Communication & Interpersonal Skills Accurately conveys relevant information to patients , families , an colleagues . Respects patient confidentiality , privacy and autonomy . Listen effectively .
No Concerns
Concerns / explanation : ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________
Professionalism Is respectful of all members of the healthcare team . Demonstrates ethically sound practices . Is sensitive to cultural , age , gender , and disability issues .
No Concerns
Concerns / explanation : ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________
Performing within desired expectations FPPE to continue The possibility of risk to patient safety exists
_____________________________________________________ Monitor ’ s Signature
____________________________ Date