Augsburg University PA Preceptor Program Reporting Form and Evaluation 
Augsburg University PA Program 



You must return this form by December 15th 2024 if you wish to receive AAPA Category 1 CME credit
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Your Name and Credentials  *
Email *
Name of Clinic or Hospital  *
How many Augsburg students did you precept at any one time? 
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How many total hours did you precept during the clinical year shown above?
Evaluation Form 

Please complete the following evaluation form. Your written comments are greatly appreciated.  For the purposes of this survey, please think about your experience as a clinical preceptor and the self-reflective processes associated with clinical teaching of PA students. This might include observing growth in a student’s knowledge, skills and professionalism following your interactions with them or soliciting and analyzing student feedback to improve your own clinical knowledge, skills, and interpersonal relations.

What was your overall opinion of the CME activity related to clinical precepting?  *
1 point
What aspects of clinical precepting did you find most  valuable to your continued development as a PA? 

What aspects of clinical precepting did you find least valuable to your continued development as a PA?  

Do you have specific suggestions as to how the preceptor program might be improved?   *
1 point
Would you participate in this CME activity again?   *
Would you recommend clinical precepting to a colleague?  
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