Clinical Instructor Evaluation of the ACCE Question Title * 1. Please provide feedback about the ACCE with regard to the affiliation listed below. ACCE Name: CCCE Name: Date: Facility Name: Question Title * 2. Maintains appropriate communication with facility regarding the academic program's policies and procedures. Does not apply Strongly disagree Disagree Agree Strongly agree Does not apply Strongly disagree Disagree Agree Strongly agree Question Title * 3. Gives the facility timely notification when requesting student affiliation placements. Does not apply Strongly disagree Disagree Agree Strongly agree Does not apply Strongly disagree Disagree Agree Strongly agree Question Title * 4. Adheres to previously agreed upon criterion, such as affiliation dates and student assignments, when placing students on affiliation at the facility. Does not apply Strongly disagree Disagree Agree Strongly agree Does not apply Strongly disagree Disagree Agree Strongly agree Question Title * 5. Provides accurate information about the students prior to the start of clinical rotation Does not apply Strongly disagree Disagree Agree Strongly agree Does not apply Strongly disagree Disagree Agree Strongly agree Question Title * 6. Provides the CCCE/CI with objectives and goals prior to the clinical education experience Does not apply Strongly disagree Disagree Agree Strongly agree Does not apply Strongly disagree Disagree Agree Strongly agree Question Title * 7. Assures that each student has an updated clinical education notebook for the CCCE/CI to evaluate his or her performance. Does not apply Strongly disagree Disagree Agree Strongly agree Does not apply Strongly disagree Disagree Agree Strongly agree Question Title * 8. Maintains appropriate communication with Clinical Instructor(s) about student progress throughout the course of affiliation. Does not apply Strongly disagree Disagree Agree Strongly agree Does not apply Strongly disagree Disagree Agree Strongly agree Question Title * 9. Provides the opportunity for students to evaluate the clinical facility and the clinical education experience. Does not apply Strongly disagree Disagree Agree Strongly agree Does not apply Strongly disagree Disagree Agree Strongly agree Question Title * 10. Provides opportunities for clinical faculty development. Does not apply Strongly disagree Disagree Agree Strongly agree Does not apply Strongly disagree Disagree Agree Strongly agree Question Title * 11. Provides adequate direction for handling questions/concerns regarding student performance. Does not apply Strongly disagree Disagree Agree Strongly agree Does not apply Strongly disagree Disagree Agree Strongly agree Done