ONLINE EVALUATION

THANK YOU FOR EVALUATING YOUR EXTERNSHIP EXPERIENCE -
Your fellow Tulane students will benefit from your wisdom and generosity in sharing your opinions.

Please respond to the following questions by typing your answers in the box provided - once you have finished the evaluation, please click on the "submit" button to send your responses. If you would like to provide a picture to be placed on the website next to your evaluation, please contact the webmaster at webmaster@tulane.edu for more information. Thanks and have a great day!



SITE/PROGRAM INFORMATION

Please answer the following questions:

What is your Name? What is your year?

What is your email address (one where you will be able to be contacted for a few years if possible)?

What is your telephone number?

What kind of externship did you do?
Established Tulane Program
Outside Organization
Followed what another student had previously organized
Organized yourself
What region of the world did you work in?
Latin America
Africa
Asia
Other
How long were you there for?
1 month
2 months
3 months
Other

How would you rate your experience overall?
 I would highly reccomend this site exactly as it is
I had a great experience but the program at my site could use improvement
I enjoyed being in country but did not enjoy my site at all
It was just another rotation
In retrospect, I would have picked a different site/country
I would recommend that this site be taken off all lists of possible externships
other

SITE CONTACT INFORMATION (will not be posted on webpage, but kept in Family and Community Med office to be given out with discretion):

University/Hospital: Address:

Website:

Phone: Fax: Email:

Supervisor:

Best way to contact (please provide email address or phone number):
Main Contact: Best way to contact:

 

 

SETTING:

Type of institution:

Setting of main facility:

Comments on setting:

Minimum duration of elective allowed at this site:

Local Costs:

Tuition or fees:

Housing costs: Housing availability:

Comments on housing:

Local travel costs:

Other costs:

 

Primary Language: Secondary Language:

Level of proficiency:

Institution partners:

Additional Comments:

 

SITE/PROGRAM EVALUATION

In outline form please indicate:

1. Strengths of the program

2. Weaknesses of the Program

3. Suggested changes to improve the program

Will you allow CMIG and the Family and Community Medicine Department to use your answers to this survey in publicizing information about your site and externships in general?
Yes Yes except for: No

Thanks for your cooperation in filling out this survey - we hope you enjoyed your externship experience.