PBL Session PPD Session CDT Session PDT Session Other: ________

GROUP: ________

Assessor’s Name: _________________________ Badge:___________________________

Topic/Title: ______________________________ Date and Time: _____________________

Student

Number Student Name X L 0 1 2 3

Key:

3 = Outstanding contribution (prepared and participated) to the group (without dominating other group members).

2= Contributed (prepared and participated) effectively to the functioning of the group (without dominating other group members).

1 = Contributed (participated) sufficiently to the functioning of the group.

0 = Did not contribute significantly to the functioning of the group.

L = Came late and/or left early and/or left during the session for more than 10 minutes.

X= Was absent.

* This form for official use only; revised as of May 2009

Instruction to the tutor: Please send immediately after the session to Academic Affairs office (Mail code 3155, ext 51067)

King Saud bin Abdulaziz Uni.

for Health Sciences

College of Medicine

Female Medical Student Branch

Form UCE 3: Participation Assessment