Clinical Practicum Evaluation Report

Clinical Practicum Evaluation Report

Student Name: Student No.

Programme: Higher Diploma in Nursing / Bachelor of Health Science (Hons): NY/SY

Hospital/ Institute: Ward/ Specialty:

Supervisor First/Second clinical practicum Night hours: _____

Types of assessment: Formative (F) Date: Summative (S) Date:

Score	Standard Procedure	Quality of Performance	Assistance
5	Safe Accurate Effect - each time Affect - each time	Proficient, coordinated and confident; Occasional expenditure of excessive energy Within an expedient time period	Without supportive cues
4	Safe Accurate Effect - each time Affect - each time	Efficient, coordinated and confident Some expenditure of excessive energy Within a reasonable time period	Occasional supportive cues
3	Safe Accurate Effect - most of the time Affect - most of the time	Skillful in parts of behaviour and coordinated Expends excessive energy Within a delayed time period	Frequent verbal and occasional physical directive cues in addition to supportive ones
2	Safe but not alone; Performs at risk Accurate – not always Effect – occasionally Affect - occasionally	Unskillful and inefficient Considerable expenditure of excessive energy With prolonged time period	Continuous verbal and frequent physical cues
1	Unsafe Unable to demonstrate behaviour	Unable to demonstrate procedure/ behaviour Lacks confidence, coordination, and efficiency	Continuous verbal and physical cues
X	Not applicable / Not Observed

Bondy, K.N. (1983). Criterion-Referenced Definitions for Rating Scales in Clinical Evaluation. Journal of Nursing Education, 22 (9), 376-381.

Krichbaum, K., Rowan, M., Duckett, L., Ryden, M.B. & Savik, K. (1994). The clinical evaluation tool: a measure of the quality of clinical performance of baccalaureate nursing students. Journal of Nursing Education, 33 (9), 395-404.

Lofmark, A. & Thorell-Ekstrand, I. (2004).  An assessment form for clinical nursing education: a Delphi study.  Journal of Advanced Nursing, 48(3): 291-298.

 Watson, R., Stimpson, A., Topping, A. & Porock, D. (2002).  Clinical competence assessment in nursing: a systematic review of the literature.  Journal of Advanced Nursing, 39(5): 421-431.

Woolley, G. R., Bryan, M. S. & Davis, J. W. (1998). A Comprehensive approach to clinical evaluation. Journal of Nursing Education, 37 (8), 361-366.
Note: Students must score 3 or above for all objectives in order to obtain a satisfactory grade.

Objectives		Score		Remarks
		F	S
1.	Assessment 1.1 Collects data for nursing assessment from a variety of sources.
	1.2 Identifies potential and actual health problems by differentiating normal and abnormal behaviour of patients and their families.
	1.3 Identifies presence of patient risk factors
	1.4 Interprets data based on acquired knowledge
	1.5 Identifies health problems
	1.6 Establishes priorities for care
2.	Planning 2.1 Develops goals with specific time frame based on health problems
	2.2 Identifies nursing interventions appropriate and relevant to patient health problems
	2.3 Explains rationale for selected interventions
	2.4 Incorporates patient and family strengths and weakness in planning
	2.5 Identifies discharge planning needs
	2.6 Identifies patient learning needs
	2.7 Participates in developing health teaching plan
	2.8 Demonstrates increasing skill in organizing nursing care
3.	Intervention 3.1 Provides for patient safety in the clinical setting
	3.2 Demonstrates safety and competence in selected psychomotor skills :
	3.3 Demonstrates awareness of self in relationship to patients and their significant others
	3.4 Uses communication techniques appropriately in patient situation
	3.5 Responds appropriately and with sensitivity to patient and family verbal and non-verbal cues
	3.6 Respects the rights and dignity of patients and their significant others
	3.7 Creates an environment which is conducive to patient recovery
	3.8 Implements health teaching plan based on identified learning needs
4.	Evaluation 4.1 Utilizes the problem-oriented method for recording relevant data
	4.2 Evaluates outcomes of care
	4.3 Recognizes the need for modification of the care plan
	4.4 Develops alternative interventions
5.	Professional Behaviours 5.1 Recognizes own strengths and limitations
	5.2 Demonstrates ability to reflect own competency, feeling and understanding of work situations through keeping of learning diary or journal
	5.3 Seeks guidance as appropriate
	5.4 Demonstrates increasing ability to criticize own work for continued development
	5.5 Communicates with other health care team members on overall plan of care for patient
	5.6 Participates in group conference and shares pertinent learning experience
	5.7 Reports on time

F = Formative Assessment

S = Summative Assessment

Narrative Comments

(Summative evaluation)

Supervisor

Student

Overall Performance: Satisfactory / Unsatisfactory
Student Signature Date
Supervisor Signature _______________________ Date