MS Alcohol Standardized Patient Rater Form (Patient)

From Clinicaltools.com

Medical Student Participant ID #:

Standardized Patient Case: Cynthia Madison Stewart

Pre-Intervention (1st) or Post-Intervention (2nd) -- Choose One

Please rate the following on a scale of 1-5: 1 (Strongly Disagree), 2 (Disagree), 3 (Neither Disagree or Agree), 4 (Agree), 5 (Strongly Agree)

1. The physician was warm and friendly throughout the encounter, not abrupt or impatient. __________

2. The physician listened carefully as I described my problem and did not interrupt me. __________

3. The physician encouraged me to ask questions. __________

4. The physician gave me adequate time to ask any questions and to express my thoughts and concerns. __________

5. The physician used words that I could understand when explaining any technical or medical terms. __________

6. The physician did not lecture or talk down to me. __________

7. The physician showed interest in me as a person, did not act bored, or ignore what I had to say. __________

8. The physician took my concerns into account when diagnosing me. __________

9. The physician used an appropriate and polite manner to end the interview. __________

10. Overall, I felt comfortable with this physician. __________