Task

Strongly agree

Agree

Neutral

Disagree

Strongly Disagree

Learner initiates IV fluids

5

4

3

2

1

Learner selects appropriate sedative medication for intubation

5

4

3

2

1

Learner selects appropriate paralytic medication for intubation

5

4

3

2

1

Learner determines if adjuvant medications are necessary

5

4

3

2

1

Learner gives medication in correct order

5

4

3

2

1

Learner recognizes if any medications are contraindicated for patient

5

4

3

2

1

Learner gives

appropriate medications for diagnosed disease process (i.e. prostaglandin, steroids, glucose)

5

4

3

2

1