
12. Has good hygiene (e.g., washes hands, wears clean clothes) 1 2 3 4 5
The Professional Environment poor excellent
13. Cleanliness and comfort of patient areas 1 2 3 4 5
Copyright © 2006 – Gregory Makoul, PhD – All rights reserved
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