Evaluation of Faculty * Denotes required field Hospital/Training Facility* Date* MM slash DD slash YYYY Your Name* First Last Faculty Member's Name* First Last Please respond to the following statementsFaculty had a structured approach to training*Strongly DisagreeDisagreeNeutralAgreeStrongly AgreeNot applicableClear goals were established for this training*Strongly DisagreeDisagreeNeutralAgreeStrongly AgreeNot applicableFaculty adjusted training appropriately to my level*Strongly DisagreeDisagreeNeutralAgreeStrongly AgreeNot applicableFaculty was encouraging*Strongly DisagreeDisagreeNeutralAgreeStrongly AgreeNot applicableFaculty was non-threatening*Strongly DisagreeDisagreeNeutralAgreeStrongly AgreeNot applicableFaculty was patient*Strongly DisagreeDisagreeNeutralAgreeStrongly AgreeNot applicableFaculty provided opportunities to ask questions*Strongly DisagreeDisagreeNeutralAgreeStrongly AgreeNot applicableFaculty communicated well*Strongly DisagreeDisagreeNeutralAgreeStrongly AgreeNot applicableFaculty took over procedure(s) when appropriate*Strongly DisagreeDisagreeNeutralAgreeStrongly AgreeNot applicableFaculty provided too much verbal input (e.g. difficult to concentrate on procedure)*Strongly DisagreeDisagreeNeutralAgreeStrongly AgreeNot applicableFaculty provided too much physical input (e.g. didn’t stretch my abilities)*Strongly DisagreeDisagreeNeutralAgreeStrongly AgreeNot applicableFaculty provided corrective critique during procedure (e.g. redirected with explanation)*Strongly DisagreeDisagreeNeutralAgreeStrongly AgreeNot applicableFaculty provided positive critique during procedure (e.g. praised with explanation)*Strongly DisagreeDisagreeNeutralAgreeStrongly AgreeNot applicableFaculty encouraged team awareness*Strongly DisagreeDisagreeNeutralAgreeStrongly AgreeNot applicableFaculty was focused*Strongly DisagreeDisagreeNeutralAgreeStrongly AgreeNot applicableFaculty encouraged self-reflection on performance*Strongly DisagreeDisagreeNeutralAgreeStrongly AgreeNot applicableI derived and agreed on learning points from the procedure*Strongly DisagreeDisagreeNeutralAgreeStrongly AgreeNot applicableFaculty is a good role model with respect to their attitude and behavior*Strongly DisagreeDisagreeNeutralAgreeStrongly AgreeNot applicableOverall, faculty member was an excellent teacher*Strongly DisagreeDisagreeNeutralAgreeStrongly AgreeNot applicableOverall, indicate the extent to which the training met your expectations*Below ExpectationsMet ExpectationsExceeded ExpectationsHow prepared do you feel to perform an MIS colectomy procedure?*Not preparedModerately preparedReadyPlease select all aspects of the course which helped prepare you to perform a laparoscopic colectomyMulti-select by using the CTRL or COMMAND keyCadaver labDidacticVideosObservation of live surgeryOther (specify)Please specify Comments