Teaching Feedback Form
TeamSTEPPS® Long-Term Care Version: Module 11
The Long-Term Care version of TeamSTEPPS adapts the core concepts of the TeamSTEPPS program to reflect the environment of nursing homes and other other long-term care settings such as assisted living and continuing care retirement communities. The examples, discussions, and exercises below are tailored to the long-term care environment.
Name: ___________________________ Date: ____________________________________
Performance Criteria | Rating | Comments | ||
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Accept- able |
Unaccept- able |
Not Applicable (N/A) |
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1. Introduced topic in terms of relevance to teamwork | ||||
2. Presented content with accuracy | ||||
3. Used examples from personal experience to optimize learner understanding of teamwork concept | ||||
4. Presented content with confidence (i.e., didn't rely on reading from text) | ||||
5. Avoided distracting mannerisms (i.e., words, gestures) | ||||
6. Coordinated slides with content | ||||
7. Promoted learner participation | ||||
8. Spoke clearly and audibly | ||||
9. Facilitated practical exercises with skill and purpose | ||||
10. Completed presentation within allotted time-frame |
Evaluator: ______________________________________________________