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>I (the service user/carer) have agreed to give feedback
Please tick a single response.
X   Yes
No

>Date of assessment
2nd March 2010

>Did the student introduce themselves fully?
Please tick a single response.
X   Yes
No
Not sure

>Do you have any further comments on this question?
He explained that he was a medical student and what he was going to do. I wasn’t sure what the iliac crest was, though.

>Did the student make you feel at ease?
Please tick a single response.
X   Yes
No
Not sure

>Do you have any further comments on this question?
He was really pleasant

(Tutor) Good to see that you put the patient at ease, especially given that this is a female patient in a potentially vulnerable position.

>Did the student explain things in a way that you could understand?
Please tick a single response.
Yes
No
X    Not sure

>Do you have any further comments on this question?
I knew what he was going to do because that was where the pain was, but not sure exactly what he meant.

>Did the student ensure that you understood what you were consenting to?
Please tick a single response.
X    Yes
No
Not sure

>Do you have any further comments on this question?
He listened to what I had to say.

>Did you feel that you could refuse to consent to the course of action?
Please tick a single response.
X    Yes
No
Not sure

>Do you have any further comments on this question?
No

>Considering the assessment you have just completed for the student would you be happy to be seen by this person again?
Please tick a single response.
X    Yes in most situations
Yes in other similar situations
Only in this particular situation / for this particular need
Only if there was no-one else to help me
No

>Would you like to make any further comments on the student's overall performance?
He was very friendly and made me feel at ease.

(Tutor) Some excellent feedback from the service user. Well done.

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