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STAFF PERFORMANCE EVALUATIONS


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THE MASTERY COMPANY  
PO Box 1806  
Woodinville, WA 98072  

info@masterycompany.com  





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DENTAL ASSISTANT PERFORMANCE REVIEW

You are about to participate in a Staff Performance Review. Please follow the instructions carefully.

This review will take less than 15 minutes to complete online. A report of findings will be automatically sent to the dentist when both Doctor and Staff have completed the survey. The report will come with a set of instructions on how to use the report.

We will not store this report data for you so we strongly recommend you store the report on your hard drive and make a hard copy of each completed report for your employee records.

Please rate each of the statements on a scale of 1 - 10 (1 = Almost Never and 10 = Almost Always).  Some statements may not apply. If that is the case, select "NA" for 'Not Applicable.'

Complete the entire evaluation and then select Submit. Please click on the Submit button ONLY once. It will take a moment to send your responses to the Test Server.

NOTE: This Staff Performance Evaluation has been created for use with Mastery Company clients. If you are not a client, but are interested in using our suite of Staff Performance Evaluations, please contact us: info@MasteryCompany.com



Dental Assistant Name *
Dentist Name(s) *
Your Name (Evaluator) *

To be completed by the staff member being evaluated ONLY:

My professional goals for the next six months:
My personal goals for the next six months:

PUNCTUALITY

1) Is generally at work and prepared as scheduled.
Almost Never - 1    2    3    4    5    6    7    8    9    10 - Almost Always   
NA   
2) Is prepared for circumstances that may cause tardiness or absence (e.g., weather, sick children or personal illness).
Almost Never - 1    2    3    4    5    6    7    8    9    10 - Almost Always   
NA   
3) In the event of tardiness or absence, notifies dentist or office manager as soon as possible.
Almost Never - 1    2    3    4    5    6    7    8    9    10 - Almost Always   
NA   

PROFESSIONALISM

1) Personal attire meets professional standards.
Almost Never - 1    2    3    4    5    6    7    8    9    10 - Almost Always   
NA   
2) Maintains clean and orderly work area.
Almost Never - 1    2    3    4    5    6    7    8    9    10 - Almost Always   
NA   
3) Attends to personal affairs outside of business hours.
Almost Never - 1    2    3    4    5    6    7    8    9    10 - Almost Always   
NA   
4) Personal problems do not impact performance.
Almost Never - 1    2    3    4    5    6    7    8    9    10 - Almost Always   
NA   
5) Speaks on the phone with confidence and professionalism.
Almost Never - 1    2    3    4    5    6    7    8    9    10 - Almost Always   
NA   
6) Is cheerful and friendly with all patients.
Almost Never - 1    2    3    4    5    6    7    8    9    10 - Almost Always   
NA   

INITIATIVE

1) Independently greets and engages patients.
Almost Never - 1    2    3    4    5    6    7    8    9    10 - Almost Always   
NA   
2) Is always prepared for work 'before' patients arrive.
Almost Never - 1    2    3    4    5    6    7    8    9    10 - Almost Always   
NA   
3) Problem solves and provides solutions before requesting help.
Almost Never - 1    2    3    4    5    6    7    8    9    10 - Almost Always   
NA   
4) Utilizes down-time efficiently (e.g., looks for ways to contribute).
Almost Never - 1    2    3    4    5    6    7    8    9    10 - Almost Always   
NA   
5) Cross-trains other staff to handle her position in case of absence.
Almost Never - 1    2    3    4    5    6    7    8    9    10 - Almost Always   
NA   
6) Generally acts on and completes goals/objectives as determined in performance evaluations.
Almost Never - 1    2    3    4    5    6    7    8    9    10 - Almost Always   
NA   
7) Actively invites people to be patients in the practice.
Almost Never - 1    2    3    4    5    6    7    8    9    10 - Almost Always   
NA   

