Clinical Preceptor Award

Nominee Information

Name*

First Last

Site & Address

Street Address Address Line 2 City Province Postal Code

Contact Phone No.

Email Address*

SAOT Membership No. (if applicable)

Nominator Information

Name

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Contact Phone No.

Email Address

SAOT Membership No. (if applicable)

Preceptor Behaviors

Provide a description of how the preceptor effectively promoted critical thinking through role modeling, facilitation, guidance and prioritization of tasks and client/patient goals. (60 words)

Practice Applications

Describe how the preceptor used, demonstrated and taught current theoretical, research-based and tacit knowledge in response to client/patient needs and intervention planning. (60 words)

Performance Evidence

Communication

Describe how the preceptor successfully imparted information, expressed ideas and gave instructions. Comment about how he or she maintained a positive relationship with you. (60 words)

Skills Development

Describe how the clinical preceptor was actively involved in your clinical learning and practical development. How did you know you were doing something right? (60 words)

Facilitation and Guidance

Linking to above statements, describe how the preceptor facilitated your reflection in clinical care and guided approach to making clinical decisions. Provide examples of how the preceptor modeled clinical reasoning and initiated meaningful dialogue about professional practice. (60 words)