St.

Alexius College Pharmacy Department

City of Koronadal

Training Evaluation Form

A. Information about the Student:

Students Name: ______________________________________________

Minor [ ] Major [ ] Community [ ] Hospital [ ] Manufacturing [ ]

B. Information about the Training Supervisor:

Date (Month, Year): _______________________

Title: ________________ Full Name: ___________________________________________________________
Position: _______________________ Department/ Division: ____________________
Company/ Organization: _____________________________________________________________________
Work Address: _____________________________________________________________________________

E-mail:

C. General Information about the Training:

1. Indicate the specific areas of the students training? (Use extra sheet if necessary)
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________

2. Was the student assigned a specific job? (Yes/No) ……In case yes, please state it below. (Use extra
sheets if necessary)
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________

3. Overall impression about the training of the student:

__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________

4. What are your suggestions to improve the training and its evaluation rubric given in section D? (Use
extra sheets if necessary)
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________

1
D. Evaluation of the Student’s Performance:

Please give an appropriate grade that evaluates the student ability to perform professionally using the
rubric below. For each of the following key performance indicators (KPIs), the student can:

KPI 5 3 1 0 Grade

 Usually demonstrate  Have acceptable level  Have acceptable level of  Have

Professional Appearance

trustful appearance and self of personal appearance personal appearance. unacceptable

confidence.  Respect his skills and personal appearance
 Demonstrate convincing abilities without being BUT
 May underestimate or
personality. arrogant.
overestimate his skills and
 Respect his personal
abilities.
skills without being
personally prideful in  May demonstrate
words or actions. arrogant attitudes.

 Be punctual, never  Be reasonably punctual,  Underestimate the  Fail to maintain

Interactions*

absent or late rarely absent or late. importance of punctuality. successful business

Professional

 Show respect for others.  Establish fair  Concentrate on interactions.

 Establish successful relationships with pears, establishing good relations
relationships with pears, superiors, and clients. with superiors or relations
superiors, and clients. based on personal benefits.
 Be initiative taker.  Be enthusiastic.  Tend to have things  Fail to have
 Be enthusiastic.  Take personal
Work Performance

done with minimum level things done on time

 Take personal responsibility for his of quality and/or effort. and within budget,
responsibility for his actions.  Fail to recognize the or
actions.  Remain business need to take personal  Tend to blame
 Remain business focused and quality responsibility for his others for own
focused and quality oriented. actions. issues and problems.
oriented.
 Analyze a problem  Listen to other  Evaluate and judge a  Have personally
objectively using facts and viewpoints. situation using personal biased perspective
Objectivity

a professional code of  Try to maintain a fair understanding. of problems and

ethics. and objective perspective.  Possibly apply a issues,
 Recognize individual personal value system.  Fail to assess
and cultural biases. things objectively.

 Be an excellent  Be a good employment  Need improvement to  Fail to compete

Finding

employment candidate. candidate. compete with others as a with other as a job

Job

job seeker. seeker.

* (Please do not allow the student to continue the training if he is absent for five days or more)
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This is to certify that I personally supervised the On-job training of the student whose name is shown
above for the period from: / / 14 H. to / / 14 H.
Corresponding to: / / 20 G. to / / 20 G.

Signature of the On-job training Supervisor: ____________________________________

Official seal of the Training Organization