pes jun2

8/8/2019 PES jun2

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IFUGAO STATE UNIVERSITY

Nayon, Lamut, IfugaoPERFORMANCE EVALUATION REPORT FORM

From June2010-October 2010

OFFICE: Main Campus

DIVISION/SECTION: College of Health Sciences

Employee: JOEFREY D. GAERLANPosition: Clinical Instructor

Part I: Performance (70%)

Duties and responsibilities

TARGET

PERFORMANCE TARGET RA

QUANTITY QUALITY TIME QN

Planned Actual Planned Actual Planned Actual

I. INSTRUCTION

1. Prepares course outline,syllabus, instructionalmaterial and clinicalteaching plan (CTP)

Syllabus covers prescribed topics in(NCM 104) Inflammatory andImmunology, Cellular Aberration in Nursing; prepares 1 Course Outline, 1Instructional Material and 1ClinicalTeaching Plan(Operating Room)

Syllabus covers prescribedtopics in Inflammatory andImmunology, Cellular Aberration in Nursing; prepares course outline,instructional material and

clinical teaching plan(Operating Room)

90 %effective

100 %effective

Submit before thedeadline ( 2 days after the start of classes)

Submitted before thedeadline ( 2 days after the start of classes)

6 8

2. Teach NCM 104Inflammatory andImmunology, Cellular Aberration in Nursing

Render 4-hour lecture per week Render 4-hour lecture per week

90 %effective

95 %effective

Finish topics before thescheduled finalexaminations

Finished topics beforethe scheduled finalexaminations

8 8

3. Design and useinstructional materials

2 drawings/illustrations5x Computer Aided Instruction

2 drawings/illustrations5x Computer AidedInstruction

90 %effective

95 %effective

Use asneeded/scheduled

Used asneeded/scheduled

8 8

4. Facilitate group activitiessuch as case analysis or situation analysis and groupdiscussion

role play, case analysis/ situationanalysis, group discussions,

role play, case analysis/situation analysis, groupdiscussions,

93 %effective

95 %effective

Facilitate activities asscheduled

Facilitated activities asscheduled

8 8

5. Check attendance of

students during lecture andRLE duties

Twice per lecture/ RLE day Twice per lecture/ RLE day 97 %

effective

100 %

effective

15 minutes after the 1st

hour and 15 minutes before the lecture or

duty ends

15 minutes after the 1st

hour and 15 minutes before the lecture or

duty ends

8 8

8/8/2019 PES jun2


8/8/2019 PES jun2


Accreditation Nutrition Month,Accreditation

TOTAL: 98 1

GRAND TOTAL: 306

AVERAGE: 7.84

EQUIVALENT POINT SCORE: 5.488

I agree to achieve these targets for the rating period from June 2010 to October 2010 I agree to assist the employee to achieve his target for the said period

JOEFREY D. GAERLAN, RN, RM MAN NANCY ANN P. GONZALES, RN, MAN, Ph.D.Instructor Name and Signature of Rater

PART II. BEHAVIORAL DIMENSION (30%)

1. Courtesy ……………………..102. Human Behavior…………….. 8

3. Punctuality ………………….. 84. Initiative ……………………. 10

TOTAL: 36

Average Point Score: 9

Equivalent Point Score: 2.7Overall Point Score: 8.18Equivalent Adjectival Rating: Very Satisfactory

EMPLOYEE COMMENT/REPORTS DISCUSSED RATING WITH: _______________________________ ___________________________________ __________________________________

_______________________________ ___________________________________ Date _______________________________

REPORT RATER’S COMMENTS/ REMARKS DISCUSSED RATING WITH:

_______________________________________ _______________________________ ___________________________________ _______________________________________ _______________________________ Date _______________________________________

_______________________________________

_________________________________ ____________________________________ Signature of Rater’s Supervisor Date

pes jun2

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