DRAFT - Student Evaluation | Office of Global Health Education

Dates of experience*

Month and year

Name of program or hospital*

City and country*

Location of program/hospital

Program website

(if applicable)

Name of program person you worked with*

Please include any contact information.

Program Details

From the list below, select what best describes your motivation for this experience.*

Other*

What was the major emphasis of this experience?*

Other*

What kind of experience was this?*

Group experience
Individual experience

Did this program/hospital have a religious affiliation?*

Yes
No

If yes, with what group?

Did this program/hospital have an academic affiliation?*

Yes
No

If yes, with what institution?

Costs

Airfare Cost

Other Cost

Please specify type. (example: camping gear)

Other Cost

Please specify type. (example: camping gear)

Other Cost

Please specify type. (example: camping gear)

Other Cost

Please specify type. (example: camping gear)

Your Experience

List three educational outcomes you achieved with this experience.*

Was this experience a good use of time for you during medical school?*

Yes
No

Did you have adequate clinical supervision?*

Yes
No
Not Applicable

Did you have adequate opportunities for hands-on clinical work?*

Yes
No
Not Applicable

Would you recommend this program to other medical students?*

Yes
No

If you would recommend, please elaborate on why.*

If you would not recommend, please elaborate on why.*

Was the program responsive to your needs?*

Yes
No

Did you have appropriate arrangements for housing, food and safety/health issues?*

Yes
No

Please describe.*

Did you have adequate information about what to expect in advance?*

Yes
No

What would have been helpful?*

Did you feel that you had adequate support from UNC in setting up this opportunity?*

Yes
No

Additional Feedback

Please include any additional information or feedback.

What could the OGHE have done differently or better to support you?

Email*

This is collected to send you confirmation of your post. Your email will not be published with this review.

DRAFT – Student Evaluation

Program Details

Costs

Your Experience

Additional Feedback