Health Care Ethics USA Archives

Winter 2009

Ethics Committee Member Self-Assessment

Using a 5-point scale where 5 means excellent and 1 means very poor, please rate your performance on the EC by writing an X in the appropriate cell following each question. Following this, please note any areas for improvement and outline a plan for improvement. This form is for your personal development as a member of the EC and does not need to be shared with anyone else.

1. My attendance at the EC meetings was ...

5=Excellent

4=Good

3=Fair

2=Poor

1=Very Poor

     

2. My participation at the EC meetings was ...

5=Excellent

4=Good

3=Fair

2=Poor

1=Very Poor

     

3. My preparation for the EC meetings in terms of reading materials, performing tasks, and so on was ...

5=Excellent

4=Good

3=Fair

2=Poor

1=Very Poor

     

4. My involvement with the EC's tasks and functions was ...

5=Excellent

4=Good

3=Fair

2=Poor

1=Very Poor

     

5. I would rate my overall performance on the EC as ...

5=Excellent

4=Good

3=Fair

2=Poor

1=Very Poor

     

I can improve in the following areas:

 

 

My plan for improvement is as follows:

 

 

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