Formative evaluation is a process of ongoing feedback on performance.  The purposes are to identify aspects of performance that need to improve and to offer corrective suggestions.  Be generous with formative evaluation.  Share your observations and perceptions with the student.  You might simply share your observation and then ask the student if (s)he can think of a better approach for the next time.  Formative evaluation need not make a judgment.  When giving formative feedback, offer some alternatives to the student, e.g., "That procedure will be more comfortable for the patient if you?."  If you observe unsafe or questionable practices, address those directly and immediately with the student.

Use the student's patient management documentation as well as your observations of performance to offer formative evaluation.  The student's charting reveals organizational skills, priorities, thought process, and judgment.  Over the duration of the student's experience with you, point out improvement to the student.

Summative evaluation is a process of identifying larger patterns and trends in performance and judging these summary statements against criteria to obtain performance ratings.  The faculty assumes responsibility for completing the summative evaluation at the end of the course.  However, faculty rely upon your evidence and perceptions to justify ratings.

The table below compares formative and summative evaluation according to the kind of information provided and the timing.

Give both formative and summative evaluation to the student in private as a general rule.  However, formative evaluation is needed if safety concerns arise in a student's practice while with a patient.  Also, at times you will lose a learning opportunity if you do not give the student a chance to practice an alternative approach at the time, but reserve your suggestions for a later conversation.  Use your judgment and employ tact and sensitivity to avoid embarrassing the student.