Medical Student Placement Feedback

2. Placement start date *

	DD/MM/YYYY

3. Placement end date *

	DD/MM/YYYY

4. Select your level of satisfaction to the following statements *

	😠 Very dissatisfied	🙁 Dissatisfied	😐 Neutral	🙂 Satisfied	😀 Very satisfied
Clinical Involvement	Clinical Involvement [EMOJI_1] Very dissatisfied	Clinical Involvement [EMOJI_2] Dissatisfied	Clinical Involvement [EMOJI_3] Neutral	Clinical Involvement [EMOJI_4] Satisfied	Clinical Involvement [EMOJI_5] Very satisfied
Supervisor support	Supervisor support [EMOJI_1] Very dissatisfied	Supervisor support [EMOJI_2] Dissatisfied	Supervisor support [EMOJI_3] Neutral	Supervisor support [EMOJI_4] Satisfied	Supervisor support [EMOJI_5] Very satisfied
Timetable and other materials provided for your placement	Timetable and other materials provided for your placement [EMOJI_1] Very dissatisfied	Timetable and other materials provided for your placement [EMOJI_2] Dissatisfied	Timetable and other materials provided for your placement [EMOJI_3] Neutral	Timetable and other materials provided for your placement [EMOJI_4] Satisfied	Timetable and other materials provided for your placement [EMOJI_5] Very satisfied
Theatre session/Ward Work	Theatre session/Ward Work [EMOJI_1] Very dissatisfied	Theatre session/Ward Work [EMOJI_2] Dissatisfied	Theatre session/Ward Work [EMOJI_3] Neutral	Theatre session/Ward Work [EMOJI_4] Satisfied	Theatre session/Ward Work [EMOJI_5] Very satisfied

5. Would you recommend Great Ormond Street Hospital as a placement to others? *

Yes
No
Maybe

Comments:

6. Please feedback on your placement *

7. Following your placement at GOSH, would you consider Paediatrics as a career? *

Yes
No
Unsure

Comment:

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