PATIENT RELATIONSHIP

1) Exhibits maturity and confidence when interacting with patients.
Almost Never - 1    2    3    4    5    6    7    8    9    10 - Almost Always   
NA   
2) Relaxes patients in non-verbal ways (e.g., eye contact, smiles).
Almost Never - 1    2    3    4    5    6    7    8    9    10 - Almost Always   
NA   
3) Independently demonstrates concern for patients.
Almost Never - 1    2    3    4    5    6    7    8    9    10 - Almost Always   
NA   
4) Maintains a balance between friendliness and job efficiency.
Almost Never - 1    2    3    4    5    6    7    8    9    10 - Almost Always   
NA   
5) Accurately assesses the patientís needs (e.g., skilled listener).
Almost Never - 1    2    3    4    5    6    7    8    9    10 - Almost Always   
NA   

STAFF RELATIONSHIPS

1) Actively seeks ways to help co-workers during down-time.
Almost Never - 1    2    3    4    5    6    7    8    9    10 - Almost Always   
NA   
2) Is open to suggestions from fellow staff without becoming defensive.
Almost Never - 1    2    3    4    5    6    7    8    9    10 - Almost Always   
NA   
3) Makes suggestions for ways to improve performance or service in a positive, productive manner.
Almost Never - 1    2    3    4    5    6    7    8    9    10 - Almost Always   
NA   
4) Participates in all facets of the office operations.
Almost Never - 1    2    3    4    5    6    7    8    9    10 - Almost Always   
NA   
5) Communicates effectively with both dentist and fellow staff members.
Almost Never - 1    2    3    4    5    6    7    8    9    10 - Almost Always   
NA   

DENTAL KNOWLEDGE

1) Displays a working knowledge of dental terminology and procedures.
Almost Never - 1    2    3    4    5    6    7    8    9    10 - Almost Always   
NA   
2) Is able to clearly explain dental problems and dental procedures to patients.
Almost Never - 1    2    3    4    5    6    7    8    9    10 - Almost Always   
NA   
3) Understands and can communicate with patients about dental insurance.
Almost Never - 1    2    3    4    5    6    7    8    9    10 - Almost Always   
NA   
4) Understands OSHA regulations and performs tasks appropriately.
Almost Never - 1    2    3    4    5    6    7    8    9    10 - Almost Always   
NA   
5) Understands HIPAA regulations and performs tasks appropriately.
Almost Never - 1    2    3    4    5    6    7    8    9    10 - Almost Always   
NA   

POSITION SKILL SET

1) Performs procedures with a minimum of discomfort to the patient.
Almost Never - 1    2    3    4    5    6    7    8    9    10 - Almost Always   
NA   
2) Uses both hands in independent, but simultaneous operations.
Almost Never - 1    2    3    4    5    6    7    8    9    10 - Almost Always   
NA   
3) Monitors dental supplies and orders as appropriate.
Almost Never - 1    2    3    4    5    6    7    8    9    10 - Almost Always   
NA   
4) Manages projects to on-time completion (e.g., lab work is completed, confirms lab work from outside vendors has arrived, orders supplies in time).
Almost Never - 1    2    3    4    5    6    7    8    9    10 - Almost Always   
NA   
5) Follows proper sterilization techniques per OSHA.
Almost Never - 1    2    3    4    5    6    7    8    9    10 - Almost Always   
NA   
6) Is proficient in basic skills and expanded duties consistent with state regulations.
Almost Never - 1    2    3    4    5    6    7    8    9    10 - Almost Always   
NA   
7) During specific procedures knows the proper timing and sequence of instruments and materials (e.g., knows exactly what the dentist needs at all times).
Almost Never - 1    2    3    4    5    6    7    8    9    10 - Almost Always   
NA   

EMPLOYEE SATISFACTION (Staff Only)
The scoring in this section will be reflected on the Evaluation Report as a single composite score.

1) I continue to be excited about my job.
I Disagree - 1    2    3    4    5    6    7    8    9    10 - I Agree   
2) My pay is fair.
I Disagree - 1    2    3    4    5    6    7    8    9    10 - I Agree   
3) My benefits package is fair.
I Disagree - 1    2    3    4    5    6    7    8    9    10 - I Agree   
4) I am given the opportunity to participate in training or education programs.
I Disagree - 1    2    3    4    5    6    7    8    9    10 - I Agree   
5) I consider this practice a good place to work.
I Disagree - 1    2    3    4    5    6    7    8    9    10 - I Agree   

* Required to submit this form





 


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