Q1.

Dietetic Intern Evaluation: Food Systems Management

To better align our evaluation with the "Career Development Guide" from the Academy of Nutrition and Dietetics, the Ball State Dietetic
Internship has adjusted the terminology that is used. Please note the following:
Definition of Performance Standards:
1. Proficient: Demonstrates additional knowledge, skills, and experience in a focus area of dietetics practice; above entry-level practice
2. Competent*: Demonstrates sound knowledge, confidence, and effective use of entry level skills; seeks assistance after
investigating potential solutions
3. Beginner: Requires supportive or directive cues occasionally; applies principles accurately with occasional cues; works at
acceptable standards
4. Novice: Requires frequent supportive and occasional directive cues: identifies principles but needs direction to identify application
5. Not applicable: not observed/not applicable
*The goal of the Ball State Dietetic Internship is to have 80% or more of interns attain a level of competent for each ACEND
competency.
Directions: Using the ratings above, please evaluate the intern on the following competencies:
NOTE: The online forms cannot be saved or edited after submission. Please e-mail ljballenger@bsu.edu if you would like a copy emailed to you.

Q2. Please fill out the following information:

Intern name (First and Last):

Rosemarie Biancardi

Facility:

Community Hospital Anderson

Preceptor Name (First and Last):

Jenny Martin

Preceptor E-mail:

jmartin@ecommunity.com

Date:

11/2/16

Q3. Name of person completing the form (if different from the preceptor):

Q4. Based on the ratings on the first page, please evaluate the intern on the following competencies related to Professional Attributes:
Novice _____ Beginner ___ Beginner ___
(6 pts)
(7 pts)
(8 pts)
Prepare appropriately for rotation
Demonstrate
collaboration/teamwork
Demonstrate proactive problemsolving skills
Demonstrate customer focus
Demonstrate risk-taking
Demonstrate critical thinking
Demonstrate flexibility

Competent
__ (9 pts)

Competent
__ (10 pts)

Proficient __
(10 pts)

Not
applicable

Demonstrate time management

Demonstrate work prioritization
Demonstrate advocacy
Demonstrate work ethic
Develop goals and objectives
Respect life experiences, culture
diversity, educational
background
Demonstrate negotiation skills
Demonstrate assertiveness
Develop effective oral
communication skills
Develop effective written
communication skills
Use informatics technology
Dress is appropriate for given
work setting

Q5. Please list any additional comments about the intern's Professional Attributes:

Q12. Please comment on any of the BSU-Assigned Projects (if applicable):

Q6.
Please comment on the interns areas of strength:
Rosemarie Does a great job with projec t management. She c ompletes all tasks, asks pertinent questions and stays on-trac k to finish assignments. Flexible- keeps a
positive attitude even when pulled into multiple directions.

Q7. Please comment on the interns areas for improvement:

Work on assertiveness with staff (which c omes with time).

Q9. Please answer the following questions about the intern's attendance:
Please specify the number of days the
0
intern was late during the rotation:
Please specify the number of days the
0
intern was absent during the rotation:
Did the intern make up all if the days
days/hours he/she was absent?
(yes/no)

N/A

If late or absent, the intern contacted

me ahead of time to explain the
situation? (yes/no)

N/A

Q10. Final Comments:

Rosemarie did a great job.

Q11. Would you hire this intern for employment? (yes/no) Any comments?

Yes

Location Data
Location: (39.840103149414, -86.054801940918)
Source: GeoIP Estimation